Cervical Cancer
- The cervix is the lower part of the uterus that opens into the vagina, Cervical cancer occurs when there is uncontrolled growth of abnormal cells on the cervix.
- GLOBOCAN 2018 statistics show incidence of cervix cancer to be 6.6 % of all cancer cases in women, 80% of the new cervical cancer cases occur in developing countries, like India, which reports nearly a quarter of the world’s cases of cervical cancer each year.
- Cervical cancer mortality has been claimed to be 3.3% annually.
- Survival of cervix cancer with distant metastasis for 5 years is 17% as per Cancer Treatment Centre of America (CPCA) amongst US citizens.
- Cervical cancer is a disease which predominately affects women over 45 years of age and is the second commonest cancer in women worldwide. The peak age of incidence of cervical cancer is 55-59 years, and a considerable proportion of women report in the late stages of the disease.
- The main types of cervical cancers are :
– Squamous cell carcinoma.
– Adenocarcinoma.
Causes
- Chronic Cervicitis.
- HPV Infection – Prevalent studies reveal that infection with human papilloma virus (HPV), particularly type 16, is strongly associated with cervical intraepithelial neoplasia and invasive cancer.
- Smoking : Cigarette smoking women are at twice the risk of developing cervical cancer in comparison to non-smokers.
Carcinogenic agents with sufficient evidence in humans (ref-IARC) :
- Diethylstilbestrol (exposure in utero).
- Estrogen – progestogen contraceptives.
- Human immunodeficiency virus type 1.
- Human papillomavirus types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59.
- Tobacco smoking.
Agents with limited evidence in humans (ref- IARC)
- Human papillomavirus types 26, 53, 66, 67, 68, 70, 73, 82.
- STD : A history of a sexually-transmitted disease makes a woman susceptible to develop cervical cancer.
- Overweight : Overweight women are more likely to develop adenocarcinoma of the cervix.
- Promiscuity : Having multiple sex – partners or having a partner who is promiscuous, increases the chances of developing cervical cancer.
- High parity : Having seven or more number of full- term pregnancies predisposes a woman to develop cervical cancer.
- Oral Contraceptives : Long -term use of oral contraceptives makes a woman more prone to develop cervical cancer.
- Hereditary : Cervical cancer may run in some families.
Signs and Symptoms
- Pre-cancerous disease
– Precancerous disease of cervical cancer is by its nature asymptomatic and may only be detected by routine screening, cytology, colposcopy, and histological examination.
Invasive cervical cancer symptoms
– Early stages of cervical cancer may be asymptomatic.
– When the disease presents itself, the cardinal symptom is abnorma vaginal bleeding.
– Abnormal vaginal bleeding occurs in post coital or intermenstrual bleeding.
– Excessive Foul – smelling, yellow vaginal discharge which may be mucoid or offensive.
– Lower back pain.
– Pain during urination (dysuria).
– Pain during sex (dyspareunia).- Metastatic cervical cancer symptoms
– Constipation.
– Blood in the urine (haematuria).
– Abnormal opening in the cervix.
– Ureteral obstruction.
– Deep pelvic pain.
– Sciatica pain-due to nerve root entrapment.
– Unilateral leg edema-due to blockage of lymphatics etc.
Investigations / Screening
- Physical examination and history.
- Pelvic Examination –
A routine screening is advisable for women over the age of 18 years and who are sexually active, as this helps in the early detection of cervical cancer. A speculum examination can reveal a polypoid mass or infected ulcerated lesion in advanced stage. Bimanual examination by gynaecologist will help diagnose the disease. Biopsy / PAP Smear –
It is commonly diagnosed through a Pap smear test. It is done by inserting a speculum into the vagina and removing cells, from the lining of the cervix, using a cotton swab or a spatula. The cells are then smeared on a glass slide and sent for microscopic examination.The test is not considered for women below the age of 25 years and over the age of 65 years. A 3 – yearly examination is recommended for women between the ages of 25 – 49 years while for the age group between 50-64 years a Pap smear once in every 5 years is recommended.
- Other diagnostic tests –
Colposcopy enables a detailed visual examination of the cervix using a Colposcope, and Cone biopsy which removes a cone-shaped tissue from the cervix to be examined microscopically. An endocervical Curettage scrapes down the lining to be examined for abnormal changes. - PET scan/MRI/CT scan.
- Biomarker investigations.
Treatment
- To plan personalised treatment for each individual patient as every individual is different even if they have the same type of cancer.
- To improve health related quality of life (QOL) in all types and stages of cancer patients.
- To plan for partial or total regression of tumour depending on the nature of tumors.
- To increase overall survival (OS) of patients.
- To increase disease free survival (DFS) where complete resection of tumour is achieved.
- To provide a treatment option to patients who are refractory to conventional treatments like chemotherapy / radiotherapy / immunotherapy etc.
- To reduce the rate of growth of the tumor in recurrent and advanced staged cases.
- To increase progression free survival in advance cases.
- To reduce impact of symptoms related to progression of disease.
- To improve confidence of patients.
- To provide palliative support in end-of- life cancer cases.
- To add happiness and extension of life to cancer patients.
- To compliment other therapies like chemotherapy, radiotherapy in a synergistic way.
- To reduce severity or adverse effects of other conventional treatment. This reduces incidence and frequency of hospitalization.
- It is pertinent to note that Rasayu Cancer Clinic does not claim or blame anything while communicating any aspect to cancer patients.
- Rasayu Cancer Clinic focuses on Ayurveda fundamental based therapies.
- Rasayu Cancer Clinic believes in continuous improvement in service and science.
- Rasayu Cancer Clinic always advocates patient centric approach which leads to long and happy life of cancer patients.
- Every patient has a right to choose the therapy.
- Rasayu Cancer Clinic never imposes Rasayana therapy on patients but helps them to take the right decision, hence making patients/ relatives well aware about the disease and possible outcomes along with its risk benefit and cost benefit ratios.
- Rasayu Cancer Clinic is well connected with global updates in cancer care and therapies, through advisors and collaborations with national and international institutes.
Surgery
- There are different surgical methods available according to cancer stage.
- It may involve following types of surgery like Cryosurgery, Laser surgery, Conization,
Hysterectomy, Radical hysterectomy, Pelvic lymph node dissection, Trachelectomy etc. - To know more about surgery of cervical cancer – Click Here
- For further details on the side effects of cervical cancer treatment – Click Here
Chemotherapy
- Chemotherapy treatment uses medicine to weaken and destroy cancer cells at the original cancer site and any cancer cells that may have spread to other parts of the body.
- While destroying cancer cells, it destroys fast dividing normal cells, which further creates multiple side effects.
- Chemotherapy side effects to know more – Click Here
- Side effects of Chemotherapy – Click Here
- Adverse drug reactions (ADRs) of Chemotherapy – Click Here
Radiation Therapy
- It is a treatment with high energy rays or particle that kills cancer cells also termed as External beam radiation (Radiation given by machine from outside of body).
- It may involve External beam radiation or Brachytherapy.
- Radiotherapy side effects – Click Here
- Side effects of radiotherapy – Click Here
- Side effects of cervical cancer treatment – Click Here
Targeted Therapy
- Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
- Bevacizumab – a monoclonal antibody can be used to treat this cancer.
- However, studies have revealed its severe toxicities and may lead to deaths – Click Here
- For more details about HPV-targeted adoptive T Cell therapy for advanced cervical cancer click the following link – Click Here
Immunotherapy
- Efficacy of this treatment is still not clear as per the National Library of Medicine, since there is a need for improved biomarkers.
- Cost of this treatment is high and many times does not fit into cost benefit ratio.
- Side effects – Click Here
- Risk and benefits of immunotherapy – Click Here
- Side effects of immunotherapy – Click Here
Rasayu Cancer Clinic Rasayan Treatment Protocol – To know more please click here
Rasayu therapy is recommended for those :
1. Who voluntarily opted for this treatment as their first choice.
2. Who are disenchanted with the past treatments.
3. Who do not see.any other options of treatments.
4. Who are looking for personalized treatment plan.
5. Who desire a convenient home-based oral therapy which is easy for consumption.
6. Who are susceptible to acquire hospital borne infections/ complications, hence not willing to be hospitalised.
7. Who are looking for favourable risk benefit ratio.
8. Who desire to improve Quality of Life benchmarks based on global standards and monitored regularly.
9. Who wants to be involved in decision making for choice of treatment.
10. Who are willing to be involved in monitoring the efficacy of Rasayana Therapy.
11. Who believe in the transparency of the process by conducting regular investigations by biochemical parameters/ hi tech imaging techniques like PET scan etc.
12. Who are looking for professionals being sensitive to the patient, the care givers and the family.
13. Who desire to take even with other treatments including Chemotherapy / Radiotherapy.
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