Cervical Cancer Treatment

As a surgical oncologist who has treated many women with cervical cancer, I understand how overwhelming this diagnosis can feel. My goal is to guide you through understanding this disease — from what cervical cancer is, its causes, how we detect it early, available treatments, and importantly, how to prevent it.

What Is Cervical Cancer?

Cervical cancer is a type of cancer that begins in the cervix, the lower, narrow end of your uterus that opens into the vagina. It develops when cells in the cervix start changing abnormally and grow uncontrollably, forming tumors.

These abnormal changes usually happen over many years and are caused mainly by infection with a virus called Human Papillomavirus (HPV). HPV spreads through intimate skin-to-skin contact, often during sexual activity.

There are many types of HPV, but only some “high-risk” types like HPV 16 and 18 cause cervical cancer. While HPV infection is very common and often clears on its own, persistent infection with these high-risk types can cause cervical cells to become precancerous and then cancerous over time.

Who Is at Risk of Cervical Cancer?

You may wonder, “Am I at risk?” Some factors increase the chance of developing cervical cancer:

• Persistent high-risk HPV infection: This is the most important cause.
   
• Smoking: Tobacco weakens your immune system and causes damage to cervical cells.
   
• Weakened immune system: Conditions such as HIV or immunosuppressive medications reduce your ability to fight HPV.
   
• Early sexual activity and multiple partners: These increase the chance of HPV infection.
   
• Long-term use of oral contraceptives: Using birth control pills for more than 5 years slightly raises risk.
   
• Lack of screening: Not getting regular Pap smears or HPV tests means precancerous changes may go unnoticed.
   
• Poor nutrition and low socioeconomic status: These can indirectly affect immune response and access to healthcare.

As Dr. Chirag Bhirud, oncological specialist in Pune, often emphasizes—knowing your risk factors is the first step toward prevention and early intervention. It empowers you to take timely, informed action for your health.

Understanding Cervical Cancer Stages

Cervical cancer is staged to understand how far it has grown or spread. This helps guide the right treatment plan and gives an idea of the prognosis. Here’s a breakdown of the stages:

Stage I: Cancer is limited to the cervix
At this early stage, the cancer is only present in the cervix (the lower part of the uterus). It hasn’t spread anywhere else. Many women diagnosed at this stage have excellent outcomes with timely treatment, which may include surgery or radiation.

Stage II: Cancer has spread beyond the cervix
In this stage, the cancer has extended beyond the cervix into nearby tissues like the upper part of the vagina or the surrounding tissues (called the parametria). However, it hasn’t reached the pelvic wall or the lower part of the vagina. Treatment may involve a combination of surgery, radiation, and chemotherapy depending on the exact size and spread.

Stage III: Cancer has reached the pelvic wall or lower vagina
Here, the cancer is more advanced. It may block the ureters (tubes connecting the kidneys to the bladder), which can cause kidney swelling or damage. Treatment typically includes radiation therapy and chemotherapy. Surgery is usually not an option at this stage.

Stage IV: Cancer has spread to other organs
This is the most advanced stage. The cancer may have spread to nearby organs like the bladder or rectum (Stage IVA), or to distant organs such as the lungs, liver, or bones (Stage IVB). Treatment focuses on controlling the disease, relieving symptoms, and improving quality of life — often with a combination of chemotherapy, targeted therapy, or palliative care.
 

Early Signs and Symptoms of Cervical Cancer

One challenge with cervical cancer is that early stages often cause no symptoms at all. This is why regular screening is so important.

When symptoms do appear, they may include:

1. Abnormal vaginal bleeding
This is the most common early warning sign. You might notice bleeding after sexual intercourse, spotting between your regular periods, or bleeding after menopause. Any bleeding outside of your normal cycle should be evaluated by a doctor promptly.

2. Unusual vaginal discharge
Changes in vaginal discharge, such as watery fluid, pink or brown spotting, or a foul smell, may indicate cervical abnormalities. While discharge can have many causes, persistent or unusual changes warrant a checkup.

3. Pelvic pain or pain during intercourse
Pain in the pelvic area or discomfort during sex often occurs when the cancer has grown beyond the cervix into surrounding tissues. This symptom should never be ignored and needs immediate medical attention.

4. Heavier or longer menstrual bleeding
Though less common, some women experience unusually heavy or prolonged menstrual bleeding. This can sometimes be a sign of cervical cancer or other gynecological conditions, so it’s important to discuss it with your healthcare provider.

If you notice any of these, do not delay seeing a doctor. Early diagnosis improves outcomes dramatically.

The Power of Screening: How to Detect Cervical Cancer Early?

Screening is the most effective way to detect precancerous changes before they become invasive cancer. Here are the main screening tests:

→ Pap Smear (Pap Test)

This is a simple test where cells are gently scraped from the cervix and examined under a microscope to look for abnormal changes. It’s painless and quick.

→ HPV DNA Test

This test detects whether you have high-risk HPV types in your cervix. It can identify risk even before abnormal cells appear.

Who Should Get Screened and When?

• Women aged 21-29: Pap smear every 3 years.
   
• Women aged 30-65: Pap smear plus HPV test every 5 years, or Pap smear alone every 3 years.
   
• Women over 65: May stop screening if past results have been normal, but discuss with your doctor.

Even if you have been vaccinated against HPV, regular screening is necessary because vaccines do not protect against all cancer-causing HPV types.

What Happens After an Abnormal Screening Result?

An abnormal Pap or HPV test does not mean cancer — it means we need further evaluation.

We may perform:

• Colposcopy: A procedure using a special microscope to closely examine the cervix for abnormal areas.
   
• Biopsy: Taking a small tissue sample from suspicious areas to check for cancer cells.
   
• Imaging Tests (MRI, CT, PET): If cancer is confirmed, these scans help determine the extent or “stage” of cancer.

This detailed assessment helps us choose the best cancer treatment in Pune, tailored specifically for your condition and needs.

Treatment Options for Cervical Cancer

Treatment depends on the cancer stage, your overall health, and personal preferences. Here’s a breakdown:

→ Surgery

Surgery is often the first choice for early-stage cervical cancer. Options include:

• Conization: Removing a cone-shaped piece of abnormal tissue for very early lesions.
   
• Hysterectomy: Removing the uterus and cervix. This can be simple or radical (including nearby tissues).
   
• Minimally invasive surgery: Techniques like robotic or laparoscopic surgery reduce pain, scarring, and recovery time.

Surgery aims to remove cancer completely while preserving quality of life.

→ Radiation Therapy

Radiation uses high-energy rays to kill cancer cells. It’s often combined with chemotherapy (chemoradiation) for better results, especially in more advanced stages or if surgery isn’t possible.

→ Chemotherapy

Anti-cancer drugs are used to kill cancer cells or stop their growth. Chemotherapy is often given with radiation or in advanced disease.

→ Targeted Therapy and Immunotherapy

These are newer treatments that focus on specific cancer cell markers or stimulate your immune system to fight cancer. They are used in select cases and often as part of clinical trials.

Preventing Cervical Cancer: Your Best Defense

→ HPV Vaccination

The HPV vaccine is a powerful tool for prevention. It protects against the most dangerous HPV types that cause about 70% of cervical cancers.

• Recommended for girls and boys aged 9 to 14 before they become sexually active.
   
• Catch-up vaccination is available for young adults up to 26 years and some adults up to 45 years after consulting a doctor.
   

→ Healthy Lifestyle and Safe Practices

• Quit smoking to boost your immune defense.
   
• Practice safe sex using condoms and limit the number of sexual partners.
   
• Maintain a balanced diet rich in vitamins to support your body’s healing and immune function.
   

→ Regular Screening

Even after vaccination, continue regular Pap and HPV screening as recommended by your doctor. Screening saves lives by catching problems early.

Frequently Asked Questions (FAQ)

Conclusion

Early detection and timely treatment make cervical cancer highly preventable and treatable. With over 9 years of experience as a Gynaecological Cancers specialist in Pune, I am committed to providing expert, compassionate care tailored to your needs.