Treatment and Prevention
Treatment options for cervical cancer include surgery, radiation therapy, and chemotherapy.
Treatment decisions are made by an oncologist (a doctor specializing in cancer) based on the following factors: size of the tumor, stage of the cancer (severity of the precancerous changes or presence of cancerous changes), the woman's individual factors (e.g., age, whether the woman wants children), the woman's overall health, and prior treatment if any. The oncologist will discuss the most suitable treatment options with the patient.
Surgery
- Cryosurgery is a procedure that destroys abnormal cells by freezing them with liquid nitrogen. This type of surgery is usually done to treat precancerous changes of the cervix.
- Laser surgery employs a high-energy beam of light to destroy abnormal cells. It is done to remove precancerous or cancerous cells. Laser surgery is usually used when the affected area of the cervix cannot be reached by cryosurgery.
- Loop electrosurgical excision uses a fine wire loop electrode to remove affected lesions. It is done under local anesthesia.
- Hysterectomy refers to the surgical removal of the uterus to treat more invasive cervical cancer (larger spread or tumor sizes). Other organs, such as the ovaries, fallopian tubes, lymph nodes, and parts of the vagina, may also be removed at the same time. There are different types of hysterectomy:
- total hysterectomy: removal of the cervix and the uterus
- radical hysterectomy: removal of the cervix, uterus, upper part of the vagina, some supporting tissues, and affected lymph nodes
Radiation therapy
Radiation therapy refers to the use of high-energy rays, particles, or radioactive materials to destroy cancer cells in a localized area of the body. The goal of radiation therapy is to kill the cancer cells while minimizing the exposure of normal cells to radiation.
Chemotherapy
Chemotherapy may be used in combination with radiation therapy. Chemotherapy refers to the use of one or more anticancer medications that prevent the cancer cells from growing and reproducing. It can be used to treat metastatic (spreading to other organs) cancer and recurrent tumors.
Prevention
Women can minimize their risk of developing cervical cancer by reducing their risk of HPV infection. The virus is most commonly transmitted via sexual contact and intercourse. Since most HPV infections do not cause any symptoms, it is not possible to know for certain whether you or your partner is infected with HPV. However, refraining from genital contact with an infected person or using a condom will reduce the risk of HPV infection. It is important to note that condoms are not 100% effective because they only protect the covered area. Other forms of contraceptives and barriers such as birth control pills, diaphragms, and intrauterine devices (IUDs) do not protect women against HPV infection.
If a woman smokes, quitting also reduces her chance of developing cervical cancer.
Another effective way to prevent cervical cancer is through vaccination. The world's first vaccination against HPV was approved in Canada and the United States in 2006. The vaccination provides protection from 4 different types of HPV. Two of these HPV types cause 70% of cervical cancer.
The vaccine is currently available for girls and women aged 9 to 26. Since the vaccine is most effective in females who have not yet been exposed to HPV, it is recommended that females receive the vaccine before they become sexually active. Women who are already sexually active can also benefit from the vaccine if they have not yet contracted the HPV types included in the vaccine. The vaccination is given in 3 doses over a period of 6 months. The vaccine can also help protect against genital warts in boys and young men aged 9 to 26.
Since the HPV vaccine does not offer protection against all types of HPV that can cause cervical cancer, regular Pap test screening remains essential in preventing disease caused by HPV infection.
Ed Tanner, MD, Gynecologic Oncology Fellow at Memorial Sloan-Kettering Cancer Center, New York, NY. Review provided by VeriMed Healthcare Network.