Cancer is a deadly disease but with early detection, deaths are preventable with appropriate treatment. If you are diagnosed with Cervical cancer, chances are that you still have a chance to fight this disease. Allow us to guide you through this journey with the best medical treatment and surgeons to save your life and enjoy this gift of life.
Cervical cancer is cancer which is in the lower part of the uterus (womb) that connects to the vagina. This happens when the cells of the cervix grow abnormally, invading the deeper tissues of the cervix and could spread to the vagina, rectum, bladder, liver, and lungs.
Cervical cancer is a slow growing process. This enables early detection of precancerous cells that could be diagnosed and treated. Women diagnosed with precancerous cervix are usually in their 20s – 30s while those that are diagnosed with Cervical cancer are on average in their 40s – 50s.
Girls who are sexually active before age 16 or within a year of the start of their menstrual period have a higher chance of developing Cervical cancer. Women aged between 21 – 29 should have cervical screening every 3 years while those between 30 – 65 years should have it every 5 years.
Causes of Cervical Cancer
- Human Papilloma Virus (HPV) – almost all Cervical cancer patients are those previously infected with HPV. HPV is a group of viruses that spreads through sexual contact, and other types of sexual contact like skin-to-skin contact of the genitals or using sex toys.Not all HPV types are cancerous, but some are high risk types. Since most HPV types do not cause any symptom, you may not be aware of your infection at all until a Screening is done.
- Precancerous Cervical Abnormalities – changes in the cells of the cervix start to show before any Cervical cancer is developed. These changes are cervical abnormalities called Cervical Intraepithelial Neoplasia (CIN) or Cervical Glandular Intraepithelial Neoplasia (CGIN) depending on which cells are affected.These precancerous abnormalities are not immediately life threatening but, could cause cancer if not detected and treated early.
- Other Risk Factors - some other factors are:
- Multiple sexual partners – numerous sexual partners from your side and your partner’s could increase a greater chance of acquiring HPV.
- Early sexual activity – having sexual activity at a young age increases chances of having HPV.
- Other sexually transmitted infections (STIs) – chlamydia, gonorrhoea, syphilis, HIV/AIDS also increase chances of HPV.
- A weak immune system – chances of Cervical cancer if you have a compromised immune system and have HPV.
- Smoking – women who smoke are twice as likely to acquire HPV possibly because of harmful chemical effect of tobacco on the cells of the cervix.
- Oral contraceptives – taking oral contraceptives for more than 5 years increases acquiring HPV although it still remains unclear.
- Having more than 5 children or having them at an early age (under 17 years).
- Taking the hormonal drug Diethylstilboestrol (DES)- while being pregnant risk the child of having HPV. Although this link is unclear, it may possibly be the hormonal drugs during pregnancy making the cervix more vulnerable to HPV.
Types of Cervical Cancer
There are two main types of Cervical cancer:
- Squamous Cell Carcinoma – this cancer begins in the thin, flat cells called Squamous cells that lines the outer part of the cervix. It projects into the vagina. This is the most common of Cervical cancer.
- Adenocarcinoma – cancer begins in the column-shaped glandular cells that lines the cervical canal.
Symptoms of Cervical Cancer
Symptoms are not obvious until at a later stage. Symptoms include:
- Unusual bleeding during or after an intercourse, between periods, or after menopause
- Discomfort or pain during an intercourse
- Vaginal discharge that is unusual and unpleasant
- Pain in the lower back or pelvis
Diagnosis and Tests
- Screening which involves PAP test or HPV DNA test
- If suspected with Cervical cancer
- Through examination by doctor by means of Colposcopic examination and obtaining biopsy through Punch biopsy or Endocervical curettage
- Other to obtain biopsy option include Electrical wire loop or Cone biopsy
- If diagnosed with Cervical cancer, Staging is done to determine the extent of your cancer. The tests include:
- Imaging tests – X-Ray, MRI, PET, and CT Scans
- Visual examination of your bladder and rectum
Types of Treatment
The treatment depends on the type of Cervical cancer you have, Stage, age and whether you want to have children in the future. The treatments available are:
- Cryosurgery – when the abnormal cells are found on the surface of the cervix, the surgeon may fill these abnormal cells with a gas called liquid nitrogen forming an “ice ball” causing the bad cells to die.
- Laser surgery – this also done for early Stage of cancer where the surgeon uses laser beams to burn the abnormal cells.
- Conization – this is recommended before chemotherapy or radiation and to those wishing to have children later. The surgeon uses the loop electrosurgical excision procedure or LEEP to remove a cone shaped piece of tissue from the cervix which will be examined and if cancer cells are found, chemotherapy or radiation will be suggested.
- Radiation – high powered energy beams like X-Ray or protons are used to kill the tumours. It may be used alone or with chemotherapy. Undergoing radiation therapy will leave you with an early menopause. You may ask your doctor how to preserve your eggs before treatment.
- Chemotherapy – medications are injected in the vein to kill the cancer tumours. Low doses may be combined with radiation while higher doses are used for advanced cancer stage.
- Hysterectomy – the surgeon removes your uterus and cervix and may leave your ovaries and fallopian tubes intact unless necessary depending on your condition.
- Radical hysterectomy – this is when the surgeon removes the uterus, a part of your vagina, lymph nodes and tissues nearby. The ovaries and fallopian tubes are not removed unless necessary.
- Trachelectomy – this is also recommended for those who still want to have children. The surgeon removes your cervix and the top part of your vagina, but leaving the uterus intact, placing a stitch or band where the cervix was. Lymph nodes nearby the cervix or uterus may also be removed.
- Pelvic Exenteration – this is a surgical means for those cancer cells that came back. The surgeon removes the cervix, uterus and surrounding lymph nodes and organs if the cancer has spread. If a part of your colon or bladder is removed, you may need to wear a colostrum.
- Physical examination of the uterus by your doctor.
- Screening and diagnostic tests to be done.
- Your doctor will find the extent/Stage of your cancer through tests.
- Your doctor will discuss the best treatment options for you.
- Inform your doctor of all your medical history, current medications taken along with any allergies.
- You will be asked to stop certain medications if taking any like blood thinners or herbal supplements.
- You will be asked to quit smoking as it affects the healing process.
- You will be asked to fast 8 – 12 hours before surgery.
- Any medications given should be taken with small sips of water.
- You will be given general anaesthesia, so you will be asleep and feel no pain.
- Depending on your condition, appropriate surgery will be done to you.
- Incisions may be done through the abdomen or vagina.
- The surgeon may do a laparoscopic surgery using surgical instruments and camera.
- The incisions are stitched, and dressing done.
- The operation may take about an hour or so depending on the complications.
- You may feel a temporary sore or discomfort and if necessary, pain medication will be administered.
- You may stay in the hospital for three to five days.
- Recovery takes about four to six weeks.
- If you are given a colostrum, you be acquainted with self-care.
- Follow up will be scheduled as suggested by your surgeon.
Risks and Complications
As with any surgery, it is not without risks. Some complications that could occur are:
- Blood clots
- Early menopause
- Narrowing of the vagina
Factors affecting the cost of Cervical Cancer
The cost of Cervical cancer treatment starts from US $1800. Cost price may vary depending on certain factors such as:
- Type and Stage of cancer
- Type of treatment
- Location of the hospital
- Choice of hospital
- Cost of diagnostic tests
- Surgeon’s fee
- Medical treatment
- Duration of hospital stay