Treatment of Cervical Cancer

Risk factors

As with many other malignant neoplasms, the incidence of cervical cancer has a definite relationship with age. So, most often the tumor is found in women at the age of 35-55, while at a young age the disease is much less common. Besides, some other factors increase the risk for cervical cancer development. These include:

• Papillomavirus infection
• Long-term use of hormonal contraceptives (birth control pills)
• Cervical injury during childbirth
• Chronic genital infections
• Genetic predisposition
• Smoking
• Abortion or complex surgical interventions

The most significant among the listed provoking factors for cervical cancer development is the human papillomavirus (HPV) infection, which is capable of disrupting the health mechanisms of the body's antitumor defense at the cellular level. This pathogen is found in about 95% of patients with cervical cancer. In most cases, HPV infection is transmitted during a sexual contact. The list of factors that significantly increase the risk of developing the health condition also includes the premature onset of sexual activity and multiple sexual partners.

What are the symptoms?

The main symptoms and clinical manifestations of cervical cancer are bleeding, genital discharge (so-called leucorrhoea), and pain that appears already at an advanced stage.

Bloody vaginal discharge can be different, from bloody discharge appearing after sexual intercourse to profuse bleeding, accompanied by a decrease in hemoglobin levels. Such health conditions usually require emergency hospitalization.

Also, the symptoms include pain, which is usually localized in the lower abdomen but also observed in the lumbosacral region. Moreover, it’s typical for such symptoms to disturb at rest.

In addition to the listed symptoms, cervical cancer is characterized by involvement of the urinary system organs in the pathological process, which can lead to impaired urination, pain and burning sensation during urination, or other symptoms of functional impairment.

Surgery

Depending on the types and stages of tumor development, as well as the age, health condition, and reproductive plans of a woman, radical or organ-preserving intervention is conducted. Surgery for cervical cancer treatment is often combined with chemotherapy and radiation therapy.

Any acute or chronic infections must be eliminated before the intervention. Preliminary preparation of the gastrointestinal tract provides necessary conditions for performing extensive surgical intervention.

Organ-preserving surgery is suitable for patients with preinvasive cervical cancer, or for patients planning to spare their reproductive potential. In other cases, the uterus, appendages, adjacent tissues, regional lymph nodes are excised, which avoids relapse. Further, the patient requires comprehensive rehabilitation.

Hysterectomy (uterine resection) is physician-approved genital removal surgery for cervical cancer. Many of its modifications have been developed. Some of them involve the preservation of organs not affected by the disease. So, for example, a simple hysterectomy or type A hysterectomy involves the partial removal of tissue around the uterine. Type D hysterectomy involves the excision of tissue of the pelvic wall.

At the early stages of cervical cancer, organ-preserving surgeries like conization can also be performed. Conization of the cervix is the removal of part of the mucous membrane of the cervix. The uterus can be preserved during the intervention. Such types of surgery for cervical cancer will be prescribed only if the results of the biopsy show a low risk of metastasis of cervical cancer.

Radical trachelectomy (vaginal or abdominal) is a laparoscopic surgery, which allows sparing fertility.

Exenteration of the pelvis is a radical operation to remove the organs of the reproductive system. It’s carried out for cervical cancer of the advanced stages, when tumor growth outside the reproductive organs is detected. During the intervention, the affected bladder and rectum are excised.

The doctor must not only master the techniques of performing the operations, but also be able to manage any complications that may arise during the surgery. The doctor is supposed to have the skills of a vascular surgeon, urologist, and proctologist.

Radiotherapy

Radiotherapy is a leading method for cervical cancer treatment, specifically when cancer only starts to develop. With large neoplasms, the standard therapeutic protocol also includes radiotherapy.

To understand how the radiation therapy for cervical cancer treatment works, it’s important to understand the specifics of its two main types: external (remote) and internal ones.

External radiation therapy is performed remotely and usually has shorter radiation sessions. The whole course can be carried out on an outpatient basis. The stage, the volume of the neoplasm, and patient’s health condition determine the necessary radiation period.

In internal radiation therapy, the affected cervix and surrounding areas are irradiated more. Special applicators with a radiation source inside are inserted near the affected area. Applicator placement and radiation therapy itself differ in patients after hysterectomy and those with a preserved uterus.

As a rule, a course of internal high-dose therapy is prescribed for cervical cancer, with a patient being irradiated with high doses for about 15 minutes. Also, in some cases, low-dose radiotherapy is indicated, in which the patient is exposed to low doses of radiation for about 12-24 hours.

With a high risk of the disease recurrence, a course of postoperative radiation therapy is often prescribed. In such cases, radiation is usually combined with chemotherapy.

Chemotherapy

Chemotherapy is a high-tech method used to treat cancer. This is a modern technique used in many countries of the world. Treatment is based on the introduction of drugs into the body, which are antineoplastic chemotherapeutic agents. These are the substances that can damage cells that are dividing rapidly.

The goal of chemotherapy is to destroy these abnormal cells, inhibiting their division and growth. This is an effective therapy that reduces the risk of metastasizing to both distant and nearby organs. The disadvantage of this technique is that the agents affect the entire body, as a result of which immunity suffers significantly. Normalization of the health condition and the work of organs is achieved by inhibiting the development of a neoplasm of a malignant nature. After the introduction of drugs, a person's health condition deteriorates greatly. It takes time to restore the body's normal functioning.

The therapy is carried out on an inpatient basis or an outpatient basis. The drugs are produced in the form of tablets or solutions for injections. The duration of the course is selected on an individual basis. It depends on the stage of the disease, the general health condition of a patient, and the rate of recovery of the body.

In severe cases, therapy consists of few courses lasting several years. During the use of therapy in outpatient treatment, patients should undergo follow-up examinations and visit a doctor.

Typically, a course consists of few cycles. Doctors take a break between them, which can last as long as a week or a month. This is necessary so that healthy cells have time to recover. At the same time, the malignant elements will not recover after exposure to drugs.

Treatment for stage 4 cervical cancer

Oncological process of the advanced stage penetrates tissues actively. Therefore, treatment for stage 4 cervical cancer has to be somewhat aggressive. Treatment for stage 4 cervical cancer involves exenteration of pelvic organs. And in terms of surgical treatment for stage 4 cervical cancer, palliative treatment is applied too.

Radiotherapy is prescribed for treatment for stage 4 cervical cancer if contraindications to various types of surgical treatment are present.

The effectiveness of treatment for stage 4 cervical cancer is assessed according to the updated diagnostic information (follow-up examinations).

How to choose the best hospital for treatment abroad

Medical tourism is becoming increasingly popular today. But where to start to search for hospitals? We suggest deciding on the country first.

The most popular country for cervical cancer treatment abroad is currently Germany. Here’s why.

By German law, all hospitals undergo state certification.

Here, the most modern developments are introduced into the practice of hospitals. In German hospitals, cancer care is of high level. German hospitals are equipped with the latest and advanced technology.

In Germany, highly qualified doctors undergo training at leading medical institutions. This provides the country with doctors of the highest category. Doctors in German hospitals perform complex operations unavailable in hospitals in other countries.

Over 50 clinics among leading German hospitals offer cervical cancer treatments.

To get more information about the hospitals that offer the treatment of cervical cancer, visit the Booking Health website.

The price range for treatment abroad

The cost of treatment in hospitals differs. It is influenced by the state's pricing policy for medical services for foreign patients.

The cost of treatment depends on the disease’s rate of progression, the volume of interventions, the category of the healthcare facility, type of treatment (outpatient or inpatient), and the duration of inpatient stay:

• The price for chemotherapy is in the range of 8,190-30,230 EUR.
• The price for radiotherapy is in the same range of 8,190-30,230 EUR.
• The price for surgical resection is 6,125-24,900 EUR.

The average price of oncological rehabilitation after cervical cancer treatment is 1,280 EUR per day, the minimum price is 1,041 EUR per day, and the maximum price is 1,553 EUR per day. Visit the Booking Health website to see more information on the cost of treatment abroad.

Organizing treatment abroad: how does this work?

To start the treatment abroad you will need translated documents indicating the completion of the local treatment, if you underwent any, translated results of local diagnostics, or any related documents with medical information.

Further, you’ll need to select a hospital and a doctor. You will receive a treatment plan from the clinic and the approximate cost of treatment. And then organizational issues start.

However, there’s another option, i.e. using the services of a medical tourism agency. One of the most reputable medical tourism companies in the world is Booking Health. Unlike many other companies, Booking Health provides the cost of treatment guarantee.

With Booking Health, you don’t need to worry about the organization of treatment at all. Booking Health will assist you in all medical and related issues.

Besides, the efficacy of such an approach is proved by thousands of patients undergoing treatment abroad with Booking Health.

If you have any questions or concerns, please leave a request on the Booking Health website, and a medical advisor will provide you with the necessary information.

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

Sources:

National Cancer Institute

Cancer. Net

Healthline