CERVICAL cancer usually takes a long time to appear, i.e. it has a pre-cancerous phase. As the risk factors of cervical cancer are known, measures can be taken to prevent the development of the condition, among them:
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The vaccines are reported to be generally well tolerated. However, the cost of the vaccines may limit widespread usage.
Treatment of cervical pre-cancer
The treatment depends on factors like the degree of abnormality, whether any more children are contemplated, age of the patient and her general health, and the preferences of the patient and her doctor.
A low-grade abnormality may not require further treatment, particularly if the abnormal area has been completely removed during the biopsy. However, regular pelvic examinations and Pap smears will be advised.
Cervical pre-cancer treatment methods include burning (diathermy), freezing (cryosurgery) or laser surgery. These methods destroy the abnormal area without harming adjacent healthy tissue. The abnormal tissue can also be removed by conisation or loop electrosurgical excision procedure.
If the abnormal areas extend up into the endocervical canal, conisation (cone biopsy) is done. Conisation may also be used as treatment for cervical pre-cancer if the entire abnormal area can be removed. The treatment may cause cramps, lower abdominal pain, bleeding or a watery discharge.
Sometimes, surgical removal of the whole uterus including the cervix (hysterectomy) is used to treat cervical pre-cancer, especially if no more children are contemplated and/or the abnormal cells are found inside the cervical canal.
Treatment of cervical cancer
In most instances, the treatment involves surgery and/or radiotherapy. Sometimes, chemotherapy and biological therapy is used. The choice of treatment depends on the site and size of the cancer, the stage of the condition, the age and general health of the patient and other factors.
Surgery involves the removal of the cancerous areas in or near the cervix. If the cancer is confined to the surface of the cervix only, the treatment methods used are similar to that used to treat cervical pre-cancer.
If the cancer has invaded deeper areas of the cervix but has not spread beyond it, the whole uterus – including the cervix, and sometimes, the ovaries and fallopian tubes – is removed. The lymph nodes near the uterus are removed, too. Sometimes, a hysterectomy may be the patient’s choice, especially if no more children are planned.
There may be pain, nausea, vomiting and problems passing urine or opening the bowels immediately after the operation. Normal activities, including sexual intercourse, can usually be resumed in four to eight weeks. There will be no more periods and pregnancy will not be possible.
Radiotherapy involves external or internal radiation, or both.
The side effects include tiredness; loss of hair; red, dry, tender and itchy skin in the treated area; diarrhoea; frequent passing of urine and urgency; discomfort or even pain during sexual intercourse.
Chemotherapy is sometimes used with surgery and/or radiotherapy. Medicines are used, with varying side effects depending on type of medicine and doses given. The side effects include loss of hair, nausea, vomiting, diarrhoea, mouth sores, poor appetite, and an increased likelihood of infections, bruising and bleeding.
Follow-up
Regular follow-up with pelvic examinations, Pap smears and other laboratory or imaging tests are essential for those who have been treated for cervical pre-cancer or cervical cancer. If any problems arise or you have any concerns before the follow-up appointment, you should contact your doctor and bring forward the appointment.
Conclusion
Cervical cancer has a pre-cancer phase which can last about 10 years. By dealing with the risk factors, it is possible to not only prevent but also reduce the incidence of the condition.
Dr Milton Lum is Chairperson of the Commonwealth Medical Trust. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organisation the writer is associated with.
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