Cervical cancer - Part 2

Treatment

Treatment of cervical cancer depends on tumor stage, tumor size, comorbidities and patient preference. Cervical cancer is treated using radiation, chemotherapy and surgery in isolation or combination depending upon the requirement. 

Surgery: Treatment of early-stage cervical cancer usually commences with surgery. However, the type of surgery depends on tumor size and location.

1. Surgery for cancer removal: This is a fairly simple procedure in which a part of the cervix containing the tumor is removed leaving most of the cervix intact, which improves the possibility of future pregnancy.
2. Trachelectomy or removal of the cervix: This surgical procedure removes only the cervix keeping the uterus intact, thereby improving chances of future pregnancy. 
3. Hysterectomy or removal of cervix and vagina: This is a more exhaustive surgical procedure to treat early-stage cervical cancer. A radial surgery is performed to remove the cervix, uterus, parts of the vagina and associated lymph nodes. Although this extensive surgery reduces the risk of cancer recurrence by many folds, becoming pregnant isn’t an option. 

Radiation Therapy: In radiation therapy, high intensity radiation beams are used to kill the cancer cells preventing them from spreading further. Radiation can be applied externally by directing a beam on the external surfaces, internally by placing a radiation generating instrument in the vagina for a few minutes, or by combining both internal and external radiation. 

Chemotherapy: The other most commonly used treatment method is Chemotherapy, where a drug is given intravenously or orally using pills. It uses different types of drugs like Monoclonal Antibodies, Small Molecules like Tyrosine Kinase Inhibitors, Antibody Drug Conjugates known as targeted therapy and Taxols and platins that encompass the non-targeted chemotherapy.

For early-stage cancer, a combination of chemotherapy with radiation therapy is the usual course of action. If the patients receive chemo and radiation before surgery, it is called Neo-Adjuvant, but after surgery, it is called Adjuvant therapy. 

Immunotherapy: Immunotherapy is a newly emerging method of treating cancer including cervical cancer. In this strategy, the body’s immune cells are primed to attack the cancer cell and kill them. However, immunotherapy is still in its preliminary stages of development and this method is employed only when the disease has advanced or as a last resort. 

Despite the fact that there has been massive progress in the field of cervical cancer treatment, some diseases are incurable with a terminal diagnosis. Although it is a stressful diagnosis, having an open conversation with your caregivers and family members is key to handling such challenging situations. Hospice care and Palliative Care are usually offered to women with a terminal diagnosis. 

In our next and final article, we will talk about all the steps that can be taken to reduce the chances of developing cervical cancer.