Cancer of the uterine cervix (the lower part of the uterus which extends slightly into the top of the vagina) is one of the most common cancers in women. An early symptom is abnormal vaginal bleeding. It has been noticed that most cases develop among women in their 30s or 40s. If cervical cancer is diagnosed at an early stage, it can result in better outcomes. Before engaging with uterine cervical cancer treatment, regular cervical screening tests can help in early detection.
What is important is that the patient promptly reports any abnormal vaginal bleeding (bleeding between periods, heavy periods, bleeding after intercourse) or vaginal discharge promptly to a doctor which will help ascertain the treatment of cervical cancer. Even in cases of post cervical cancer treatment, patients are advised to consult their respective doctors to check for any recurrence and early prevention during diagnosis.
There are two main types of cervical cancer:
A woman may have no symptoms when the cervical tumour is small. As the tumour becomes large, the first symptom to be seen is abnormal vaginal bleeding, which can be:
All of the above symptoms can be caused by various other common conditions. If a woman develops any of these symptoms, she should have it followed-up by a doctor to determine the possibility of cervical cancer treatment.
A cervical tumour starts from one abnormal cell and then goes to other cells. This abnormal cell growth (dysplasa) occurs on the surface lining of the cervix or the endocervical canal commonly known as the opening between the uterus and the vagina. In cases where severe dysplasa is observed then it is called as CIN 3. The initial 'pre-cancerous' abnormality of cervical cells is usually caused by a prior infection with the Human Papilloma Virus.
Human Papilloma Virus (HPV) and Cervical Cancer
Other factors that increase the risk of developing cervical cancer are:
To confirm the diagnosis, the specialist will usually do a vaginal examination if a woman has symptoms which may indicate cervical cancer. If the doctor may feel an abnormal cervix during examination, a colposcopy (a more detailed examination of the cervix) is advised. For this test a speculum is gently put into the vagina so the cervix can be seen in detail using a magnifier (Colposcope). During a colposcopy a small piece of tissue from the cervix is taken for a biopsy. This process is vital for the diagnosis of cervical cancer detection and treatment.
To assess and confirm the extent to which the cancer may have spread the specialist may advise for a few screening tests like:
This assessment is called 'staging' of the cancer. The aim of understanding cervical cancer treatment by stage is to find out:
Treatment options for cervical cancer which may be considered to include different types including gynaecological oncology, medical oncology, radiation oncology, or a combination of these treatments which is best determined by the specialist. In terms of modalities, the treatment advised for each case depends on factors including the stage of the cancer and the general health of the patient.
As part of the cervical cancer operation treatment, a surgery is conducted to remove the cervix and uterus (radical hysterectomy) which is a common course of action. In some cases where the cancer is at a very early stage(requiring treatment), it may be possible to perform removal of the cervix affected by the cancer without removing the entire uterus, for fertility preservation which keeps the pregnancy option open for the patient. Cervical Cancer Treatment becomes ineffective when patients opt out of hysterectomy, which is the recommended treatment option.
Post the hysterectomy cancer treatment, in case the cancer has spread to other parts of the body, surgery may still be advised, often in addition to other treatments. Even if the cancer is advanced, some surgical techniques may be used to ease symptoms.
Chemotherapy is a cervical cancer treatment using anti-cancer drugs which kill cancer cells, or stop them from multiplying. Chemotherapy may be given in addition to radiotherapy or surgery in certain situations. Nowadays concomitant chemo-radiotherapy is the preferred method of treatment for cervical cancer.
Radiation Oncology is a treatment which uses high energy beams of radiation focused on cancerous tissue, killing the cancer cells or stopping them from multiplying. Radiotherapy alone can be curative for early stage cervical cancer treatment and may be an alternative to surgery which involves laser surgery. For more advanced cancers, radiotherapy may be advised in addition to other treatments.
Two types of radiotherapy are used for cervical cancer, external and internal. In many cases both types are used:
Radiotherapy has been a convenient option for outpatient treatment especially for patients who would not like to get into the complexity of hospital admission.