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Cervical Cancer

An estimated 5,70,000 women were detected with Cervical Cancer worldwide and about 3,11,000 women passed from the disease.

However, with the advancement of technology, experience, and new protocols, the survival rates of cervical cancer patients are also increasing.

Though the detection of cervical cancer itself is a matter of concern but with the right treatment with the right doctor at the right time, you can beat cervical cancer. 

Let’s understand from the experience of Amy, a 41-year-old woman from Abuja, Nigeria. Amy is a housewife she has two sons, a beautiful daughter, and a wonderful husband.

Three years back, Amy had vaginal bleeding for about a week followed by no period the next month which was abnormal. The abnormal bleeding was observed once again in the subsequent month along with severe pelvic pain. She decided to set up an appointment with her gynecologist. Her appointment was scheduled, the doctor examined Amy. The doctor had suggested a few investigations along with the PAP test. 

After a few days, the result of the PAP test came and the hospital called Amy to visit the doctor. Amy visited the hospital and the gynecologist gave her the bad news that she had an aggressive form of cervical cancer. 

The doctor told her to get an appointment with an oncologist as soon as possible.

After listening to the cancer news, Amy and her family were in shock. Amy’s husband Joseph supported her very well and wanted the best treatment for her wife. Joseph showed Amy to a nearby oncology hospital and admitted Amy for treatment. After a few day’s Joseph didn’t get convinced with the treatment as his wife’s health was deteriorating fast.

Cervical Cancer Patient Image
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Joseph was looking for a second opinion with the best cervical cancer specialists. While researching online Joseph visited the MedicoExperts website and left an inquiry on the website and the MedicoExperts patient care department got in touch with Joseph.   

Joseph sent all the medical reports of Amy to the MedicoExperts and MedicoExperts booked the online video consultation of Joseph with the best oncologist from the empanelled hospital. After the consultation, the doctor is able to clear all the doubts of Joseph regarding the treatment protocols. 

Joseph understood the gaps in the ongoing treatment. He decided not to take any chance and visit India for treatment. However, Joseph was worried about the logistics support and requested the MedicoExperts team to guide him. MedicoExperts team, helped him to arrange Visa on priority, and all other arrangements in India.

After 15 days, Joseph and Amy came to India for treatment, and Amy got admitted to the hospital. Amy’s evaluation was done to check the current condition of cancer. The reports clarified that cervical cancer is identified in stage II. Stage II means that the cancer was extended beyond the cervix to the upper portion of the uterus. Amy’s treatment started and she was advised to undergo a radical hysterectomy followed by a course of radiation therapy. 

After 3 months another evaluation test was performed to validate the outcome of the treatment. Reports came and the result was in favor of Amy. 

Amy and Joseph were very happy to hear that and thanked the doctor and MedicoExperts.  

This could be your story as well. You also need the right treatment at right time with the right guidance.

Before we start discussing the different treatment options, let’s first understand what cervical cancer is.

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What is Cervical Cancer?

Cervical cancer is cancer that forms in the cervix, the lowermost portion of the uterus that connects to the vagina.

Vagina, the birth canal is the upper part of the uterus, and the uterus is where a baby grows when a woman is pregnant. It occurs more commonly in women over age 30.

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images of cervical cancer types

What are the different types of Cervical Cancer?

There are two main types of cervical cancer that help to determine your prognosis and treatment:

  • Squamous cell carcinoma

    In this, cervical cancer starts in the thin cells (squamous cells) lining the outer part of the cervix which projects into the vagina.

  • Adenocarcinoma

    In this, cervical cancer starts in the glandular cells that line the cervical canal.

  • Other Cervical cancer types

Few cervical cancer cells have feature characteristics of both squamous cell carcinoma and adenocarcinoma. These are called as “adenosquamous carcinomas” or “mixed- carcinomas”.

Stages

What are the different stages of Cervical Cancer?

The stages are assigned by evaluating the tumor and whether cancer has spread to other parts of the body:

 In this early stage, cancer has spread from the cervix lining into deeper tissue but still within the uterus.

Stage IA

Here, the cervical tissues or cells are examined under the microscope, or imaging tests are used to determine the tumor size.

  • Stage IA1 – At this stage, the tumor is less than 3mm in depth.
  • Stage IA2 – At this stage, the tumor is between 3mm to 5mm in depth.

Stage IB

Here, the tumor is larger but still limited to the cervix.

  • Stage IB1 – At this stage, the tumor is 5mm or more in-depth and less than 2cm wide.
  • Stage IB2 – At this stage, the tumor is 2cm or more in-depth and less than 4cm wide.
  • Stage IB3 – At this stage, the tumor is 4cm or more in width.

At this stage, cancer has spread from the uterus to nearby areas such as the vagina but still within the pelvic area.

Stage IIA

Here, the tumor is constrained to the upper two-thirds of the vagina and has not spread to the tissue next to the cervix which is called as parametrial area.

  • Stage IIA1 – At this stage, the tumor is less than 4cm wide.
  • Stage IIA2 – At this stage, the tumor is 4cm or wider.

Stage IIB

Here, the tumor has spread to the parametrial area but has not reached the pelvic wall.

The tumor affects the lower third of the vagina and has spread to the pelvic wall causing swelling of the kidney called hydronephrosis which stops kidney functioning and involves regional lymph nodes.

Stage IIIA

At this stage, the tumor involves the lower third of the vagina but has not grown into the pelvic wall.

Stage IIIB

At this stage, the tumor has grown into the pelvic wall.

Stage IIIC

At this stage, the tumor involves regional lymph nodes and can be detected using an imaging test or pathology.

  • Stage IIIC1 – Here, cancer has spread to lymph nodes in the pelvis.
  • Stage IIIC2 – Here, cancer has spread to para-aortic lymph nodes. These lymph nodes are discovered in the abdomen.

Stage IVA

At this stage, cancer has spread to the bladder but has not spread to other parts of the body.

Stage IVB

At this stage, cancer has spread to other parts of the body.

symptoms

What are the symptoms of Cervical Cancer?

The most common Cervical Cancer signs and symptoms are:

  • Bleeding between or following periods
  • Bleeding or pain during sexual intercourse
  • Bleeding post menopause
  • Increased vaginal secretion with a strong odor
  • Persistent pelvic pain

Any of these symptoms should be reported to a doctor, the earlier the cancer is found and treated, the better the chances of curing or preventing it.

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Cervical Cancer Causes image

Causes

How is Cervical Cancer caused?

Risk factors of cervical cancer that increase the risk of acquiring cervical cancer include:

  • HPV: It’s a sexually transmitted virus and there are more than 100 different types of HPV that can occur and at least 13 of them lead to cervical cancer.
  • Many sexual partners or becoming sexually active early: Women who have many sexual partners generally have the chances of getting in contact with an HPV-infected individual and are at higher risk of HPV infection. As a result, they are at a higher risk of developing cervical cancer.
  • Smoking: This also increases the chances of developing cervical cancer.
  • Birth control pills: Women using oral contraceptives for the long term have higher chances of risk to develop cervical cancers.

Diagnosis

How to diagnose of Cervical Cancer?

The following are a wide range of methods used by doctors to diagnose cervical cancer:

During this exam, the doctor checks for any signs of changes in your pelvic organs that include the uterus, cervix, vagina, and other pelvic organs. Here, the doctors use an instrument to keep your vaginal walls open. This is just a preliminary test and cannot conclude whether you have cervical cancer or not. 

During this test, the doctor scrapes a few cells from your uterus or cervix which are examined for any abnormalities. This test detects if there is any abnormal or cancerous growth.

It is like a pap test where a small sample of cells is taken from the cervix to test for HPV. Certain types of HPV like HPV-16 and HPV-18 are prominent in women who are diagnosed with cervical cancer. But testing positive does not mean that you have developed cervical cancer hence this test alone cannot be used to determine cervical cancer.

A colposcopy which is a low-powered microscope is used to view your cervix to identify abnormalities. During this examination, the doctor might remove a small sample of tissue to check for malignant cells.

This is the only way for confirming cervical cancer. During this test, the doctor will remove a sample of tissue from your cervix and examine it under a microscope.

These scans are done to determine how far the cancerous cells have spread in your body.

Treatment

Best cervical cancer treatment in India

Cervical Cancer Treatment in India depends upon several factors like stage of cancer or your preferences:

Early-stage cervical cancer is usually treated with surgery when cancer has not spread from the cervix. This treatment is only possible if the disease is still confined to the cervix which is less than Stage II. There are different types of surgery performed that include:

Radical Trachelectomy for cervical cancer treatment in India

It is a type of surgery that removes the cervix but keeps the uterus intact. This is recommended for young women who want to preserve their fertility in the future.

Conization for cervical cancer treatment in India

In this, a laser or surgical knife is used to extract tissue from your cervix to get rid of cancerous cells which can only be done with a microscope.

Hysterectomy for cervical cancer treatment in India

This can further be divided into simple or radical. In simple hysterectomy, uterus and cervix are removed whereas in radical hysterectomy, uterus, cervix, upper vagina, and the entire tissue surrounding the cervix are removed. This has consequences on the patient’s fertility and removing surrounding tissue makes it more complex than the hysterectomy done for other cases like fibroids.

Side effects from Cervical cancer surgery in India may vary depending upon the type of surgery done. Patients may occasionally experience bleeding, infection, or damage to the urinary and intestinal systems. Talk with doctors before the surgery about the side effects since these procedures affect sexual health. The doctor may be able to help reduce the side effects and provide support resources to cope with any changes.

During this treatment, high-powered energy beams such as X-rays are used to kill cancerous cells.

It can be controlled in two ways:

  • Externally by directing a radiation beam at the affected body parts.
  • Internally by placing a small device with radioactive material inside the vagina.

You may have radiotherapy:

  • As the main treatment of cancer has advanced
  • After surgery usually with chemotherapy to stop cancer occur again
  • To help improve symptoms like bleeding

For early-stage cervical cancer, a combination of radiation therapy and low-dose chemotherapy is often done. This combination is used to control cancer in the pelvis to cure cancer without surgery. Side effects from radiation therapy include fatigue, mild skin reactions, stomach upset, and bowel movements.

In this treatment, drugs are utilized to kill the cancerous cells. It can be either given orally or injected into your veins to target cancerous cells that surgery cannot remove. It consists of a specific number of cycles for a certain period. Each cycle is followed by a break that allows your body to rest for some time.

You may have chemotherapy:

  • With radiotherapy as the main treatment for your cervical cancer
  • Before surgery to make the cancer cells smaller
  • After surgery usually with radiotherapy to stop cancer occur again
  • If cancer has spread to other parts of the body or has occurred again.

The side effects of chemotherapy depend on the dose and the individual, which may include fatigue, infection, nausea, vomiting, loss of appetite, and diarrhea. These side effects are over once the treatment is finished.

It is a type of drug treatment that helps your immune system to fight cancer. The cancerous cells produce proteins that make it undetectable by your disease-fighting immune system hence immunotherapy interferes with that process and lets your immune system fight against the cancerous cells.

Different immunotherapy can cause different side effects that may include skin reactions, diarrhea, and weight changes.

If you have advanced cervical cancer or cancer has occurred again, then you will be treated with targeted therapy. During this treatment, cancer cells with specific weaknesses are targeted to block them which causes cancer cells to die. In this treatment, targeted medicine called bevacizumab also called Avastin is given to make the cancer cell smaller or stop it from getting larger. It is usually combined with chemotherapy.

prostate cancer survival rate

Survival Rate

Cervical Cancer Survival Rate in India

The 5-year survival rate of cervical cancer is 66% and it can differ depending upon various factors such as race, ethnicity, and age. For white women aged 50 and older, the 5-year survival rate is 71% and for young women less than age 50, the 5-year survival rate is 78% whereas for black women aged 50 or older, the 5-year survival rate is 46% and for young women less than age 50, the 5-year survival rate is 58%.

Treatment

Cervical cancer treatment cost in India

The Cervical Cancer treatment cost in India can be between $5000- $7000 (377659 –  528722 INR) depending upon the type of treatment, infrastructure, and quality of medical services.

If the patient is in the early stages of cervical cancer, Trachelectomy, a highly-skilled fertility-sparing procedure is recommended. There are specialist gynecologic oncologists and super-specialty hospitals in India to perform this surgery. If the condition of the patient is extremely grave, then hysterectomy is suggested. The cost for a hysterectomy in India starts from 3000 USD (226595 INR). In cases of advanced cervical cancer, radiation therapy with or without chemotherapy is advised for a complete cure. The cost of chemotherapy ranges between 500 to 1000 USD / cycle (37765 – 75531 INR).

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Frequently Asked Questions and patient concerns:

Is Cervical Cancer curable?

Cervical cancer is often viewed as curable, especially when the cancer is diagnosed in the early stage. Like most cancers, early detection is the key to achieving a positive outcome.

How to prevent Cervical Cancer?

Young women are encouraged to go for a Pap test once every 3 years between the ages of 25 to 29 or an HPV test for age 30 and above even if they do not experience any symptoms.

What is the most common age to get cervical cancer?

Cervical cancer is most widely diagnosed in women between the age of 35 to 44 and it rarely develops in women younger than age 20.

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