A Guide on Cervical cancer and its treatment

A Guide on Cervical cancer and its treatment

Cervical cancer begins in the lowest portion of a woman’s uterus called the uterine cervix. Cervix connects the uterus with the vagina. Cervical cancer develops over time and is the fourth most common type of cancer for women worldwide.

Signs and symptoms of Cervical Cancer

• Abnormal bleeding per vaginum or abnormal vaginal bleeding: Unusual bleeding after sexual intercourse, bleeding after menopause, bleeding and spotting between periods
• Heavier menstrual bleeding than usual
• Pelvic pain
• Discomfort or pain during sexual intercourse
• Unusual discharge from the vagina: the discharge may be colorless or may contain some blood and may occur between the periods or after menopause.
• Back pain
• Pain during urination
• Swelling in legs
• Urinary incontinence and blood in the urine
• Symptoms like shortness of breath, confusion, and bone fractures
• In the advanced stage of cancer, Kidney failure due to a urinary tract or bowel obstruction

These symptoms may also indicate other health problems that are not related to cervical cancer, but it is suggested to consult the expert if you experience any of the above-mentioned symptoms to increase the chances of successful management of the case.

Risk factors for Cervical Cancer

• HPV -Human papillomavirus infection: The most important risk factor for cervical cancer is infection by the human papillomavirus, which is a group of more than 150 related viruses. This virus can spread from one person to another person via skin contact.
  There is no cure for HPV infection but there are ways to treat warts occurred due to infection and abnormal cell growth caused by HPV.
• Smoking: Females who smoke are at more risk to get cervical cancer as compared with non-smoker females. Research proves that few substances present in smoke damage the DNA of cervix cells that may contribute to the development of cervical cancer.
• A weakened immune system: Women with a weak immune system put them at higher risk for getting HPV infections.
• Chlamydia infection: A kind of bacteria, Chlamydia, which is spread by sexual contact, can infect the reproductive system. Infection caused due to Chlamydia bacteria can cause pelvic inflammation, leading to infertility.
  Women show no signs, who are infected with chlamydia unless they are tested for chlamydia during a pelvic examination.
• Less intake of fruits and vegetables: Females who take fewer fruits and vegetables may be at more risk for cervical cancer.
• Obesity or overweight: Overweight Women are more likely to develop cervix cancer.
• Long-term use of birth control pills or oral contraceptives: Research suggests that women who take oral contraceptives for a longer time are at more risk of getting cervical cancer. The risk goes down again after the birth control drugs are stopped, and normalizes about 10 years after stopping.
• IUD or Intrauterine device use: Women with IUD have some risks related to cervix cancer so it is suggested to discuss the possible risks and benefits with her doctor before opting for IUD.
• Having multiple pregnancies: Women who have had more than 3 full-term pregnancies are more likely to have the risk of cervical cancer development.
• Family history of cervical cancer: If someone in the family had cervical cancer that increases the risk.
• Multiple sexual partners: If any woman is involved with multiple sexual partners, more are the chances that she may develop cervical cancer.
• Age: The average age of a woman who is diagnosed with cervical cancer is 48.

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Stages of Cervical Cancer

The stage of Cervical cancer like any other cancer indicates the extent to which it has spread in the body. Different stages of any cancer help the oncologist to define the best treatment plan and increase the chances of survival.
Generally, cervical cancer has five stages:

• Stage 0: This stage is referred to as carcinoma in situ (CIS) because, in this stage, the abnormal cells are present only on the surface of the cervix.
• Stage I: In this stage, cancerous cells have outgrown from the surface into deeper tissues of the cervix and possibly into the uterus but have not spread to any surrounding lymph nodes or organs.
• Stage II: In this stage, the tumor has spread beyond the cervix and uterus, affecting nearby lymph nodes but does not involve the pelvic walls or the lower part of the vagina.
• Stage III: In this stage, the cancerous cells have invaded the lower part of the vagina or pelvic wall.
• Stage IV: In this stage, cancer has spread to the bladder or rectum, or to the organs in other areas of the body.

How to diagnose Cervical Cancer

1. Physical examination and Medical history

The first step is the evaluation of the patient by the doctor to define the general state of the patient’s health.

2. Pap Smear

Pap smear is an important and preventive diagnostic tool in diagnosing cervical cancer as this test can reveal abnormalities of the cervix before they progress into cancer.
The Gynaecologist in Pap smear test removes a tiny amount of tissue from the cervix. It is a matter of only a few seconds. The sample is sent to the laboratory for analysis.

3. Human Papillomavirus Testing

HPV testing is done as a Pap smear test is done. The collected sample is sent to the laboratory to analyze for the Virus.

Women with symptoms of cervical cancer or abnormal Pap results are recommended to undergo the following tests:

1. Colposcopy: A lighted magnifying instrument called Colposcope is used to visualize the vagina to see the surface of the cervix closely and clearly. If the Gynaecologist detects any abnormality, a biopsy is done in this case. A biopsy is the removal of a small piece of tissue from the vagina, which is sent to the laboratory to look for the abnormal area if it is a pre-cancer, true cancer, or neither.
2. Blood tests: A blood cell count help analyze any liver or kidney-related problems.
3. CT scan: CT scans are usually done in case of large tumors or if there is concern about cancer spread.
4. MRI: MRI shows soft tissue parts of the body sometimes better than other imaging tests.
5. Pelvic ultrasound: shows an image of the target area on a monitor.
6. A chest x-ray is done to see if cancer has spread to the lungs. This is usually done when the cancer is in an advanced stage.
7. PET scan (Positron emission tomography): PET scan is helpful in assessing the affected site other than the cervix as it scans the whole body.

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Treatment Options for Cervical Cancer

Similar to another type of cancer, treatment for cervical cancer too depends on certain factors, such as the stage of cancer, age of the patient, and other health problems the patient may have.
Various treatment options for cervical cancer include Surgery, radiation, chemotherapy, or a combination of the three.

1. Surgery

Surgery is a common treatment method when cancer has not spread from the cervix to other sites in the body.

• Surgery to remove cancer only. It is possible to remove a very small cervical cancer entirely with a cone biopsy. This procedure removes a cone-shaped piece of cervical tissue leaving the rest of the cervix intact.
• Trachelectomy: Surgery to remove the cervix. Trachelectomy procedure removes the cervix and some surrounding affected area in early-stage cervical cancer, leaving the Uterus intact.
• Hysterectomy: Surgery to remove the uterus along with the cervix. Hysterectomy means removal of the Uterus if it is affected.

Treatment for advanced cervical cancer

Cancer Surgery is not the only option when cancer has spread beyond the cervix. Advanced stage cancer requires more extensive treatment, which involves either radiation therapy or a combination of radiation therapy and chemotherapy.

2. Radiation therapy

Radiation therapy uses beams of high-energy X-rays or radiations to kill the cancer cells. Radiation therapy can be used after surgery in case the experts detect an increased risk that cancer can come back.

3. Chemotherapy in Delhi

Chemotherapy destroys cancerous cells using certain chemicals or medications. Chemotherapy targets cancer cells that cannot be removed by surgery. Since chemotherapy is a drug treatment so can be given through a vein or taken orally in pill form. Some cervical cancer patients undergo chemotherapy sessions for weeks, while other patients may receive them for months.
In few cases where cervical cancer is advanced locally, chemotherapy is combined with Radiation therapy to enhance the effects of radiation and prevent the symptoms of advanced cancer to distant sites in the body.

4. Targeted therapy

Targeted therapy interrupts the cellular processes that promote the growth of cancer cells using certain drugs. Target therapy is used for advanced cancers. This type of therapy stops the tumors to make new blood vessels, which is required for tumor growth.

5. Immunotherapy

Immunotherapy helps the immune system to fight cancer using certain medicines. Immunotherapy is considered in advanced cancer and when other treatment options are not working.

6. Palliative care or Supportive care

Palliative care is supportive care provided by a professional team of doctors, nurses, and other specially trained professionals. Such a team aims at improving the quality of life for patients with cancer and their families. These team professionals work closely with the patients and their families to provide extra support that complements their ongoing care.
With such care along with all of the other appropriate treatments, cancer patients may feel better and live longer.

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