Know Your Cancer

Treatment for various stages of Cervical cancer

Cancer treatments are often complex, with different cancer patients showing positive results to different treatments. Best Cervical Cancer treatments involve using multidisciplinary teams, MDTs, to treat Cervical Cancer and adapt the treatment program for the cancer patient. Various treatment options are available at the best Cervical Cancer hospitals such as Chemotherapy or subjected therapies, Radiation therapy, Surgeries, Hormone therapy, Immunotherapy, and Bone marrow or stem-cell therapy. Staging is a measurement to know how far the cancer has spread. After conducting various cancer tests, Cervical Cancer stages are analyzed.

Stage 0:

Precancerous cells are present. Stage 0, also known as Carcinoma in situ, is treated by providing local ablative or by performing excisional measures such as: Cryosurgery: A type of Surgery that is performed by expert surgeons. Under this surgery, the abnormal tissues are destroyed by using extremely cold temperatures. It involves the usage of liquid nitrogen, carbon dioxide, and argon. Laser ablation: This is the process of removing abnormal cervical cells through laser therapy so that healthy cells can grow back in its place. The survival rate under stage 0 Cervical Cancer is 100%, as the cancerous cells can be treated at the initial stage. According to a study, more than 90% of the women survive for five years after stage 0 diagnosis.

Stage 1

In stage I, cancer cells are detected and can be found in the cervix only. Stage I is then divided into stages IA and IB, depending on the size of the tumor and the deepest point of invasion.

• STAGE IA: Under this stage, there are sub-categories known as IA1 and IA2, depending on the deepest point of tumor invasion.
• STAGE IA1: Small amounts of cancerous cells are seen with the help of a microscope. The deepest point of tumor invasion is 3 millimeters or less.
• STAGE IA2: The deepest point of invasion is more than 3 millimeters but less than 5 millimeters. This stage can be seen under a microscope in the tissues of the cervix.
• STAGE IB: STAGE IB is categorized into stages IB1, IB2, IB3, based on the size of the cancer cell and the deepest point of tumor invasion.
• STAGE IB1: Under this stage, the tumor cell is sized up to 2 centimeters or smaller, and the point of invasion is more than 5 millimeters.
• STAGE IB2: The cancerous tumor is larger than 2 centimeters but lesser than 4 centimeters.
• STAGE IB3: Under this stage, the tumor is seen under a microscope and is larger than 4 centimeters.

To eliminate such early Cervical Cancer signs, Hysterectomy is followed by a course of Radiotherapy to prevent the cancer from coming back. Two types of hysterectomies are designed to treat cervical cancer:

• Simple Hysterectomy: Some parts of the woman's reproductive system, namely the cervix, womb, ovaries, and fallopian tubes, are removed.
• Radical Hysterectomy: Preferred mode of treatment only when the cancer reaches stage 1 or an early stage 2 Cervical Cancer. The cervix, womb, top of the vagina, surrounding tissues, lymph nodes, fallopian tubes, and if advised, ovaries are all removed. For women who are in Stage I of Cervical Cancer have 80-90% chances of survival given the treatment options are performed.

Stage 2:

Under STAGE II, the cancerous cells have reached the upper twothirds of the vagina and across the tissue around the uterus. STAGE II is divided into STAGES IIA and IIB, depending on how far the tumor cells have spread:

• STAGE IIA: In this case, the cancer cells have spread from the cervix to the upper two-thirds of the vagina but have not reached the tissues around the uterus. STAGE IIA is categorized into STAGES IIA1 and IIA2, based on the size of the tumor.
• Under STAGE IIA1: The cancerous tumor is 4 centimeters or smaller
• Under STAGE IIA2: The tumor is larger than 4 centimeters.
• STAGE IIB: The cancer has escalated from the cervix to the tissue surrounding the uterus.

Radiotherapy can be used with another form of Surgery for the elimination of Cervical Cancer at Stage 2. Radiotherapy can be delivered either:

• Externally: A machine with high-radiative energy is used to beam waves into the pelvis to remove cancerous cells.
• Internally: In such cases, a radioactive implant is planted beside the tumor inside the vagina. This treatment is known as Brachytherapy, which aims to lessen the harm to the surrounding tissue by administering the radiation closer to the tumor.
Chemotherapy : This treatment option involves using either a single Chemotherapy drug or a merger of different medical drugs to destroy the cancer cells. This treatment is used to slow the progression of cancer cells and relieve its symptoms. Chemotherapy is given directly into the vein using a drip.

According to a recent study, approximately 60% of Cervical Cancer patients survived after 5 years from their Radiation therapy. However, along with chemotherapy, survival chances are improved.

Stage 3:

In the section of STAGE III, the cancer has spread to the lower third of the vagina and/or to the pelvic wall and/or has caused kidney issues. STAGE III is categorized into STAGES IIIA, IIIB, and IIIC, depending on how far the cancer has spread.

• STAGE IIIA: The tumor has spread to the lower section of the vagina but not to the pelvic wall
• STAGE IIIB: Cancer has crossed the pelvic wall, and/or the tumor has grown enough to block one or both the ureters or has caused any of the kidneys to function abnormally.
• STAGE IIIC: STAGE IIIC is divided into further two stages; IIIC1 and IIIC2, depending on the increased rate of cancer cells to the lymph nodes:
• STAGE IIIC1: Cancer has advanced to the lymph nodes in the pelvis.
• STAGE IIIC2: Cancer has now reached to the lymph nodes in the abdomen near the aorta. Trachelectomy: When Cervical Cancer is identified at the stage III, then this treatment is best suited for the cancer patient. During this procedure, the cervix and the upper section of the vagina are removed. The womb sits at its original place and will be reattached to the lower section of the vagina. Also, it is advised to wait for a period of 6 to 12 months to conceive as the womb and vagina needs time to heal.

Cervical Cancer patients with stage III experience a 5-year survival rate of 63%. The chances of the cancerous cells hitting back are reduced to 42% by providing best-in-class treatment.

Stage 4:

• Under STAGE IV, the tumor has spread beyond the pelvis or has spread nearby to the lining wall of the bladder or rectum, or has extended to the other tissues of the body. STAGE IV is divided into further two stages IVA and IVB:
• STAGE IVA: The cancer has developed in the nearby organs such as the bladder or rectum.
• STAGE IVB: Cancer has passed on to the other parts of the body like the liver, lungs, bones, or distant lymph nodes.
• Large Loop Excision of the Transformation Zone (LLETZ): Under this cancer treatment, the cancerous cells are removed by using a fine wire with an electric current. This treatment is done by giving local anesthetic and can be performed at the same time as a colposcopy.
• Cone Biopsy: During this surgery, surgeons remove a cone-shaped area of the abnormal tissue. This is usually performed under general anesthetic.
• Pelvic Exenteration: This Cancer Treatment option is usually recommended when Cervical Cancer hits back after its first treatment and diagnosis. This Surgery is performed if the cancer returns to the pelvis but has not started to spread beyond that area. A pelvic exenteration has two phases:
• The cancerous cells, along with the vagina, are removed. In some cases, it might involve removing the bladder, rectum, or lower section of the bowel.
• Stoma holes are created in the tummy, which allows passage of stool and pee out of the body into pouches known as colostomy bags.
• Stage IV Cervical Cancer patients have a survival rate of 57%, based on the treatment options mentioned above. The patients who are diagnosed in stage IV and decide not to continue with the treatments mentioned above have a lifespan of 6 months to a year.