We would tie up the Cervical Cancer awareness by taking a brief look at the Management.
There are a few medical terms you’ll have to get grip of in order to understand what we do and possible outcome.
All cancers are staged: looking at the size and spread. This informs us of how advanced the cancer is and possible ways of managing it.
Cervical cancer is mostly clinically or surgically staged depending on your Doctors preference. I’ll give us an international standard by FIGO (Fédération Internationale de Gynécologie et d’Obstétrique), with some explanation. Then summarize what may be done and possible outcome. The details is left for the Medical Professionals.
Just to remind us,
1. The Cervix is the gateway to the uterus
2. It has a pathway from the vagina (tube like structure)
3. Which opens to the outside.
Cervical Cancer is cancer that develops in this gateway
When the cancer has not gone through the foundation of the Cervical cells, also known as Basement Membrane, it is Stage 0 also known as Carcinoma in situ.
If it has gone beyond this but is confined to the cervix, it is Stage 1
If it has gone beyond the cervix but has not spread to the pelvic wall or lower third of the Vagina, it is Stage 2
If the cancer has spread to the pelvic wall or lower third of the vagina, Stage 3
If it has spread to surrounding structures and/or travelled out to other parts of the body, it is Stage 4.
3 and 4 are considered to be advanced.
Cervical Cancer management usually has:
3. Chemical (known as chemotherapy – drugs)
4. Others (supporting therapy which may include psychotherapy).
as components depending on the stage and Doctor’s preference (in some cases).
A. When it is still within its foundation (basement membrane) at Stage 0, your Doctor may want to perform the following:
1. Surgical excision (removal) of the affected area(s)
2. Cryosurgery. Use of extreme cold to surgically remove the cancer cells
3. Laser ablation. Use of focused heat
4. Loop excision
Other options may exist, but those are common. Some Doctors prefer surgical removal to the rest because they can check the removed tissue in a lab.
B. In Stage 1. Your Doctor may want to:
1. Totally take out your Womb, known as hysterectomy (uterus with the cervix too)
2. Completely remove the cervix (conization).
For more advanced forms of this stage (not mentioned due to the ambiguity), radiation may be included in the treatment.
C. For Stage 2, your Doctor may not be Surgery trigger happy. Radiation is mostly used in different forms. This is true for Stage 3 and early part of 4 (again not mentioned to avoid ambiguity).
D. When it has traveled far, Stage 4 proper, palliation (all that can be done to make you comfortable) is used. For this, radiation can be used to reduce bleeding, analgesics for pain, hospice care.
Your Doctor will discuss with you the options available in your Country for treatment and their risks/benefits.
In most African Countries, Women usually come to the Hospital at 3rd to 4th stage which is sad because little can be done with resources available to keep them alive. This can be prevented by following recommended guideline for screening.
Stay alive, get screened, tell others.