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A complete guide to warning signs, cervical cancer, the HPV vaccine and why early action saves lives.

Featuring insights from Dr. Sunita Wadhwa, Cancer Detection Centre

Here is a number that should stop us in our tracks. India accounts for nearly a quarter of all cervical cancer deaths in the world. Cervical cancer is the second most common cancer among Indian women. And yet, it is one of the most preventable cancers we know of. There is a vaccine. There are screening tests. There are clear warning signs that the body gives us.

So why are so many women still dying from it?

We sat down with Dr. Sunita Wadhwa from the Cancer Detection Centre, who works actively on women’s health and cancer prevention, to get some clear answers. What she shared is something every woman in India needs to hear.

The honest answer is a mix of things: lack of awareness, stigma around women’s health, fear of what the results might show and a healthcare system that has not always made it easy for women to put themselves first. Cervical cancer is not the only one either. Breast cancer, uterine cancer and other cancers affecting women often go undetected for the same reasons.

This blog is about changing that, one conversation at a time.

What Even Are Gynaecological Cancers?

Gynaecological cancers are cancers that affect the female reproductive system. According to Dr. Wadhwa, the most common among Indian women are cervical cancer, uterine cancer and breast cancer. These cancers develop when normal cell growth goes wrong, triggered by a combination of genetic factors and environmental changes.

When it comes to cervical cancer specifically, the risk factors are more concrete than most people realise. Genetics play a role: if a mother or elder sister has had cervical cancer, the risk goes up. But lifestyle and environmental factors carry significant weight too. Smoking, early sexual activity, multiple partners, unprotected sex and multiparity (having many children) are all factors that increase a woman’s chances.

Knowing your risk is the first step. Acting on it is the next one.

Your Body Is Giving You Signals. Are You Listening?

Ask any woman why she put off going to the doctor and the answer is usually some version of: I thought it was nothing. I was too busy. It went away after a while.

Dr. Wadhwa has seen this pattern repeatedly and she is direct about it.

“Abnormal bleeding, bleeding in between the periods, abnormal pattern of bleeding, bleeding after intercourse, too much bleeding, watery discharge, blood discharge, foul-smelling discharge. These are all early symptoms which truly women in India ignore if they are not aware.”

— Dr. Sunita Wadhwa, Cancer Detection Centre

Here are the early warning signs no woman should dismiss:

• Unusual bleeding: Between periods, after sex or any bleeding after menopause. None of this is normal and all of it needs medical attention.
• Unusual discharge: A change in colour, smell or consistency, especially if it is watery, blood-tinged or foul-smelling.
• Persistent lower abdominal pain: Pain without an obvious reason that keeps coming back.
• Loss of appetite, fatigue and general muscle wasting: When the body is fighting something, it often signals through exhaustion and unexplained changes.
• A lump in the breast or armpit: Not every lump is cancer, but every lump deserves a doctor’s assessment.

The rule is simple: if something feels off and it has been there for more than two to three weeks, please see a doctor. You know your body better than anyone else does.

Cervical Cancer Is 100% Preventable. Yes, Really.

This is not a motivational statement. It is a medical fact and Dr. Wadhwa says it plainly.

“If we treat the abnormal findings at that stage itself, cancer will not happen at all. It is a 100% preventable cancer, cervical cancer.”

— Dr. Sunita Wadhwa, Cancer Detection Centre

Cervical cancer develops from HPV, the Human Papillomavirus. HPV is extremely common and most people’s bodies clear it on their own. But in some women, certain high-risk strains persist and, over time, cause pre-cancerous changes in the cervix. The key word here is time. Those changes do not become cancer overnight. And that window is exactly where screening and vaccination come in.

Pap Smear and HPV DNA Testing: Simpler Than You Think

One of the most common reasons women avoid cervical screening is fear. Fear of the procedure itself, fear of what might be found and in many cases, myths about what these tests actually involve.

Dr. Wadhwa addresses this directly.

“It is a simple procedure. No invasive procedure, no cutting. Just with a wooden spatula we take the smear or for HPV DNA we use a brush which is non-harmful. Without anaesthesia we do it, nothing happens. If the patient is explained properly, she will readily agree for this test.”

— Dr. Sunita Wadhwa, Cancer Detection Centre

Here is what the screening schedule looks like:

• Start Pap smears from age 21 to 25, done every 2 to 3 years if results are normal.
• HPV DNA testing every 5 years if normal.
• After age 50, annual screening is recommended.
• If any abnormality is found, it can be treated immediately with simple procedures like colposcopy, thermal ablation or LEEP, well before cancer develops.

It is five minutes that could change everything.

The HPV Vaccine: Get It Before You Need to Think About It

The HPV vaccine is one of the most powerful tools we have against cervical cancer and it is widely underused in India. Dr. Wadhwa is clear about who should get it and when.

“HPV vaccine is very important. It should be given to girls before they start their sexual activities. We recommend it at the age of 9 to 15. It can be given up to the age of 45, but the best results are when you give it before the start of sexual activity.”

— Dr. Sunita Wadhwa, Cancer Detection Centre

A few things worth knowing about the HPV vaccine:

• It protects against the HPV strains most commonly responsible for cervical cancer.
• It is available in India. The nine-valent version covers more strains and offers broader protection.
• It does not give 100% protection against every strain, but it significantly reduces risk.
• Even if you have been vaccinated, continue with regular Pap smear and HPV DNA screening. The vaccine and screening work together, not instead of each other.
• Women up to age 45 can still benefit. Speak to your gynaecologist about whether it makes sense for you.

It Is Not Just Cervical Cancer: The Bigger Picture

Cervical cancer gets a lot of attention in this conversation and rightly so. But the picture is broader. Breast cancer has now overtaken cervical cancer as the most common cancer among Indian women in urban areas. Uterine cancer is also on the rise.

What ties all of them together is the same truth: early detection dramatically improves survival. A woman diagnosed with breast cancer at Stage 1 has a survival rate of over 90%. At Stage 4, that number drops sharply. The difference, more often than not, comes down to whether she got checked.

Dr. Wadhwa’s advice on lifestyle is practical and straightforward:

“You should be physically active. If you are smoking, stop smoking. Eat healthy foods, vegetables, a healthy balanced diet. Avoid alcohol. Build up your immune system. Patients with a weak immune system are more prone to cancer-like diseases.”

— Dr. Sunita Wadhwa, Cancer Detection Centre

No miracle diets, no expensive supplements. Stay active, eat in moderation, do not smoke and go for your screenings. That is genuinely most of it.

The Part Nobody Talks About: The Emotional Weight

Ask any woman why she has been putting off her screening and chances are the answer is not just about time or access. A lot of it is fear. Fear of what the results might say. Fear of disrupting the family. Fear of being a burden.

And once a diagnosis comes, the emotional impact does not get smaller. It grows. The anxiety, the uncertainty, the loneliness of not knowing who to talk to or how to ask for help.

Dr. Wadhwa has seen firsthand what a difference support makes in outcomes.

“Mental health and emotional support is very important. Family support, support by caregivers and mental health professionals, they are very important in guiding the patient. I have seen a patient, 86 years old, coming out of breast cancer very well because she had a very strong family to support her.”

— Dr. Sunita Wadhwa, Cancer Detection Centre

Eighty-six years old. Coming out of breast cancer. Because of family.

That is what emotional support looks like in practice. It is not a soft extra. It is part of the treatment.

This is exactly why the Indian Cancer Society Delhi created the Kiran Campaign.

Meet Kiran: Because Healing the Body Starts With Healing the Mind

Kiran is the Indian Cancer Society Delhi’s awareness campaign built around one simple but powerful belief: that emotional support is not a luxury in cancer care. It is a necessity.

Running under the tagline ‘Healing the unseen side of cancer,’ the campaign was created to normalise conversations around the psychological impact of cancer, whether you are a patient, a survivor or a caregiver quietly holding everything together. It is built on the belief that nobody should have to navigate any part of this alone.

Kiran is also a 24/7 AI-powered chatbot available on the Indian Cancer Society Delhi website. You can talk to Kiran any time you have a question about cancer support resources, ICS services or the Rise Against Cancer app. No appointments, no waiting. Just a steady, helpful presence whenever you need it.

Dr. Wadhwa herself pointed to digital tools as an important resource, noting that the Rise Against Cancer app gives patients access to all the information they need and that volunteers connected to ICS who have already been through cancer can help guide others through their journeys too.

The #BeSomeonesKiran movement asks all of us to think about who in our lives might need that nudge, that kind word, that gentle push to go get checked. Sometimes being someone’s kiran, their ray of hope, looks like forwarding them this blog. Or sitting with them at their appointment. Or simply saying: you are not overreacting. Go find out.

Because the women who get screened, who get vaccinated, who act on their warning signs early: they do not just save their own lives. They stay present for everyone who loves them.

What You Can Do Right Now

You do not need to do everything at once. Start with one thing.

• Book a Pap smear if you have not had one in the last 3 years.
• Ask your doctor about the HPV vaccine at your next visit.
• Do a breast self-examination this week and make it a monthly habit.
• Download the Rise Against Cancer app for guidance, support resources and more.
• Talk to Kiran on indiancancersocietydelhi.in if you have questions and are not sure where to start.
• Share this blog with one woman in your life who needs to hear it.

Preventable cancer only gets prevented when we act. And acting starts with knowing.

Now you know. So does someone you love.

Want to Hear More?

Listen to the full conversation with Dr. Sunita Wadhwa on the Indian Cancer Society’s podcast: https://youtu.be/3RwVt4kd2Ro

This article is based on an interview with Dr. Sunita Wadhwa, Gynaecologist, Cancer Detection Centre, conducted as part of the Indian Cancer Society’s Kiran Initiative

For cancer support, screening information and resources, visit indiancancersocietydelhi.in or download the Rise Against Cancer app.

By Sonakshi Arora
Initiative by Group Imagination Unleashed

Vaishali was just a daughter trying to help her mother get through cancer treatment. What she didn’t expect was how much it would cost her — and what she had to do to come back from it.

If you’ve ever sat beside a hospital bed and felt like you had to be the strong one — you already know what this piece is about. Not the patient’s journey, but the other person in the room. The one who drives to every appointment, talks the doctor into explaining it one more time, and cries in the car on the way home so no one sees.

Vaishali was that person. In a recent episode of the Indian Cancer Society Podcast, host Sonakshi Arora spoke with her about what it really looked like — not the Instagram version of caregiving, but the actual, exhausting, complicated truth of it.

Here’s what stood out.

Caregiving Is Emotional Labor — And It Is Exhausting

There’s a version of caregiving that looks organized and calm from the outside. Vaishali lived a different version — the kind where you’re emotionally on call 24/7, trying to find the right thing to say at 2 AM while your own fear sits in the background, waiting.

She described it as learning to “talk her mother out of the pain” — not just managing logistics, but being a constant emotional anchor. And the thing about being someone else’s anchor is that nobody anchors you back.

Most caregivers don’t name this as labor. They just call it love. But naming it matters — because if you can’t name it, you can’t notice when it’s depleting you.

Burnout Doesn’t Always Look Like Crying — Sometimes It Looks Like Anger

This is the part of Vaishali’s story that most caregivers will recognize and few will admit out loud.

She started snapping at people. Getting irritated over small things. Feeling a low simmer of anger that had nowhere to go. And for a while, she thought it meant something was wrong with her.

It didn’t. It meant she was human and she had maxed out.

Caregiver burnout doesn’t always show up as breakdown-level exhaustion. It shows up as:

• Losing your patience with people you love

• Feeling resentful — and then guilty for feeling resentful

• Going through the motions without actually being present

• Feeling like you can’t talk about any of this because “it’s not about you”

Recognizing the signs for what they are — signals, not character flaws — is step one.

Stepping Away Is Not the Same as Walking Away

At some point, Vaishali started giving herself permission to leave the house — not to run errands, but just to be somewhere that wasn’t the hospital or the worry. She attended coaching sessions. She met friends. She sat in rooms where the entire conversation wasn’t about illness.

She said it plainly: that time was the only thing that kept her going.

There’s a persistent myth in caregiving culture — especially in Indian families — that needing a break means you don’t care enough. That the more you sacrifice, the more you love. But that math doesn’t work. A depleted caregiver doesn’t give more; they give less, and they resent it.

Taking care of yourself is how you stay capable of taking care of someone else. That’s not selfishness. That’s strategy.

There Is Lightness Even in Hard Places — And That’s Okay Too

Not everything Vaishali shared was heavy. She described a moment in the chemo ward that still makes her laugh — a couple sitting together where the husband was bald and his wife had a full head of hair. Everyone in the room assumed he was the patient. They offered him sympathy, advice, encouraging words. Then the nurse called the wife’s name.

“We all had a good laugh,” she said.

This matters. Because one of the quiet cruelties of long-term caregiving is the guilt that comes with laughing, with enjoying a meal, with having a normal moment while your loved one is suffering. That guilt isn’t useful. And those moments of lightness — the jokes, the unexpected connections — are part of how people survive hard things.

It’s Okay to Ask for Professional Help — That’s Not Weakness, That’s Awareness

Vaishali spoke about the Rise Against Cancer app and the value of professional support — therapy, coaching, structured spaces to process what caregiving actually costs you emotionally.

In India, seeking therapy is still loaded with stigma in a lot of families. Admitting that you’re struggling as a caregiver can feel like a betrayal — like you’re making the patient’s illness about yourself. But the reality is that unprocessed caregiver stress doesn’t disappear; it just accumulates and eventually shows up somewhere else — in your health, your relationships, your ability to be present.

Asking for help isn’t admitting you can’t cope. It’s being honest about what coping actually costs you.

If you are in the middle of this right now — know this: what you are doing is hard. It is allowed to be hard. You are allowed to need things too. And the fact that you keep showing up, even on the days it costs you everything, says more about you than you probably realize.

Caregivers are often the first ray of light in someone else’s darkest chapter. But even light needs somewhere to rest.

You are doing more than enough. Rest when you can.

By Unnati Saxena
Initiative by Group Imagination Unleashed

Talking to a child about cancer is one of the hardest conversations a parent or caregiver may ever have. Parents want to protect children from fear, pain and uncertainty. The fear of saying the wrong thing, making it too frightening, or not being honest enough can feel paralyzing.

But children feel more than we realise. They notice changes. They sense tension. And when questions go unanswered, their imagination often fills the gaps in ways that are far more frightening than the truth. There is a way to have this conversation that balances truth with hope.

Priya Dixit, a clinical psychiatrist working in the survivorship space of psycho-oncology, recently shared practical guidance with the Indian Cancer Society’s Kiran Initiative on navigating this conversation. What she offers isn’t just medical advice, it’s a compassionate roadmap for one of parenting’s toughest moments.

Understanding Psycho-Oncology in Children

Psycho-oncology focuses on the emotional, psychological and social impact of cancer, not just on patients, but on families as well.

Priya works closely with children and families after treatment, during what is often called the survivorship phase. This is the stage where physical recovery may be visible, but emotional and cognitive challenges quietly begin to surface.

Children may experience:

• Difficulty with attention, memory or learning
• Emotional changes like irritability, withdrawal or anxiety
• Behavioural shifts that parents often mistake as “acting out”
• Confusion about what has happened to their body and life

With the right guidance, counselling and timely interventions, children are able to cope better, adjust emotionally and live fulfilled lives.

But that journey often begins with how the story of cancer is told to them.

Age Matters: When Children Are Ready to Know

The question every parent asks is: how much should I tell my child? Priya offers clear, evidence-based guidance: “It is known that a child fully develops insight at the age of 8, therefore any child above that age must be made aware of his diagnosis, with the consent of the parents.”

This isn’t arbitrary. By age eight, children can understand cause and effect, grasp complex emotions and process difficult information when it’s presented with care. Before this age, simpler explanations work better, tailored to what the child can developmentally handle.

But here’s the important part: “When a child asks questions related to his disease and treatment it is important to note it as an indication of his understanding, then offer appropriate information and emotional support to the child,” Priya explains. Your child’s questions are actually windows into what they’re ready to hear. Listen first, then respond honestly at their level.

The BREAKS Protocol: How to Talk to Children About a Cancer Diagnosis

When it comes to talking to children about cancer, medical professionals don’t rely on instinct alone. They follow a structured and compassionate framework known as the BREAKS protocol, designed to help families share a cancer diagnosis in a way that balances honesty with emotional support.

The framework includes:

• Background: Understanding the child’s personality, age and family context
• Rapport: Creating a safe, trusting space before sharing difficult news
• Explore: Gently asking what the child already understands
• Announce: Explaining the diagnosis in clear, simple language
• Kindling: Allowing emotional reactions and responding with empathy
• Summarise: Ending with reassurance and a clear treatment plan

Parents can borrow from this approach when breaking a cancer diagnosis to a child. The goal is not to make the news less serious, but to make it less frightening. Choose a quiet moment. Use age-appropriate words. Answer questions honestly. Pause when needed. And most importantly, end with clarity about what happens next because uncertainty often feels scarier than the truth.

At the same time, families do not have to handle this conversation alone. Hospitals and cancer care teams can actively support the process. In many settings, oncologists work alongside psycho-oncologists and mental health professionals to guide families through these discussions. When doctors, psychologists and psychiatrists come together to share the news, children receive not just medical information, but emotional safety and a structured plan forward.

This team-based approach reduces anxiety, prevents misunderstandings and strengthens trust. It ensures that the child hears not only the word “cancer,” but also hears about treatment, support and hope.

Whether parents choose to lead the conversation themselves or seek help from healthcare professionals, what truly matters is that the child feels heard, informed and emotionally supported. Because when emotional care is integrated into cancer care from the very beginning, children cope better, both during treatment and in survivorship.

What Parents Miss When Focusing Only on Physical Recovery

When you’re tracking blood counts and managing medication schedules, emotional signs can slip through the cracks. But they matter just as much.

Watch for changes in appetite, sleep disturbances and mood shifts—irritability, withdrawal, persistent sadness. “If you see a pattern that you are not eating food or have started eating a lot now, if you feel drastic changes in your appetite before and after cancer, if you feel drastic changes in your sleep disturbances or your mood is generally getting worse, then we call this a warning sign of emotional distress,” Priya explains.

Don’t wait for things to get worse. Reach out to your doctor or counsellor. Emotional care isn’t a luxury, it’s essential medical support.

When Good Intentions Cause Harm: The Trap of Toxic Positivity

One of the most overlooked aspects of cancer care is how well-meaning words can sometimes hurt more than help. We’ve all heard them. “Stay positive! You’ll be fine!” Or “Have you tried this miracle cure?” Or the especially painful, “God only gives battles to strong people.”

These phrases, however well-meaning, can cause real harm. Priya is clear about this: “Many times, because of this, we go on a path of false positivity when we guide patients in a more positive direction. The disease is very real for the person who is suffering from cancer. So I think we should not convey anything unreal in the form of false positivity.”

This creates what psychologists call cognitive dissonance, an uncomfortable mental conflict when you’re told to feel one way (positive, hopeful) while experiencing something else entirely (terrified, exhausted). It’s the emotional equivalent of being told your very real fear doesn’t matter.

“Sorrows when conveyed loudly often creates an uncomfortable scene,” Priya notes. Control your shock. Your loud distress can frighten your child more than the diagnosis itself.

What to do instead? “Well wishers must offer their sincere presence and empathy to show support and care.” Sometimes just being there with no advice, no false promises, no fixing is the most powerful thing you can offer.

Psycho-Education: Knowledge That Heals the Family and Children

Psycho-education means giving families accurate, age-appropriate information about what’s happening medically, emotionally and psychologically. When families understand the full picture, they cope better and feel less alone.

Priya recommends reliable resources like the Indian Cancer Society’s Rise Against Cancer app, which includes Kiran—a chatbot designed to offer authentic information and emotional support when you need it most.

“If you have a problem in reading something, but you understand things more by talking, then you can ask them any question, they will try to give you the right answer to that question to a large extent,” she says. It’s support available whenever anxiety strikes at 2 AM.

Support Groups: You’re Not Alone in This

One of the most powerful resources? Support groups. “These groups are made so that someone else, who is going through the same journey of cancer, along with that, you can share your pain, because your struggles become similar. The support groups help not only in sharing things, they also tend to give you a lot of strength to deal with what’s going to come,” Priya explains.

There’s something deeply healing about being understood without having to explain. When someone else knows exactly why you’re crying in the hospital parking lot at 3 PM, that shared understanding becomes a lifeline.

How Initiatives Like KIRAN Can Help

The Indian Cancer Society’s Kiran Initiative exists because healing isn’t just about the body—it’s about the mind and heart too. Kiran means “ray of light” in Hindi and that’s exactly what this campaign aims to be for families navigating cancer.

Through workshops, support groups, psycho-education resources and compassionate counselling, Kiran reminds families that they’re not alone in the invisible journey of emotions, fear and hope that comes with cancer treatment.

You can be someone’s Kiran too. Show up. Listen without fixing. Offer empathy without judgment. Sometimes the smallest acts of presence become someone else’s light in the dark. #BeSomeonesKiran

Moving Forward With Honest Hope

Talking to kids about cancer will never be easy. But with honest, age-appropriate communication, awareness of toxic positivity, attention to emotional warning signs and access to support systems like psycho-education and support groups, families can navigate this with resilience.

As Priya reminds us, cancer care isn’t just about treatment, it’s about holding space for the heavy emotions, providing non-judgmental support and giving families the care they truly need. Because healing happens in the mind just as much as it does in the body.

Want to Hear More?

Listen to the full conversation with Priya Dixit on the Indian Cancer Society’s podcast: https://youtu.be/Qo0m0BSB5i4

This article is based on an interview with Priya Dixit, Clinical Psychiatrist working in the survivorship vertical of Psycho-Oncology, conducted as part of the Indian Cancer Society’s Kiran Initiative.

For more information about the Kiran Initiative and cancer support services, visit the Indian Cancer Society or download the Rise Against Cancer app.

By Sonakshi Arora
Initiative by Group Imagination Unleashed