Let us know few important and common aspects of cervical cancer
1) What is cervical cancer ?
Cervical cancer is an abnormal growth of cells that starts in the cervix. The cervix is the lower part of the uterus that connects to the vagina.
2) What is the main cause of cervical cancer?
Nearly all cervical cancers are caused by a human papillomavirus (HPV) infection. Typically, most of low-risk HPV infections resolve spontaneously. The high-risk HPV when not identified timely and addressed over years transform to abnormal cells and cause cervical cancer, but in women with weakened immune systems, such as untreated HIV, this process can be even faster.
Other important cofactors include some sexually transmittable infections (human deficiency virus [HIV] and Chlamydiatrachomatis), smoking, a higher number of childbirths, and long- term use of oral contraceptives
3) What are the trends of cervical cancer in india?
Cervicalcanceris the fourth most common cancer in terms of both incidence and mortality in women as per Globo can 2022. Cervical cancer ranks as the 2nd most frequent cancer among women in India after breast cancer and the 2nd most frequent cancer among women between 15 and 44 years of age. We are certainly observing a broad decline in the incidence owing to factors like improving human development index, awareness and compliance to screening protocols and certainly improved awareness and accessibility to cervical cancer vaccines.
4) What are the stages of cervical cancer?
5) Are there ways to prevent ?
Prophylactic vaccination against HPV and screening and treatment of pre-cancer lesions are effective strategies to prevent cervical cancer and are cost-effective.
The currently available HPV vaccines in India such as targets to prevent HPV 16 and 18, and target to prevent HPV 6, 11, which cause warts and HPV 16 and 18 infections, which cause cervical cancer. The other currently available HPV vaccine in India, targets HPV 6, 11, 16, 18, 31, 33, 45, 52, 58. Each of these vaccines were found to be safe and effective offering protection against 90% of HPV strains that cause genital warts, cervical cancer , anal cancer and most strains that cause oral and throat cancer too.
6) Are there ways to detect early?
Pap smear (Conventional versus Liquid Pap). Liquid pap is better HPV testing
Visual inspection with acetic acid (VIA)
Screening can be started at the age of 21 years with either onceevery3 years,
onceevery5yearstill the age of 65yrs. HPV testing can be
incorporated from 30yrs of age onwards.
7) What are the common symptoms of cervical cancer?
• vaginal bleeding after intercourse or vaginal bleeding after attaining menopause
• vaginal bleeding between periods or periods that are heavier or longer than normal
• vaginal discharge that is watery and has a strong odour or that contains blood
• pelvic pain or pain during intercourse
• difficult or painful urination or blood in the urine
• dull backache, swelling of the legs and pain in the abdomen
• feeling tired
8) What Are The Modes Of Treatment?
Your treatment depends on several factors. These include what type of cervical cancer you have, how big it is, whether it has spread (the stage) and the grade. It also depends on your general health.
For very early-stage disease, less than 2cm and confined to cervix only, Surgery is preferred.
From IB3-IVA CHEMORADIATION FOLLOWED BY BRACHYTHERAPY IS THE STANDARD OF CARE
For very advanced and metastatic diseases systemic chemotherapy is considered.
9) Recent Advances In The Treatment Options?
In the local treatments after completion of external beam radiation therapy , brachytherapy is the cornerstone of treatment and is the best form of conformal treatment for carcinoma cervix. Availability of advanced applicators, three-dimensional imaging is making the brachytherapy treatment more versatile and aiding in providing improved clinical outcomes.
There are advantages with conformal external beam radiation delivery techniques too. Availability of good image guidance is the key to deliver good tumoricidal dose to disease and minimize bowel and bladder related immediate and long term effects.
Newer trials are suggesting benefit of Immunotherapy in advanced metastatic and recurrent cervical cancer and it is being explored in locally advanced and high nodal burden cases also.
it is important to know that with the advances in technology and availability of advanced systemic treatments, there is improvement in cervical cancer outcomes. Three- dimensional image guided radiation therapy, advanced brachytherapy, advances in systemic therapy approaches have upscaled the local control and survival outcomes while minimising the long-term toxicities.
As a clinician while focussing on the advances in treatments, I feel the need to highlight the importance of screening, vaccination.“An ounce of prevention is worth a pound of cure ”-Benjamin Franklin.
with all the latest information about cervical cancer and for queries pls contact Dr. Shilpa Reddy .K Consultant Radiation Oncologist Apollo Cancer Hospitals Hyderabad.
DR. SHILPA REDDY.K
Consultant Radiation Oncologist
Apollo Cancer Hospitals, Hyderabad