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Cervical cancer, often referred to as cancer of the uterine cervix, affects the lower part of the uterus, extending slightly into the upper part of the vagina. The condition starts to develop when the cells on the cervix’ surface get infected with Human Papillomavirus (HPV) and start growing abnormally, resulting in a cervical tumour. In India, cervical cancer holds the unfortunate distinction of being the most common cancer among women and ranks as the second most frequent worldwide. Each year, approximately 1.3 lakh new cases of cervical cancer are diagnosed in India, resulting in the tragic loss of around 74,000 lives.
Cervical cancer, often referred to as cancer of the uterine cervix, affects the lower part of the uterus, extending slightly into the upper part of the vagina. The condition starts to develop when the cells on the cervix’ surface get infected with Human Papillomavirus (HPV) and start growing abnormally, resulting in a cervical tumour. In India, cervical cancer holds the unfortunate distinction of being the most common cancer among women and ranks as the second most frequent worldwide. Each year, approximately 1.3 lakh new cases of cervical cancer are diagnosed in India, resulting in the tragic loss of around 74,000 lives.
There are two primary types of cervical cancer, requiring a tailored approach to treatment. The team of specialists at MAX Healthcare, one of India's best cervical cancer hospitals, has extensive experience in the staging, diagnosis, and treatment of both types of cervical cancer, which are:
There are also less common types of cervix cancer, known as adenosquamous, clear-cell, and small-cell carcinomas.
Cervical cancer often develops between the ages of 40 and 55. Symptoms usually do not appear until abnormal cervical cells become cancerous and invade the nearby tissues. A cervical tumour usually starts from one abnormal cell. The exact reason why a cell becomes cancerous is unclear. The initial 'pre-cancerous' abnormality of cervical cells is generally caused by a prior infection with the Human Papillomavirus (HPV).
Very early-stage cervical cancer may have no symptoms at all. This means going for regular cervical screenings is essential so that any cell changes can be picked up early. Some signs and symptoms of cervical cancer include:
Understanding the risk factors is important for cervical cancer prevention and early detection. While having one or more of these risk factors does not guarantee the development of the disease, it can increase the overall risk significantly.
Screening History: Regular cervical screening, including Pap smears (Pap tests or cervical cytology) and HPV testing, is crucial in reducing the risk of cervical cancer. Women who do not undergo routine screenings or neglect follow-ups on abnormal results face a higher risk of advanced cervical cancer.
HPV Infection: Cervical cancer is primarily caused by the human papillomavirus (HPV), making it the most significant risk factor. HPV types 16 and 18 are strongly associated with cervical cancer development. Risk factors related to HPV include having multiple sexual partners or engaging in early sexual activity, as HPV is a sexually transmitted infection.
Sexual History: A history of other sexually transmitted infections (STIs), such as chlamydia or gonorrhoea, can also increase the risk of cervical cancer.
Smoking: Women who smoke are at a higher risk of developing cervical cancer. Smoking can weaken the immune system's ability to combat HPV infections and contribute to the progression of cervical cell abnormalities.
HIV Infection: HIV weakens the immune system, making it more challenging to fight HPV infections, further increasing the risk of cervical cancer among individuals with HIV.
Birth Control Pills: Long-term use of certain birth control pills has been associated with a slightly increased risk of cervical cancer.
Multiple Children: Having multiple children can increase the risk of cervical cancer, possibly due to hormonal changes during pregnancy and childbirth that can affect the cervix. Regular screening remains crucial for early detection and prevention.
Weak Immune System: Conditions like HIV infection or immunosuppressive medications can weaken the immune system, making it harder for the body to clear HPV infections and increasing the risk of cervical cancer.
Family History: A family history of cervical cancer may slightly elevate the risk, suggesting a potential genetic predisposition.
At Max Institute of Cancer Care, testing for cervical cancer is an important way of detecting early changes in the cervix cells, so that treatment can be given to prevent cancer from developing. It involves taking a sample of cells from the cervix using a test known as liquid-based cytology. The age range for screening varies between the ages of 25-64.
If abnormal cells are found during the cervical screening test, to confirm the diagnosis, a colposcopy is advised. For this test, a speculum is gently put into the vagina so the cervix can be seen in detail using a magnifier (colposcope). During colposcopy, it is usual to take a small piece of tissue from the cervix (biopsy). The biopsy sample is then examined under a microscope for cancer cells.
This assessment is known as 'staging' of the cancer. Staging aims to find out:
Cervical cancer screening typically involves two primary tests: a Pap smear (Pap test) and, if indicated, an HPV test. These screenings play a crucial role in the early detection of cervical cancer, allowing for timely intervention and improved outcomes.
Preparation: To ensure accurate results, it's essential to schedule your cervical cancer screening when you're not menstruating. Additionally, for a few days before the test, avoiding douching, using tampons, or applying vaginal creams or medications is advisable.
Arrival: On the day of your screening, you'll visit your healthcare provider's office or a clinic. It's a routine procedure in a medical setting to ensure your comfort and safety. 3. Gown and Privacy: Upon arrival, you will be given a gown and asked to undress from the waist down. Rest assured, you'll be given privacy to change, ensuring your comfort throughout the process.
Positioning: You'll then be asked to lie on an examination table with your feet in stirrups. This position allows the healthcare provider better access to the cervix, ensuring a thorough examination.
Speculum Insertion: The next step involves the gentle insertion of a speculum into the vagina. This instrument widens the vaginal canal, allowing the healthcare provider to visualise the cervix clearly.
Pap Smear: Using a small brush or spatula, the provider will collect a sample of cells from the surface of the cervix. While this may cause mild discomfort, it should not be painful. This sample is essential for the Pap smear, detecting abnormal cervical cells.
HPV Test (if indicated): In some cases, an HPV test can be performed simultaneously with the Pap smear. A swab is used to collect a sample of cervical cells to check for the human papillomavirus (HPV), a common cause of cervical cancer.
Speculum Removal and Conclusion: Following the collection of samples, the speculum is gently removed, and you can proceed to get dressed. The procedure is generally quick and straightforward.
Results: Your collected samples will be analysed in a laboratory. Typically, it takes a few weeks to receive your results. You can receive them via phone or a letter from your healthcare provider.
Follow-up: Depending on your results, your healthcare provider will discuss the next steps with you. This may involve further testing, such as a colposcopy, or recommendations for regular screening intervals to monitor your cervical health.
When it comes to cervical cancer,Max Institute of Cancer Care believes in the philosophy of providing holistic, integrated care. This includes a consolidated review of each and every case from experts in surgical oncology, radiation oncology, and other concerned specialities depending on the need. The cases are discussed in the Tumour Board. Based on international evidence-based guidelines, a plan of action is formulated. The options of management offered are surgery, radiotherapy, chemotherapy, or a combination of all the above modalities. The treatment depends on the clinical staging of cervical cancer. When the cancer is confined to the cervix, a cervical cancer surgeon may prescribe surgery to remove the cancer.
Primary prevention: HPV vaccines have the potential to prevent cervical cancer. Routine vaccination with proper counselling is recommended for females aged 11 to 26. Please consult your gynaecologist and understand the risks and benefits.
Secondary Prevention: By diagnosing and optimally treating the precancerous conditions of cervical cancer.
Cervical cancer staging is crucial for understanding the extent of the disease and guiding treatment decisions. The International Federation of Gynecology and Obstetrics (FIGO) staging system is commonly used. It categorises cervical cancer into various stages:
At this stage, cancer is confined to the surface of the cervix and has not invaded deeper tissues. It's often referred to as "in situ" cancer or pre-cancer.
Cancer is limited to the cervix, with two sub-stages:
Cancer has spread beyond the cervix but has not reached the pelvic sidewall or the lower third of the vagina. Stage II is further divided into:
Cancer has extended to the pelvic sidewall, the lower third of the vagina, or has led to kidney problems (hydronephrosis). It is categorised into:
Cancer has advanced to nearby organs outside the pelvis, such as the bladder or rectum, or distant organs like the lungs or liver. Stage IV is divided into:
These stages help cervical care surgeons determine the appropriate treatment plan for individuals diagnosed with cervical cancer. Understanding the stage of the disease is vital in providing the best possible care and outcomes for patients.
Depending on the cancer stage, patients are grouped into early and locally advanced cancer types. In the early stages, patients are treated with cervical cancer surgery, followed byradiation if required. In Locally advanced cervical cancer, patients are treated by chemotherapy and radiotherapy. Most cervical cancers are curable and preventable with hopes of a cure. Cervical cancer medical procedureoptions include the following:
The cervical cancer treatment cost depends on the type of procedure required for the patient and it varies patient to patient.
A cervical cancer vaccine, such as the HPV vaccine, plays a pivotal role in safeguarding against infections caused by high-risk strains of the human papillomavirus (HPV), the primary cause of cervical cancer. This vaccine prompts the immune system to generate antibodies targeted at specific HPV types, thus thwarting the virus from inducing changes in cervical cells that can ultimately lead to cancer. Remarkably effective, the vaccine is strongly recommended for adolescents and young adults prior to their initiation of sexual activity, and it is administered through a series of shots.
Max Institute of Cancer Care (MICC) at Max Hospitals, India, is one of the leading facilities in India, which offers the latest treatments under surgical oncology, radiation oncology, and medical oncology. It is one of the largest cancer centres in North India, with presence in Saket, Patparganj, Shalimar Bagh, Vaishali, Mohali and Bathinda. It offers high-end treatments like Intensity Modulated Radiotherapy (IMRT) and Image-Guided Radiation Therapy (IGRT) with facilities like Cone-beam Computerised Tomography (CBCT) and ExacTrac.
Max Institute of Cancer Care offers comprehensive cervical cancer treatment and care, which is delivered by trained/certified surgical oncologists, radiation oncologists and medical oncologists with a complete backup of requisite speciality services. Skilled professionals on the multidisciplinary team include genetic counsellors, medical geneticists, medical oncologists, nurse navigators, nurse practitioners, pathologists, plastic and reconstructive surgeons, radiation oncologists, radiologists, Social workers, surgical gynaecologists, and surgical oncologists.
When it comes to cervical cancer, we have a team of experienced cervical cancer doctors specialising in cervical cancer surgery and different types of treatment options available for the condition.
A: Cervical cancer is indeed curable, especially when detected early through routine screenings. The key to successful treatment is catching it at its earliest stages, which provides a broader range of effective treatment options and significantly enhances the chances of a favourable outcome for the patient.
A: Early signs of cervical cancer include abnormal bleeding, pelvic pain, unusual discharge, and pain during intercourse. Recognizing these signs early and promptly seeking medical advice can significantly affect diagnosis and treatment.
A: Treatment for Stage 3 cervical cancer often involves a combination of surgery, radiation, and chemotherapy.
A: Gynecologic oncologists typically treat cervical cancer. These specialised doctors have expertise in treating gynaecological cancers. They are well-equipped to provide comprehensive care for cervical cancer patients.
A: Cervical cancer screening is generally safe, but there can be rare complications like false positives or negatives.
A: Cervical cancer is a prevalent form of cancer around the world, with its frequency varying among different regions and age groups.
A: Yes, cervical cancer can be prevented through two primary measures: HPV vaccination and regular screenings. These interventions are crucial in detecting and managing the risk of developing cervical cancer.
A: Cervical cancer screening is generally safe, but it's essential to be aware of the possibility of rare complications, such as false positives (incorrectly indicating cancer when it's not present) or false negatives (missing signs of cancer when it is present). Understanding these terms can help individuals make informed decisions about their health.
A: The five warning signs of cervical cancer that should not be ignored are bleeding between periods, pelvic pain, unusual discharge, pain during sexual intercourse, and swollen legs. If you experience any of these symptoms, it is essential to consult a healthcare professional promptly for a thorough assessment.
A: You have several excellent options when seeking cervical cancer treatment in India. One of the recognised hospitals known for its expertise in cancer care is Max Healthcare. However, many other prestigious institutions in India also excel in cervical cancer treatment. It's advisable to research and consult with healthcare professionals to determine the best-suited hospital for your specific needs.
A: Max Healthcare Hospital is indeed globally renowned for its healthcare services. When it comes to cervical cancer treatment, you can trust that every Cervical cancer specialist at Max Healthcare possesses the necessary skills and expertise to provide top-notch care.
The cost of cervical cancer treatment varies depending on the type of procedure required for the patient, which is decided after a thorough assessment of the case, patient’s history, and other dynamics at play.
Reviewed By Dr. Alka Dahiya, Associate Consultant - Cancer Care / Oncology, Surgical Oncology, Gynecologic Oncology, Robotic Surgery, Breast Cancer on 20 May 2024.
Max Healthcare is home to 5000 eminent doctors in the world, most of whom are pioneers in their respective fields. Additionally, they are renowned for developing innovative and revolutionary clinical procedures.
Max Healthcare is home to 5000 eminent doctors in the world, most of whom are pioneers in their respective fields. Additionally, they are renowned for developing innovative and revolutionary clinical procedures.
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