DIAGNOSIS
Early diagnosis is key to treatment and cure. Treatment of precancerous changes is much more likely to be successful than treatment of a full blown invasive cancer.
Papanicolaou Test (Pap Smear) and high risk HPV testing
- Widespread use is key in early detection.
- During a Pap Smear, cells from the cervix are obtain and examined for any abnormalities. If abnormalities are found in the Pap Smear, a sample of cervical tissue will be obtained and analyzed (biopsy) to diagnose cancer.
Various diagnostic tools include:
- Colposcopy
- Loop electrosurgical excision procedure (LEEP) technique
- Conization
Precancerous changes
- Most often called squamous intraepithelial lesion (SIL)
- Low-grade SIL (LGSIL)
- Early, subtle changes in the size and shape of cells that form on the surface of the cervix are considered low grade
- May disappear or develop into a High-grade SIL (HGSIL)
- Can appear in any age but often occur in women ages 25 to 35 years
- High-grade SIL (HGSIL)
- A large number of precancerous cells which involve only cells on the surface of the cervix
- Can appear in any age but often occur in women ages 30 to 40 years
Invasive cancer
- Spread of abnormal cells deeper into the cervix and/or to other tissues or organs.
- Occurs most often in women aged 40 years or older.
If the biopsy results show invasive cancer, a series of tests will be performed which include:
- A chest X-ray to for lung involvement
- Blood tests for liver involvement; a CT scan may be necessary if results are not definitive.
- IVP or a CT scan for urinary tract involvement; the bladder and urethra are evaluated by cystoscopy.
- Colposcopy for vaginal involvement
- Procto signoidoscopy and barium enema for rectal involvement
- Lymph nodes are evaluated by CT scans, MRI scans, or PET scans; the MRI is superior to the CT scan and the PET scan is superior to both.
These tests are used to “stage” the cancer:
- Cervical cancer is staged from stage 0 (least severe) to stage IV (metastatic disease, the most severe).
- Staging is based on size and depth of the cancerous lesion, as well as degree of spread
- Recommended treatment will be based on the cancer staging
RECOMMENDED MEDICATIONS
Chemotherapy
- Shrink cervical cancer and decrease tumor growth
- May be a stand alone treatment or used with radiation (chemoradiation)
- May be used to treat cervical cancer that has spread beyond the cervix
Chemoradiation
- Improves survival in early-stage cervical cancer
Medicine choices
Common chemotherapy medicines used to treat cervical cancer include:
- Bevacizumab
- Carboplatin
- Cisplatin is the medicine most often used in chemoradiation for cervical cancer
- Docetaxel
- Fluorouracil (5-FU)
- Gemcitabine
- Ifosfamide
- Mitomycin
- Paclitaxel
Dealing with side effects of medicines
Most chemotherapy will cause some side effects, such as nausea, vomiting, and hair loss. Your doctor may prescribe medications to help alleviate these side effects.
