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If you have heavy vaginal bleeding that will not stop, seek emergency care now. Also seek urgent care for severe abdominal pain with distension, inability to pass urine, or fever during chemotherapy.

Home  /  Treatments  /  Cancer treatment  /  Cervical and ovarian cancer

Cervical, ovarian and uterine cancer

Three distinct cancers with different presentations and treatments. Cervical cancer remains among the commonest cancers in women across several of the countries our patients travel from, and it is largely preventable.

Cervical cancer treatment contains one technical requirement that patients are rarely told about and that materially affects outcome: brachytherapy. If it is missing from a proposed plan, the plan is inadequate.

Clinically reviewed by Dr. Annie Varughese, Consultant Medical Oncologist Clinical oversight Dr. Annie Varughese, MD, FACC Last reviewed August 2026 Editorial and medical review policy
Cervical cancer
Largely preventable
Through HPV vaccination and screening
Essential in cervical cancer
Brachytherapy
Internal radiotherapy — outcomes are worse without it
Ovarian cancer
Surgery quality decides
Complete removal of visible disease matters most
Time in India
4 to 10 weeks
Surgery, or a full chemoradiotherapy course
On this page
  1. What it is
  2. Symptoms and warning signs
  3. How it is diagnosed
  4. Treatment options
  5. How the choice is made
  6. How urgent is your case
  7. What to send us
  8. Questions patients ask
The condition

What these cancers involve

Cervical cancer arises at the neck of the womb and is caused almost entirely by persistent infection with high-risk human papillomavirus. It develops slowly through precancerous changes that screening can detect and treat, which is why it has become uncommon where screening programmes exist and remains common where they do not.

Ovarian cancer typically presents late, because the early symptoms — bloating, feeling full quickly, abdominal discomfort — are vague and easily attributed to something else. By diagnosis it has often spread within the abdomen. The single strongest determinant of outcome is whether surgery removes all visible disease, which depends heavily on the surgeon's experience.

Uterine or endometrial cancer usually presents earlier because it causes bleeding after the menopause, which prompts investigation. It is often confined to the womb at diagnosis and treated primarily by surgery, with a generally favourable outlook.

The three are grouped here because they are treated by the same specialty, but their management differs completely, and the pathology report is what tells us which applies.

Symptoms

Symptoms and warning signs

Common symptoms
  • Bleeding between periods, after intercourse, or after the menopause
  • Persistent abdominal bloating or swelling
  • Feeling full quickly when eating
  • Pelvic or lower back pain
  • Unusual vaginal discharge, sometimes offensive
  • Change in bowel or bladder habit
  • Unexplained weight loss with abdominal distension
Warning signs of an emergency
  • Heavy vaginal bleeding that will not stop
  • Severe abdominal pain with distension and vomiting
  • Inability to pass urine
  • Fever during chemotherapy
  • Severe breathlessness
  • Leg swelling with pain, which may indicate a clot

Cervical cancer treatment without brachytherapy is inadequate treatment

For locally advanced cervical cancer, standard treatment is external radiotherapy with weekly chemotherapy, followed by brachytherapy — internal radiotherapy delivered directly to the cervix. Brachytherapy is not an optional extra. Treatment without it produces materially worse outcomes, and it is sometimes omitted where the facility or expertise is unavailable. If you are being offered chemoradiotherapy for cervical cancer, ask explicitly whether brachytherapy is included and how many applications are planned. If the answer is unclear, that is a reason to seek treatment elsewhere.

Diagnosis

How it is diagnosed

Diagnosis is by biopsy; imaging determines the extent and therefore the treatment.

Initial tests

  • Biopsy — of the cervix, or from the womb lining by hysteroscopy and curettage
  • Pelvic ultrasound — often the first imaging, particularly for ovarian masses
  • Blood tests — including CA-125 for ovarian cancer, though it is neither specific nor diagnostic alone
  • Examination under anaesthesia — for staging cervical cancer

The deciding tests

  • MRI of the pelvis — the key test for cervical and uterine cancer, showing local extent precisely
  • CT chest, abdomen and pelvis — for staging and, in ovarian cancer, to assess whether complete surgical removal is achievable
  • PET-CT — where nodal or distant spread is suspected
  • HPV testing and, in selected patients, genetic testing for BRCA mutations in ovarian cancer

In ovarian cancer, ask who will perform the surgery

Outcomes in advanced ovarian cancer correlate strongly with whether the surgeon removes all visible disease, and that in turn correlates with whether the operation is performed by a specialist gynaecological oncologist rather than a general gynaecologist. This is one of the clearest examples in oncology of the surgeon determining the outcome. Ask directly, and send us the CT scan so a specialist can assess whether complete removal looks achievable.

Options

Treatment options

Treatment differs sharply between the three, so the pathology report is the starting point.

Cervical cancer

Surgery, or chemoradiotherapy with brachytherapy

Early cervical cancer is treated by surgery — radical hysterectomy with removal of pelvic nodes, and in selected young women a fertility-preserving operation may be possible. Locally advanced disease is treated with external radiotherapy and weekly chemotherapy followed by brachytherapy, which must be part of the plan.

Usually appropriate whenSurgery for early stage disease; chemoradiotherapy with brachytherapy once the tumour extends beyond the cervix.
Ovarian cancer

Cytoreductive surgery and chemotherapy

Surgery aims to remove all visible disease from the abdomen, which may involve the ovaries, womb, omentum, and affected areas of bowel or peritoneum. Chemotherapy follows, and in some patients is given before surgery to shrink disease first. Where a BRCA mutation or similar is present, maintenance treatment with targeted tablets substantially delays recurrence.

Usually appropriate whenSurgery first where complete removal looks achievable; chemotherapy first where it does not, with surgery after.
Uterine cancer

Hysterectomy, usually minimally invasive

Removal of the womb, ovaries and tubes, with assessment of the pelvic nodes, frequently performed laparoscopically or robotically with a rapid recovery. Radiotherapy afterwards depends on the grade and how deeply the tumour invaded the muscle wall.

Usually appropriate whenDisease confined to the womb, which is the majority at diagnosis because bleeding prompts early investigation.
All three

Chemotherapy and targeted maintenance

Platinum-based chemotherapy is central to ovarian cancer and used alongside radiotherapy in cervical cancer. Maintenance therapy with PARP inhibitors after chemotherapy has changed the outlook in BRCA-mutated ovarian cancer, and testing determines whether it applies.

Usually appropriate whenAccording to cancer type, stage and molecular testing results.
The decision

How the choice is made

Which cancer, and what stage

The three are managed by different pathways. The biopsy and the MRI or CT determine which applies and how far the disease extends.

For ovarian cancer, whether complete removal is achievable

This is assessed on imaging and sometimes by laparoscopy first. It determines whether surgery or chemotherapy comes first, and it is the single most important decision in ovarian cancer.

For cervical cancer, whether brachytherapy is available

A radiotherapy department without brachytherapy capability should not be treating locally advanced cervical cancer. We verify this before recommending anywhere.

Fertility preservation is possible in selected early cervical cancers and in some young women with early ovarian tumours. If you may want children, say so in your first message — the discussion has to happen before surgery, not after.

Urgency

How urgent is your case

Usually safe to plan travel
  • Recently diagnosed and well
  • Investigations completed locally, planning treatment
  • Stable between chemotherapy cycles
  • Post-operative and planning further treatment
Needs local assessment before travel
  • Heavy uncontrolled vaginal bleeding
  • Bowel obstruction with vomiting and distension
  • Inability to pass urine
  • Fever during chemotherapy
  • Severe breathlessness or leg swelling with pain

We will tell you which column you are in

Advanced ovarian cancer with a large amount of abdominal fluid, or cervical cancer with heavy bleeding, needs local stabilisation before travel. Both are common reasons we ask patients to be seen at home first.

Next step

What to send us

Photographs taken on your phone are fine. Reports in Arabic, Russian or Bengali are fine — we translate them ourselves.

Most useful

  • Biopsy and pathology report
  • MRI of the pelvis or CT abdomen and pelvis
  • CA-125 and other tumour markers
  • Any treatment plan you have been offered

Also helpful

  • Ultrasound reports
  • PET-CT if performed
  • Genetic testing results if any
  • Your age, whether you have been through the menopause, and whether you wish to preserve fertility
Send my reports for review See published cost ranges
Questions

Questions patients ask

It is internal radiotherapy, delivered by placing a radioactive source directly at the cervix, allowing a very high dose to the tumour while sparing surrounding tissue. For locally advanced cervical cancer it is an essential component of curative treatment, and outcomes are significantly worse without it. Ask explicitly whether it is included in any proposed plan.

Sometimes. In selected early cervical cancers a trachelectomy removes the cervix while preserving the womb. In some early ovarian tumours affecting one ovary, the other ovary and womb can be preserved. Neither is possible after a standard radical operation, so this discussion must happen before surgery. Tell us at the outset if it matters to you.

Because its early symptoms — bloating, feeling full quickly, vague abdominal discomfort — are common and usually caused by something harmless. There is no effective screening test for ovarian cancer in the general population. Late diagnosis is the norm rather than a failure on your part, and advanced disease is still treated with the intention of long-term control.

Yes, more than in most cancers. Outcome correlates strongly with whether all visible disease is removed, and that correlates with the surgeon being a specialist gynaecological oncologist operating regularly on advanced disease. It is a legitimate and important question to ask directly.

If you have ovarian cancer, genetic testing is generally recommended. It affects your treatment — BRCA-mutated ovarian cancer responds particularly well to maintenance therapy with PARP inhibitors — and it has implications for your daughters and sisters, who can then be screened.

Largely, yes. HPV vaccination before the start of sexual activity prevents the infections that cause the great majority of cervical cancers, and screening detects precancerous changes that can be treated before cancer develops. If you have daughters, vaccination is the single most valuable thing you can arrange for them.

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Contact

Send us your reports

Send the biopsy report and the pelvic MRI or CT. For cervical cancer we will confirm that any proposed plan includes brachytherapy.

Your reports go directly to our medical team. We do not share your records with hospitals until you tell us to.

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