cervical cancer treatment

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 .

Cervical cancer vaccine

Cancer CervixHuman papilloma virus (HPV) consider to be the main cause of cancer cervix ,  the cancer cervix vaccine developed mainly to  prevent  infection by human papilloma virus and it does not have any rule in prevention of cancer cervix nor prevention of other causes of cancer cervix.

Although cancer cervix vaccine developed to prevent HPV infection , it is only act against four strains of HPV which are HPV-16, HPV-11,HPV-6,and HPV-18 , as HPV-16,18 can result in cancer cervix by about 70% , and HPv-11,6 can result in about 90% of causing genital warts , which is predisposing finally to cancer cervix.

Gardasil is the first and the clinically approved vaccine , which is used now and the clinical trial say that is safe for females from age range 9 to 26 years old  , and that vaccine offer safety reaching up to 100% to both HPV 16-18 in females who does not exposed before to the virus , there are three doses of that vaccine , the first one start by a date your health provider prescribe to you and the next dose about one months from the first one and finally the last dose after 6 months from the second dose.

Gardasil vaccine does not show to have any effects in females who previously exposed to HPV , and it only used to prevent infection by HPV in females before they begin their sexual life , as after beginning sexual life there is no rule exclude that you do not expose to the virus,  and also it does not prevent cancer cervix and that mean taking the vaccine , does not exclude that you are not need for continous  cervical cancer screening .

Gardasil vaccine have side effects like fainting is the most common side effects and so any female should be seated about 15 minutes after she receive the vaccine , there are also other side effects like muscle pain after injection , headache and generalized malaise, but there is no serious side effects.

There are another type for HPV infection it is called Cervarix , which is currently developed in india , and it act only against HPV strains 16-18 and does not show to be effective against other strains , it has the Gardasil schedule which is zero dose , after one month , after six months , it also have minimal side effects like headache , muscle pain and fatigue , but cervarix is given to females from age range 10 – 45 years old.

Which is better Cervarix or Gardasil vaccine , this is the question , up to now there is no any clinical trials compared between both vaccine , and each one has effects and side effects.

But finally the vaccine make you safe against HPV infection which is the main cause that result in cancer cervix , and that is the point , the choice between them you have to consult your health provider to help you , to pick the most effective for you and remember each female is unique and females are not the same.

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