CERVICAL CANCER TREATMENT IN INDIA
Cervical cancer treatment in India is done by expert gynecological oncologists specialist. India is home to some of the best cervical cancer doctors & hospitals in Asia.
What is cervical cancer ?
Cervical cancer is growth of cells on the lining of the cervix. Most common type of cervical cancer is squamous cell carcinoma. Another type is adenocarcinoma which is less common and difficult to diagnose because it occurs high on the cervix.
- Cancer of the uterine cervix (the lower part of the uterus (womb) which extends slightly into the top of the vagina) is one the most common cancers in women.
- A very common early symptom if abnormal vaginal bleeding.
- Most cases develop in women in their 30’s or 40’s.
- If cervical cancer is diagnosed at an early stage, there is a good chance of a cure.
- Regular cervical screening tests can detect ‘pre-cancer’ which can be treated before cancer develops.
What is important is that you promptly report any abnormal vaginal bleeding (bleeding in between periods, heavy periods, bleeding after intercourse) or vaginal discharge promptly to a doctor.
Types of cervical cancer
There are two main types of cervical cancer.
- Squamous cell cervical cancer is the most common. This develops when a skin-like cell (squamous cell) that covers the cervix, becomes cancerous.
- Adenocarcinoma cervical cancer is less common. This develops when a glandular cell (a cell that makes mucus) within the cervical canal, becomes cancerous.
Both types are diagnosed and treated in the same way. Most cases develop in women in their 30′ or 40’s. While some cases develop in older women, it is rare in women under 25 years.
Screening for cervical cancer
- Women should know about and be offerred regular cervical screening tests.
- The test involves scraping cells from the surface of the cervix, for laboratory examination.
- Dyskaryotic cells are seen in some cases, which means that some cells of the cervix are abnormal, but are not cancerous.
- Depending on the degree of the abnormality of the cells, cervical dysplasia is classed as :
- Mild – This is when there are only slight cell changes. This is sometime called CIN 1 (Cervical Intra-epithelial Neoplasia)
- Moderate or CIN 2
- Severe or CIN 3. This is when the cells are very abnormal, but are still not cancerous.
- In many cases, the abnormal cells do not become cancerous, and can revert back to normal within a few months.
- However, in some cases, often years later, the abnormal cells turn cancerous.
- If a women has just slight abnormal changes (CIN 1), she may simply be offerred another test sonner than normal. treatment may be offerred if the abnormality persists.
- For women with moderate or severe abnormal changes, treatment can clear the cervix of abnormal cells before they develop into cancer.
Causes of cervical cancer
A cervical tumor starts from the one abnormal cell. The exact reason why a cell becomes cancerous and multiplies ‘out of control’ is still unclear.
The initial ‘pre-cancerous’ abnormality of cerval cells s udually caused a prior infection with the Human Papiloma Virus.
Human Papiloma Virus (HPV) and cervical cancer
of the many strains of HPV, two types – HPV 16 and 18 are involved in the develeopment of most causes of cervical cancer. Other strains cause genital warts.
The strains of HPV associated with cervical cancer are usually passed on by having sexual intercocurse with an infected person.
An infection may be devoid of symptoms. So it is impossible to tell if the woman herself or the person with whom she has sexual intercourse are infected with one of these trains of HPV.
The HPV vaccine has been intreoduced fro the girls from the age of 12. Studies have shown that the HPV vaccine is vert effective at stopping the development of the cancer of cervix and it works better when administered at a younger age.
However, even if a women has had the HPV vaccine, she must regularly undergo cervical screening.
Other factors that increase the risk of developing cervical cancer :
- Smoking : Smokers are more likely than non-smokers to develop certain cancers, incuding cervical cancer. If you smoke and have HPV infection, the risk is compunded.
- A poor immune system. People with AIDS or people taking immunosuppressant medication have an increased risk.
- oral contraceptive pills : A possible link between the oral contraceptive pill and an increased risk of cervical cancer (if the pill is taken for more than eight years) has been mooted.
Symptoms of cervical cancer
A women may have no symptoms when the tumor is small. As the tumor becomes larger, in most cases the first symptom to develop is abnormal vaginal bleeding, such as :
- Bleeding between normal periods (intermenstrual bleeding)
- Bleeding after having sex (Post-coital bleeding)
- Any vaginal bleeding in women past menopause
An early symtom in some cases is a vaginal discharge that smells unpleasant, or discomfort or pain during sex. In time, if the cancer spreads to other parts of the body, various other symptoms can develop.
- Vaginal bleeding between periods
- Menstrual bleeding that is longer and heavier
- Bleeding after intercourse
- Pain during intercourse
- Unusual discharge from the vagina
- Excessive tiredness
- Leg pain or swelling
- Low back pain
Diagnosis & assessment of cervical cancer
To confirm the diagnosis
- A doctor will usually do a vaginal examination if a woman has symtoms which may indidcate cervical cancer.
- The doctor may feel an abnormal cervix.
- If cervical cancer is suspected, a colposcopy (a more detailed examination of the cervix ) is advised.
- For this test a speculum is gently put into the vagina so the cervix can be seen in the detail using a magnifier (colonoscope).
- The test takes about 15 minutes.
- During a colonoscopy it is usual to take a small piece of tissue from the cervix. The biopsy sample is then examined under a microscope to look for cancer cells.
Accessing the extent and spread of cervical cancer
- CT Scan
- An MRI scan
- A chest x-ray
- An untrasound scan
- Blood tests or other tests
- This assessment is called staging of the cancer. The aim of staging is to find out :
- How much the tumor has grown, and whether it has grown to other nearby structures such as bladder or the rectum.
- Whether the cancer spread to local lymph glands (nodes)
- Whether the cancer has spread to other areas of the body
- Exactly what tests are needed depends on the initial assessment and the results of the biopsy.
- Finding out the stage of the cancer helps doctors advise on treatment option, and gives a reasonable indication of outlook.
Treatment of cervical cancer
- Treeatment option which may considered include surgery, radiotherapy, chemotherapy, or a combination of these treatments best determined by the treating doctor.
- The treatment advised for each case depends on factors including the stage of the cancer and the general health of the patient.
- The goals of the treatment are generally cure (complete remission), living with the cancer without much symptoms (partial remission), or palliation (generally for advancedd disease to control the symptoms such as pain for giving a better qualtiy of life without any realistic hope of cure).
Surgery in cervical cancer
- Suitable for early stage disease
- If the aim is to cure, an operation to remove the cervix and uterus (hysterectomy) is a common course of action.
- In some cases where the cancer is at a very early stage, it may be possible to just remove the part of the cervix affected by the cancer without removing the entire uterus, or fertility preservation.
- If the cancer has spread to other parts of the body, surgery may still be advised, often in addition to other treatments.
- Even if the cancer is advanced and a cure is not possible, some surgical techniques may be employed to ease symptoms, for example to relieve blockage of the bowel or urinary tract.
Radiotheray in cervical cancer
- Radiotherapy is a treatment which uses high energy beams of radiation focussed on cancerous tissue, killing the cacner cells or stopping them from multiplying.
- Radiotherapy along can be curative for early stage cervical cancer and may an alternative to surgery.
- For more advanced cancers, radiotherapy may be advised in addition to other treatments.
- Two types of radiotherapy are used for cervical cancer, external and internal. IN many cases both types are used:
- External radiotherapy : This is where radiation is targetedd on the cancer from a machine. ( This is a common type of radiotherapy used for many types of cancer).
- Internal radiotherapy: This treatment involves placing a small radioactive implant nect to the cancerous tumor for a short time and then it removed.
- Even if the cancer is advanced and a cure is not possible, radiotherapy may still ahve a place to ease symptoms; for example, to shrink secondary tumors whichc have devleoped in other parts of the body and are causing pain.
Chemotherapy in cervical cancer
- Chemotherapy is a treatment using anti-cancer drugs which kill cancer cells, or stop them from multiplying.
- Chemotherapy may be given in addition to radiotherapy or surgery in certain situations.
- Now a days, concomitant chemo-radiotherapy is the preferred method of treatment for stage II and stage III cervical cancer.
Vaccine has also been developed to counter HPV virus marketed by the name of Gardasil and Cervarix. These vaccines are available in India.
Best hospitals for cervical cancer treatment in India
- BLK Superspecialty Hospital, New Delhi
- Apollo Cancer Institute, Chennai
- Artemis Hospital, Gurgaon
- Mazumdar Shaw Cancer Center, Bangalore
- HCG EKO Cancer Cneter, Kolkata
- American Oncology, Hyderabad
- Gleneagles Global Health City, Chennai
- Gleneagles Global BGS, Bangalore
- Continental Hospital, Hyderabad
- Yashoda Hospital, Hyderabad
Cost of cervical cancer treatment in India
Cost of cervical cancer treatment depends upon hospital to hospital and patient to patient. Usually the cost varies between $ 3000 USD upto $ 15000 USD.
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