CERVICAL CANCER (PART 2)

HEALTH TIPS-
Dr. Tariq Jagnarine
Fam Medicine

Cervical cancer affects the entrance to the womb. It may not cause any symptoms in the early stages, but symptoms may include pelvic pain, bleeding between periods, and vaginal discharge with a strong odour.

Diagnosis
A Pap smear test can help identify the early signs of cervical cancer. Early cervical cancer diagnosis improves the success rate of treatment. The ACS recommends the following as routine screening:
Under 25 years: The ACS does not recommend screening.
From 25–65 years: People should undergo an HPV test every five years for cervical cancer.
Over 65 years: The ACS does not recommend screening for those who have had adequate screening in the past, unless they have a high risk of cervical cancer.
People who have had a hysterectomy with removal of the cervix do not need screening, unless they have had precancerous lesions or cervical cancer in the past.
These are the overall screening recommendations, but a doctor can advise each person about her screening needs.

TREATMENT
Cervical cancer treatment options include surgery, radiotherapy, chemotherapy, or combinations of these. Deciding on the kind of treatment depends on several factors, such as the stage of the cancer as well as age and overall state of health.
Treatment for early-stage cervical cancer, when the cancer remains within the cervix, has a success rate. The further a cancer spreads from its original area, the lower the success rate tends to be.

Early-stage options
Surgery is a common treatment method when the cancer has not spread from the cervix. Radiation therapy may help after surgery, if a doctor believes that cancer cells might be present inside the body.
Radiation therapy may also reduce the risk of reoccurrence (cancer coming back). If the surgeon wants to shrink the tumour to make it easier to operate, the person may receive chemotherapy, although this is not a very common approach.
Treatment for advanced cervical cancer
When the cancer has spread beyond the cervix, surgery is not usually an option.
Doctors also refer to advanced cancer as invasive cancer, because it has invaded other areas of the body. This type of cancer requires more extensive treatment, which would typically involve either radiation therapy or a combination of radiation therapy and chemotherapy. In the later stages of cancer, healthcare professionals provide palliative therapy to relieve symptoms and improve quality of life.
Radiation therapy
Doctors commonly use radiation therapy to treat advanced forms of cervical cancer. Some doctors refer to radiation therapy as radiation oncology, or XRT. It involves the use of beams of high-energy X-rays or radiation to destroy cancer cells. When the treating doctor aims radiation at the pelvic area, it may cause the following side effects, some of which may not emerge until after the treatment is over:
Diarrhoea
Nausea
Upset stomach.
Bladder irritation
Narrowing of the
vagina
Interrupted
menstrual cycle.
Early menopause
Chemotherapy
Chemotherapy is the use of chemicals (medication) to treat any disease. In this context, it refers to the destruction of cancer cells. Doctors use chemotherapy to target cancer cells that surgery could not or did not remove, or to help the symptoms of people with advanced cancer. The side effects of chemotherapy can vary, and they depend on the specific drug. More common side effects include:
Diarrhoea
Nausea
Hair loss
Fatigue
Infertility
Early menopause
Cervical cancer clinical trials
Participating in a clinical trial may be the best treatment option for some people. Clinical trials are an integral part of the cancer research process. Researchers carry them out to determine the safety and effectiveness of new treatments, and whether they are better than existing ones. People who participate in clinical trials are contributing to cancer research and innovation.
Cervical smear test
The American Cancer Society (ACS) estimates that healthcare professionals will make over 13,000 new diagnosesTrusted Source of invasive cervical cancer in 2019. The disease will be fatal in around 4,000 women. However, regular screening could prevent most of these deaths.
Screening does not detect cancer, but looks for abnormal changes in the cells of the cervix. Without treatment, some abnormal cells can eventually develop into cancer.

HPV DNA testing
This test determines whether the individual has any of the types of HPV most likely to cause cervical cancer. It involves collecting cells from the cervix for lab testing. The test can detect high-risk HPV strains in cell DNA before any anomalies become clear in the cervical cells.
If there are signs and symptoms of cervical cancer, or if the Pap test reveals abnormal cells, a doctor may recommend additional tests.

These include:
Colposcopy: This is visual examination of the vagina using a speculum and a colposcope, a lighted magnifying instrument.
Examination under anesthesia (EUA): The doctor can examine the vagina and cervix more thoroughly.
Biopsy: The doctor takes a small section of tissue under general anesthesia.
Cone biopsy: The doctor takes a small, cone-shaped section of abnormal tissue from the cervix for examination.
LLETZ: Diathermy using a wire loop with an electric current helps remove abnormal tissue. The healthcare professional then sends the tissue to the lab for checking.
Blood tests: A blood cell count can help identify liver or kidney problems.
CT scan: A medical professional might use a barium liquid to show up any cellular abnormalities.
MRI: Special types of MRI may be able to identify cervical cancer in its early stages.
Pelvic ultrasound: High-frequency sound waves create an image of the target area on a monitor.
The stage at which a person receives a cervical cancer diagnosis can help indicate their chances of survival for at least 5 more years.
Stage 1: In early stage 1, the chance of surviving at least 5 years is 93 percent, and in late stage 1, it is 80 percent.
Stage 2: In early stage 2, the rate is 63 percent, falling to 58 percent by the end of stage 2.
Stage 3: During this stage, the chances fall from 35 percent to 32 percent.
Stage 4: People with stage-4 cervical cancer have a 15 to 16 percent chance of surviving another 5 years.
These are average survival rates, and do not apply to everyone. In some cases, treatment is successful up to stage 4.