GYNECOLOGY AND OBSTETRICS

After centuries of demographic decadence and since end of World War 2, France now has one of the strongest European birth rates - an achievement that is the result of French medicine's goal to improve on care for births and maternity.

Many clinics and hospitals are now dedicated to taking care of pregnant women - regardless of their age - in prevention and prenatal care for specific illnesses, to help them give birth in the best possible conditions, and to assist them and their baby after birth. 

In addition to the many highly qualified gynecologists, this sector boasts the latest medical imagery and surgical equipment able to perform any required fetal, pre and neo-natal check-ups or obstetrics surgery. 

Some duly appointed clinics and hospital are also able to provide clinically or biologically assisted reproduction solutions (23,000 a year), while experimental surgical teams are currently transplanting uterus after cancer treatment and hysterectomy, as performed by Pr. Ayoubi from a living doner in March 2019, in Foch Hospital in Paris.

Out of 3,065 French hospitals and clinics, 451 provide standard maternity care and obstetrics, 64 with complex obstetrics and 429 for gynecologic cancers. 

Among these, C3Medical is proud to work closely with Institut Mutualiste Montsouris / IMM in Paris for complex obstetrics (please see video in the main section "Care for Complex Pathologies") and with Institut Curie for gynecologic cancers.  C3 Medical also manages their international patients.
 

Gynaecological cancers

What is gynaecological cancer?

Endometrial cancer
The most frequent type is cancer of the endometrium, the body of the uterus (as opposed to the cervix). There were 7,300 new cases in 2012, the last official figure of the Institut national du cancer (Inca). It mainly affects women aged between 60 and 70, peaking at age 68. The odds are increased by obesity, diabetes and a higher than average oestrogen level (relative hyperoestrogenia). There is a familial form in 6% of cases, called Lynch syndrome, which also associates a risk of colon and ovarian cancer and cancer of the biliary and urinary tracts. This cancer has a good prognosis at a localised stage and the mortality rate has tended to diminish over the last few years. The treatment consists of surgery, with or without radiotherapy depending on the stage, and chemotherapy for advanced forms.

Ovarian cancer
Ovarian cancer affected 4,600 women in 2012, at a median age of 65 years. There is a genetic risk: 5-10% of patients with ovarian cancer carry mutations of the BRCA1 or 2 genes. In this case, the disease may appear earlier, at around 50 years. These genetically predisposed women may be monitored so that a lesion can be detected as early as possible. They may also be offered preventive ablation of the ovaries and fallopian tubes.

This disease is often diagnosed quite late, at an advanced stage, since it is “silent” or manifested by non-specific symptoms: pain, bleeding, intestinal transit disorders and heaviness in the lower abdomen. It may be revealed by an imaging test and dosage of a marker called CA 125 in the blood, which makes it possible to monitor the evolution of the disease. If the disease is not extensive, the treatment consists of surgery to remove ovaries, uterus, various chains of ganglia and any other visible lesions in order to eliminate the macroscopic disease. This surgery is followed in the vast majority of cases by chemotherapy. If the cancer has spread, chemotherapy is applied first in order to reduce the size and number of lesions, and then followed by surgery to remove all the lesions.

Cervical cancer
3,000 women are diagnosed with cervical cancer every year. But its frequency has been decreasing steadily for 20 years, thanks to regular pap-smear screening, which makes it possible to detect precancerous lesions. In 95% of cases, cervical cancer resulting from these precancerous lesions is caused by an infection by a papilloma virus (HPV) transmitted sexually 15-20 years earlier. This is why young girls are now offered a vaccination against this virus between ages 11 and 14. A follow-up is possible up to the age of 19.

But cervical cancer is still associated with high mortality: 1,100 deaths in 2012. Yet precancerous lesions can be treated before they become cancerous. A conical biopsy can be carried out, with the inner cone of the cervix affected by lesions removed. When cancer is confirmed but is not very advanced, the treatment consists of surgery to remove the uterus and the pelvic lymph nodes. In young women who wish to become pregnant and whose cancer is not very advanced, fertility-preserving treatment can be given. In advanced forms, the treatment consists instead of a combination of radiotherapy and chemotherapy followed in some cases by surgery.
Lastly, cancer of the vulva and the vagina represent less than 5% of female cancers. They occur mainly in post-menopausal women, at around age 70 on average. It is generally preceded by a precancerous phase. These precancerous lesions arise on a pre-existing skin condition, lichen sclerosus, or are caused by the HPV virus. If detected early, they can be treated by excision, or drugs in the case of HPV infection. At a cancerous stage, the treatment is surgical, sometimes followed by radiotherapy. Survival for this cancer is excellent if the disease has not reached the lymph nodes.

Source: https://institut-curie.org/liste/different-types-cancer

Gynaecological cancers

What is gynaecological cancer?

Endometrial cancer
The most frequent type is cancer of the endometrium, the body of the uterus (as opposed to the cervix). There were 7,300 new cases in 2012, the last official figure of the Institut national du cancer (Inca). It mainly affects women aged between 60 and 70, peaking at age 68. The odds are increased by obesity, diabetes and a higher than average oestrogen level (relative hyperoestrogenia). There is a familial form in 6% of cases, called Lynch syndrome, which also associates a risk of colon and ovarian cancer and cancer of the biliary and urinary tracts. This cancer has a good prognosis at a localised stage and the mortality rate has tended to diminish over the last few years. The treatment consists of surgery, with or without radiotherapy depending on the stage, and chemotherapy for advanced forms.

Ovarian cancer
Ovarian cancer affected 4,600 women in 2012, at a median age of 65 years. There is a genetic risk: 5-10% of patients with ovarian cancer carry mutations of the BRCA1 or 2 genes. In this case, the disease may appear earlier, at around 50 years. These genetically predisposed women may be monitored so that a lesion can be detected as early as possible. They may also be offered preventive ablation of the ovaries and fallopian tubes.

This disease is often diagnosed quite late, at an advanced stage, since it is “silent” or manifested by non-specific symptoms: pain, bleeding, intestinal transit disorders and heaviness in the lower abdomen. It may be revealed by an imaging test and dosage of a marker called CA 125 in the blood, which makes it possible to monitor the evolution of the disease. If the disease is not extensive, the treatment consists of surgery to remove ovaries, uterus, various chains of ganglia and any other visible lesions in order to eliminate the macroscopic disease. This surgery is followed in the vast majority of cases by chemotherapy. If the cancer has spread, chemotherapy is applied first in order to reduce the size and number of lesions, and then followed by surgery to remove all the lesions.

Cervical cancer
3,000 women are diagnosed with cervical cancer every year. But its frequency has been decreasing steadily for 20 years, thanks to regular pap-smear screening, which makes it possible to detect precancerous lesions. In 95% of cases, cervical cancer resulting from these precancerous lesions is caused by an infection by a papilloma virus (HPV) transmitted sexually 15-20 years earlier. This is why young girls are now offered a vaccination against this virus between ages 11 and 14. A follow-up is possible up to the age of 19.

But cervical cancer is still associated with high mortality: 1,100 deaths in 2012. Yet precancerous lesions can be treated before they become cancerous. A conical biopsy can be carried out, with the inner cone of the cervix affected by lesions removed. When cancer is confirmed but is not very advanced, the treatment consists of surgery to remove the uterus and the pelvic lymph nodes. In young women who wish to become pregnant and whose cancer is not very advanced, fertility-preserving treatment can be given. In advanced forms, the treatment consists instead of a combination of radiotherapy and chemotherapy followed in some cases by surgery.
Lastly, cancer of the vulva and the vagina represent less than 5% of female cancers. They occur mainly in post-menopausal women, at around age 70 on average. It is generally preceded by a precancerous phase. These precancerous lesions arise on a pre-existing skin condition, lichen sclerosus, or are caused by the HPV virus. If detected early, they can be treated by excision, or drugs in the case of HPV infection. At a cancerous stage, the treatment is surgical, sometimes followed by radiotherapy. Survival for this cancer is excellent if the disease has not reached the lymph nodes.

Source: https://institut-curie.org/liste/different-types-cancer