Types of Cervical Cancer Treatment

Human Papillomavirus (HPV) and Cervical cancer:

The majority of cervical cancer (over 95%) is because of human papillomavirus (HPV), which is the most common sexually transmitted infection (STI). Most sexually active females and males will be infected at a certain point in their lives, and a few may be repeatedly infected. Over 90% of the infected individuals eventually clear the infection.

Cervical cancer is one of the most common HPV-related diseases. Almost all cases of this cancer can be attributed to HPV infection.

Even though most human papillomavirus infections clear up on their own and most pre-cancerous lesions resolve spontaneously, there is a probability for all women that HPV infection may become a bit chronic and pre-cancerous lesions progress to invasive cervical cancer.

It typically takes around 15 years to 20 years for cervical cancer to occur in women with healthy immune (defense) systems. It can take 5 years to 10 years in immunocompromised women, such as all those with untreated HIV infection.

Possible Treatment Options:

Cervical cancer can be treated with the help of surgery, radiation therapy, and/or chemotherapy. On behalf of a number of factors, the team of health specialists may recommend using a combination of treatments to treat cancer.

Surgery: Surgery is the preferred treatment option for small, visible cervical tumors. Patients will usually only have this surgery in case their tumor is smaller than 3cm.

A radical hysterectomy removes the cervix and its nearby parametrium, womb, top of the vagina, lymph nodes, fallopian tubes, and sometimes the ovaries. The pelvic lymph nodes are also eliminated. 

There is a possibility to retain the uterus in a few patients and preserve radical trachelectomy but this is only appropriate in those with small tumors, after discussion by the MDT and after counseling of the patient. 

Chemotherapy & Radiotherapy (Chemoradiation):

Patients are most likely to be treated with chemotherapy and radiotherapy (chemoradiation) if their cervical cancer is between Stage 1B3 up to Stage 4A. This might also be given if patients have had surgery and cancerous cells were detected in the lymph nodes not far from the cervix.

The most commonly used chemotherapy is Cisplatin. It may be given before the radiotherapy starts and continue to be given during the radiotherapy treatment. Chemotherapy is typically given once weekly throughout a 5-week radiotherapy course. Or a patient may have chemotherapy every 2 or 3 weeks. It depends on the chemotherapy medicines that they have.

Radiotherapy is given by a health specialist in a couple of ways:

External beam radiotherapy: The radiation mainly comes from the machines which aim rays directly at the tumor or the tumor site. The machines are known as linear accelerators.

Internal radiotherapy (brachytherapy): The radiation source is typically placed inside the body; usually inside the vagina; in specific applicators on or near the tumor.

This treatment is typically combined with external and internal (brachytherapy) treatments. With this, patients have daily external radiotherapy for five days every week, for around five weeks. Respective patients also have a boost of internal radiotherapy (brachytherapy) at the last stage of their course.

Targeted Therapies: 

Targeted cancer medicines change the way that cells act and help in order to control the growth of cancer. It helps certain women with advanced cervical cancer that has come back after the last therapy. These treatments may help to control the disease for a while and help some individuals to live a bit longer.

Bevacizumab (Avastin): The medicine Bevacizumab targets a cancerous cell protein known as VEGF. This protein assists cancers to grow blood vessels, so they can grab food as well as oxygen from the blood. All cancers require a blood supply to be able to sustain and grow.

The drug Bevacizumab inhibits this protein and stops cancer from growing blood vessels, so it is starved and can’t grow. Treatments that typically interfere with the occurrence of a blood supply are Known as anti-angiogenesis treatments.

Immunotherapy: Immunotherapy typically is a form of cancer treatment that uses the intensity of the immune system to prevent, manage, and eliminate cancer. Checkpoint inhibitors are a kind of precision cancer immunotherapy that helps to restore the immune (defense) system to fight cancer by liberating checkpoints that cancer considers to shut down the immune system. 

PD-1 & PD-L1 are a kind of proteins that block certain types of immune responses, enabling cancer cells to evade detection and attack by certain immune cells. A checkpoint inhibitor can inhibit the PD-1 and PD-L1 pathways and increase the potential of the defense system to fight cancer. This kind of treatment is useful in several cancers but is woefully not suitable for every patient.

Reference:

www.menopausematters.co.uk

https://www.cdc.gov/cancer/cervical/basic_info/index.htm

https://www.uicc.org/what-we-do/thematic-areas-work/cervical-cancer-elimination?gclid=Cj0KCQiAq5meBhCyARIsAJrtdr4nSwktOn580Ld8WeoWD2Px1o5affR6xg_WBUwWwDymr4ZkItUzI-kaArBTEALw_wcB