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Cervical Cancer Diagnosis Treatment

Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.

Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer.


Screening

Screening tests can help to detect cervical cancer and precancerous cells that may one day develop into cervical cancer. Most of the guidelines suggest starting screening for cervical cancer and precancerous changes at age of 21.

Screening Tests Include:

Pap Test- During a Pap test, your doctor scrapes and brushes cells from your cervix, which are examined in a laboratory for abnormalities.

A Pap test can detect abnormal cells in the cervix, including cancer cells and cells that show changes that increase the risk of cervical cancer.

HPV DNA Test- HPV DNA testing involves testing cells collected from the cervix for infection with any type of HPV most likely to cause cervical cancer. 

Discuss your cervical cancer screening options with your doctor.


Diagnosis

If cervical cancer is suspected, your doctor will likely start with a thorough examination of your cervix. A special magnifying instrument (colposcope) is used to check for abnormal cells.

During the colposcopic exam, your doctor is likely to take a sample of cervical cells (biopsy) for laboratory testing. To obtain tissue, your doctor may use:




Punch Biopsy

Which involves using a sharp tool to pinch off small samples of cervical tissue.

Endocervical curettage, 

which uses a small, spoon-shaped instrument (curet) or a thin brush to scrape a tissue sample from the cervix.

If punch biopsy or endocervical treatment is worrisome, your doctor may perform one of the following tests:

Electrical Wire Loop 

Which uses a thin, low-voltage electrified wire to obtain a small tissue sample. Usually this is done in the office under local anesthesia.


Cone Biopsy (Conization) 

Which is a procedure that allows your doctor to obtain deeper layers of cervical cells for laboratory testing. A cone biopsy may be done in a hospital under general anesthesia.

Its a procedure that allows your doctor to obtain the deeper layers of cells of the cervix for laboratory testing. A cone biopsy can be done in a hospital under general anesthesia.


Staging

If your doctor determines that you have cervical cancer, you will have further tests to determine the extent (stage) of your cancer. The stage of your cancer is an important factor in deciding your treatment.

Staging Exams Include:

Imaging Tests- Tests such as X-rays, CT, MRI and positron emission tomography (PET) helps your doctor to  determine whether your cancer has spread beyond your cervix or not.

Visual Examination Of Your Bladder And Rectum- Your doctor may use a special scope to look inside your bladder and rectum.


Treatment

Treatment for cervical cancer depends on many factors, such as the stage of the cancer, other health problems you may have, and your preferences. Surgery, radiation, chemotherapy or a combination of all three may be used.


Surgery

Early stage of cervical cancer is usually treated with surgery. Operation is best for you will depend on the size of your cancer, its stage, and whether you are considering getting pregnant in the future.

Options Might Include:


Surgery To Cut Away The Cancer Only- For a very small cervical cancers, it may be possible to remove the cancer completely with a cone biopsy. This procedure involves cutting off a cone-shaped piece of cervical tissue, but leaving the rest of the cervix intact. This option may make it possible for you to consider becoming pregnant in the future.

Surgery To Remove The Cervix (Trachelectomy)- Early-stage cervical cancer might be treated with a radical trachelectomy procedure, which removes the cervix and some surrounding tissue. The uterus remains after this procedure, so it may be possible to become pregnant, if you choose.

Surgery To Remove The Cervix And Uterus (Hysterectomy)- Most early-stage cervical cancer is treated with a radical hysterectomy operation, which involves removal of the cervix, uterus, part of the vagina, and surrounding lymph nodes. A hysterectomy can treat early-stage cervical cancer and prevent recurrence. But removal of the uterus makes it impossible to get pregnant.


Minimally invasive hysterectomy, which involves making several small incisions in the abdomen instead of one large incision, may be an option for early-stage cervical cancer. People who undergo minimally invasive surgery recover more quickly and spend less time in the hospital. But some research has found that minimally invasive hysterectomy may be less effective than traditional hysterectomy. If you are considering minimally invasive surgery, discuss the benefits and risks of this approach with your surgeon.


Radiation

Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer cells. Radiation therapy is often combined with chemotherapy as the primary treatment for locally advanced cervical cancer. It may also be used after surgery if there is an increased risk of the cancer coming back.


Radiation Therapy Can Be Given:

  • Externally, by directing a radiation beam at the affected area of the body (external beam radiation therapy)
  • Internally, by placing a device filled with radioactive material inside your vagina, usually for only a few minutes (brachytherapy)
  • Both externally and internally

If you haven't started menopause yet, radiation therapy might cause menopause. If you might want to consider becoming pregnant after radiation treatment, ask your doctor about ways to preserve your eggs before treatment starts.


Chemotherapy

Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. It can be given through a vein or can be taken as a pill. Sometimes both methods are used.

For locally advanced cervical cancer, low doses of chemotherapy are often combined with radiation therapy, as chemotherapy may enhance the effects of radiation. Higher doses of chemotherapy may be recommended to help control symptoms of very advanced cancers.



Targeted Therapy

Targeted drug treatments focus on specific vulnerabilities within cancer cells. By blocking these vulnerabilities, targeted drug treatments can cause cancer cells to die. Targeted drug therapy is usually combined with chemotherapy. It may be an option for advanced cervical cancer.


Immunotherapy

Immunotherapy is a drug treatment that helps your immune system fight cancer. Your body's disease-fighting immune system cannot attack the cancer because the cancer cells produce proteins that make them undetectable by the cells of the immune system. Immunotherapy works by interfering with that process. For cervical cancer, immunotherapy may be considered when the cancer is advanced and other treatments are not working.


Supportive (Palliative) Care

Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of serious illness. Palliative care specialists work with you, your family and your other doctors, to provide an extra layer of support that complements your ongoing care.

When palliative care is used in conjunction with all other appropriate treatments, people with cancer can feel better and live longer.

Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life of people living with cancer and their families. This form of care is offered curative or along with other treatments you may receive.

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