Endometriosis Is Not Cancer — But Its Biology Should Change How We Treat It
By Dr Vivek Salunke, Endometriosis Specialist & Advanced Laparoscopic Surgeon, Mumbai
Most patients with endometriosis reach me after years of being told things like:
- “It’s just bad periods.”
- “Your scans are normal.”
- “Don’t worry, it will settle after marriage.”
On paper, endometriosis is called “benign.” In reality, it behaves far more aggressively than that label suggests.
Endometrium-like tissue can grow on ovaries, bowel, bladder, fallopian tubes, and even on C-section or surgical scars. It doesn’t just sit on these surfaces—it infiltrates them. Over time, it can invade ligaments and organ walls, creating dense adhesions that pull organs out of shape and restrict their movement. These changes lead to chronic pain, painful periods, pain during intercourse, and sometimes difficulties with fertility.
Within these lesions, fragile new blood vessels form and rupture during every menstrual cycle. This repeated bleeding causes persistent inflammation, leading to scarring and distorted anatomy. The disease is also strongly influenced by hormones such as estrogen, much like certain hormone-sensitive cancers.
Why Endometriosis Needs to Be Taken More Seriously
Research supports this comparison. Large population studies show a slightly increased risk of certain ovarian cancers among those with severe or long-standing endometriosis—especially when it involves the ovaries. The individual risk remains low, but it reminds us that endometriosis is biologically active, progressive, and potentially damaging if left unchecked.
Despite this, our systems often treat it as a minor issue. Quick “look and burn” laparoscopies, inadequate imaging, and limited follow-up are still common. Too many patients continue to cycle through surgeries and medication changes without a clear long-term plan.
A Better Way to Approach Endometriosis
In consultations, I focus on three fundamental questions that guide better care:
- Where exactly is the disease, and how deep is it?
Precise mapping through expert imaging prevents surprises during surgery. - What is the safest and most effective way to control it now?
Not every case needs surgery, but when it does, it should be done thoroughly by experienced hands. - What does this plan mean for pain, fertility, and long-term risk?
Addressing these aspects early reduces uncertainty and improves quality of life.
Why This Approach Matters
Taking these questions seriously changes outcomes—patients receive more accurate diagnoses, more deliberate treatment plans, and fewer repeat procedures.
If we approached endometriosis with the same level of caution, coordination, and foresight that we reserve for early cancer care, we could significantly reduce suffering and recurrence rates.
The Key Message
Endometriosis may not be cancer, but its biology demands that we treat it with the same respect, planning, and seriousness.
Recognising that truth is the first step toward truly improving patient care.
About Dr. Vivek Salunke
Dr. Vivek Salunke is a senior laparoscopic surgeon based in Mumbai, India, with over 25 years of experience in endometriosis and fertility-preserving surgery.
He leads the Endometriosis & Pelvic Pain Centre and is known for his ethical, patient-centered care and advanced excision techniques.