The cervix is the lower, narrow end of the uterus that leads to the vagina or birth canal. Like many organs in the body, the cervix can develop cancer. Cervical cancer usually develops very slowly over time. Before cancer appears in the cervix, dysphasia happens. Dysphasia is where the cells of the cervix go through changes and the cells that are not normal appear in the cervical tissue. When this happens, cancer starts to spread around the cervix and to other surrounding areas. Since the cervix is an important organ in the female body, it is important for us to know what are the options available on cervical cancer treatment.
Cervical cancer is often treated by a hysterectomy where the entire uterus and part of the vagina is removed surgically. If the cancer in the cervix is at an advanced stages, lymph nodes may also need to be removed. However, since many patients want to remain fertile, other more gentle cervical cancer treatment methods need to be considered. One of such gentle treatment is the loop electrosurgical excision procedure or LEEP.
There are many advantages to a LEEP, which include low cost, a high success rate, ease of use and often only requires the use of a local anesthetic. Another such surgical procedure is the cone biopsy. In a cone biopsy, only a cone shapes sample is removed from the mucous membrane. Radiation therapy is given as external beam radiotherapy to the pelvis and internally as brachytherapy. However if the cone biopsy does not produce much positive results, there is another procedure called a trachelectomy. With a trachelectomy, the doctors will try to remove only the cancer while keeping the uterus and ovaries intact. This treatment option is particularly ideal in condition whereby the cervical cancer has not spread to other areas inside the uterus. The limitation with this treatment method is that there are only a few specialists available who are qualified and skilled enough to perform this delicate procedure. Radiation therapy is another treatment option. Radiation therapy is administered as external beam radiotherapy to the pelvis and internally as brachytherapy. However, when dealing with cervical cancer, the biggest issue besides survival is the ability to have children in the future.
It is important to explore all the treatment options available for cervical cancer and to discuss with your doctor, friends, family and husband on the best cancer treatment for you. Do get a second expert’s opinion before proceeding with any cervical cancer treatment involving surgery.
Commonly known as a slow-growing cancer; cervical cancer develops in the tissues between the uterus and the vagina where it usually shows very few signs or symptoms of being there. It is only usually detected through a cervical smear (cervical tissue exam [Pap test]) which has been responsible for reducing the mortality rate of cervical cancer by around 70% since 1955.
Around 90% of all cervical cancer cases are due to the human papilloma virus (HPV) infection; although, it is commonly acknowledged that most women during their life-time will have the virus (having the virus does not mean that it will cause cancer). Two types (strains) of human papilloma virus: 16 and 18 are responsible for around 70% of diagnosed cases. Other factors that may provoke an infection, include: early sexual activity, multiple sexual partners, bearing more than two or three children, and smoking.
HPV is commonly prevalent in women between the ages of 18 – 59 years old; where it is estimated that around 25% of this age group will have HPV, and 15% of this age group will have a high-risk strain. Although this age range can be further narrowed down to the 20 – 24 year olds being at even more risk.
Studies show that the overall average age for a woman to be diagnosed with cervical cancer is 48 years old, with the possibility of developing the disease increasing as age goes on (up to 55 years old [48 – 55 years]). The risks begin to reduce significantly after the age of 55 years old (around 50% of cervical cancer cases are diagnosed in women between the ages of 35 – 54 years old, and 15% in women under the age of 35 years old).
The mortality rate due to cervical cancer is higher between the ages of 45 – 70 years old (black women at the age of 70 years old are 50% more likely to die from cervical cancer than white women of the same age). This is why screening for the disease is important, as between 60% – 80% of American women diagnosed with the disease have not usually been screened in the 5-year period prior to their diagnosis (some women have never been screened).
A HPV vaccine is now available (believed to be 100% effective against two strains of HPV responsible for 70% of diagnosed cases) that is usually aimed at both girls and women between the ages of 9 – 26 years old before sexual activity begins; although, sexual activity has usually begun many years before the age of 26 years old. Information regarding the HPV vaccine can be obtained from most local family health clinics.
The personal risk factors to being diagnosed with cervical cancer can vary between patients. However, there are certain general things that you need to know. Before any patient – doctor questioning starts, it is advisable for you to have another person (close friend or family member) at the questioning table with you to both help remember what was said, and to help think of any relevant questions that may come to light at the meeting.
General questions to be considered while speaking with your doctor:
Cervical Cancer Specifics
- What type of cervical cancer do I have?
- What stage is the cancer at?
- What does the stage mean to me?
- What caused the cancer in the first place?
My Risks Factors
- Am I at an increased risk to the disease? – (medical/family history)
- Should I do anything specific in my case? – (if applicable)
My Treatment Options
- Can my cancer be treated? – (successfully)
- What treatment options do I have? – (alternative, traditional, modern)
- Are the treatment options usually successful?
- When can I start my treatment?
- How should I prepare myself for the treatment?
- How long will my treatment last?
- Will there be any side-effects to the treatment?
- How will they affect my day-to-day activities? – (if applicable)
- Will I still be able to have sex? – (during and after treatment/when)
- Will I still be able to have children? – (after treatment)
- Do I have to take the treatment? – (is there another option?)
- What will happen if I decide not to be treated? – (if applicable)
- Once treatment has been completed – Is that it? – (do I have to come back?)
My Life-Style Changes
- What will change for me after my treatment?
- Will I have to eat a special diet? – (if so – how do I go about it?)
- Should I exercise? – (if so – what exercises/how often should I do them?)
- Can I still drink alcohol?
- Can I still smoke? – (“think about giving-up”)
- Will sexual activity be the same as it was before?
My Future Outlook
- Will my cancer come-back one day?
- What is my prognosis? – (life-expectancy)
- Will I be able to live a normal life again?
- Write down any previously thought of questions.
- Write down the answers received for later revision.
- Make sure any answers are thoroughly understood – (if not ask the doctor to re-explain).
- Do not be afraid to ask a question, however un-important it may seem to you.