Treatment of cervical cancer has special steps not like any cancer nowadays, as it’s first and most important step is cervical cancer prevention , and then treatment of non- invasive cervical cancer which is called CIN treatment , and finally invasive cervical cancer treatment.
Follow up of these cases is not less important than treatment itself.
Cervical cancer prevention
There are multiple ways to prevent cervical cancer , the most important steps are screening by pap smear in all sexually active women and follow up that screening according to the new guide lines N.B : details n cervical cancer screening , also early detection and treatment of cervical infection with follow up of it can prevent cervical cancer , having protected sexual course also minimize the rate for sexual transmitted disease and so decrease risk for human papilloma virus infection , which is the main cause lead to cancer cervix .
Treatment of CIN( cervical intraepithial neoplasia , pre invasive cancer cervix)
According to the stages of that pre invasive cancer , the stage 1 only treated by treatment of cervical infection and then doing regularly follow up , stage 2 treated by ablation, ablation mean applying electricity(electrocautry), laser , cryocautry( applying cold steam ) to the affected part of cervix which in turn lead to complete destruction of that cervical part , that ablation is simple measure and can be done in outpatient clinic , But when the cervical lesion extend in higher cervix which make the ablation difficult to be done , in that matter conization is indicated , which mean that part of cervix will be removed , that operation is bloody and have several complication. Stage 3 treated according to the patient age , as in young ages, treatment like stage 2 , but in ld ages treatment is mainly total removal of female uterus.
Treatment of invasive cervical cancer
Treatment of invasive cervical cancer is mainly according to the staging of cancer as in
Stage 1a : when the cancer is micro invasive and can not seen except by microscope , in that case surgery is indicated and the surgery method is to remove the uterus by opening the abdomen as that operation allow the surgeon to asses if there any spread to the lymph node .
Stage 1b,2: Stage 1b mean that the cancer is still confined to cervix , but has bigger size , and stage 2 mean that the cancer start to spread locally to vagina and pelvis wall , the treatment in these stages are surgery or radiotherapy , the choice between one of them one of them is contraindicated or non available , in surgery ,there are removal of uterus , tubes and ovaries , upper one forth of the vagina and cervical lymph node and lastly cervical ligament called parametrium , that operation is one of major one and has several complication and contraindications. Radiotherapy in that stage has two types external radiotherapy in which the female patient take about 4000-5000 rad to control cancer from the skin , other type is internal radiotherapy ,in that type radiating material called radium inserted inside female cervix and it used mainly to control disease in cervix , however radiotherapy seem to be more simple than surgery it has several contraindication , such as pelvic infection , in some cases in radio resistant tumors , also in pregnant women and also in cases of decreased white blood cells, prolapse and in recurrent cases , in these cases surgery is highly indicated. Some schools prefer to do both radiotherapy plus surgery especially in cases of large lesions when the spread is unexpected.
Stage 3 : In that stage radiotherapy is the treatment f choice , by any way external radiotherapy or internal radiotherapy.
Stage 4 a : That is mainly depend on the patient general health , as in good general health surgery is indicated in which uterus , tubes , ovaries, vagina and pelvic lymph nodes are removed plus bladder or rectum or in some cases both are removed .
Stage 4b or in poor health status : In these cases chemotherapy may be indicated , and palliative radiotherapy , also analgesics are given t reduce pain , and finally blood transfusion is indicated in severe bleeding .
Follow up of cervical cancer treatment
Following up treatment is not less in importance than cervical cancer treatment , as if there is no follow up , recurrence can occur and the disease start it’ cycle again , follow up is done clinically be going to your physician and he take completed history from you asking you about the main cervical symptoms and then doing her cervical examination , also screening by pap smear is very important , also he may take biopsy from you if that indicated .