Cervical cancer

Cervical cancer is a malignant tumor that develops as a result of changes in the epithelium of the organ. According to the US National Cancer Institute, the disease almost always occurs due to infection with special strains of the human papillomavirus (HPV). This is how dangerous uterine dysplasia develops, and then cancer. Patients aged 15 to 75 are diagnosed with cervical cancer (CC). About half of them at 3-4 stages do not live the five-year mark.

Cervical cancer develops asymptomatically at an early stage. A gynecologist may suspect cervical cancer based on the results of a cytological study. Patients who do not undergo regular examinations by a female doctor turn to an oncologist at a later stage. In this case, women are less likely to have a favorable prognosis. To undergo a comprehensive diagnosis and find out the exact diagnosis, leave a request on the MedTour website.

Causes of cervical cancer

Long-term infection with certain types of human papillomavirus is a major cause of cervical cancer. HPV is transmitted from one person to another during close physical contact (through sexual intercourse between partners, during childbirth from mother to child, less often — in a household way). The danger is represented by 16, 18 and 33 types of HPV.

Scientists have identified additional factors that provoke the appearance of cervical cancer:

• Early sexual activity (before the age of 16);
• Early pregnancy and first childbirth before the age of 16 (this entails tissue rupture and significant damage to the cervix during childbirth);
• Surgical abortion (due to mechanical damage to the mucous membranes and artificial expansion of the uterus);
• Promiscuous sex life;
• Inflammatory diseases of the genital organs.

If a woman is faced with the factors that provoke cervical cancer, it is necessary to pay attention to the risk of developing the disease. The best diagnosis in the case of cervical cancer is a special screening and check-up of the whole organism. To conduct such a study and detect cancer at an early stage, leave a message on the MedTour website. The coordinating doctor will write you to a specialized clinic for examinations.

Cervical cancer symptoms

In the early stages, cervical cancer does not show symptoms. Perceptible signs of the disease in the later stages may be spotting after intercourse. This is due to the destruction of the capillaries located in the deeper layers of the organ.

Painful sensations appear when the nerve plexuses in the sacrum are compressed. This indicates the spread of the tumor process to other parts of the small pelvis. Compression of the lymphatic vessels leads to lymphostasis — stagnation of lymph in the legs, impaired outflow of urine and renal failure.

In the later stages of cervical cancer, the bladder is damaged, resulting in dysuric disorders (soreness, difficulty urinating). If the cancer has spread to the rectum, the act of defecation is impaired. Serious complications of the disease include uremia (accumulation of toxic elements in the blood) and peritonitis (an acute inflammatory process in the peritoneum).

Local symptoms of cervical cancer:

• Vaginal discharge mixed with blood;
• Pain during intercourse;
• Changes in the nature of menstruation;
• Increased inguinal lymph nodes.

Common symptoms include:

• Lack of appetite;
• Significant weight loss;
• Subfebrile temperature (about 37.3° C).

Diagnosis of cervical cancer

During a gynecological examination using a medical mirror, the doctor may suspect a pathology of the cervix. To establish an accurate diagnosis, it is necessary to conduct a comprehensive examination of the patient, which will include:

• Cytological screening — examination of smears obtained from the cervix;
• Colposcopy — examination of the genitals using an optical device — a colposcope (the procedure is also called video colposcopy);
• Bacterioscopic examination is a laboratory method for diagnosing a smear to detect infections;
• Targeted cervical biopsy — analysis of a tissue sample to identify abnormal cells;
• Scraping of the cervical canal — diagnostics of early precancerous conditions;
• CT with internal contrast of the chest, abdomen and pelvis.

To obtain reliable diagnostic data, doctors perform PET-CT scans on patients. Thanks to this examination, the doctor determines the localization, size of the tumor and metastases exactly up to 2 mm. With the help of PET-CT, the oncologist can make the correct diagnosis and develop an effective treatment plan.

The cost of PET-CT for cervical cancer in the world’s leading clinics:

• Turkey — from $800;
• South Korea — from $ 1 000;
• Israel — from $1 300;
• Germany — from $1 400.

Survival for cervical cancer

According to the American Society of Clinical Oncology, under the conditions of high-quality treatment of cervical cancer, at stages 1-2, up to 92% of patients live a 5-year milestone. In some cases, a complete cure is possible if the doctor uses modern therapy drugs in combination with surgery.

Cervical cancer is difficult to treat in its later stages. This is due to the specific location of a part of the organ. The cervix is ​​closely adjacent to the body of the uterus, rectum and bladder. As a result, tumor invasion (spread to neighboring structures) often occurs in these organs.

In cervical cancer, tumor infiltration often appears. This is the accumulation of fluid with cancer cells in the abdominal cavity and carcinomatosis — the spread of multiple metastases along the peritoneum. In such conditions, the prognosis of survival worsens, therefore, it is necessary to observe different specialists with the use of several types of therapy.

According to international statistics, 5-year survival rates are as follows:

• Stage 1 — 80-93% among all cases of cervical cancer;
• For stage 2, the indicator varies from 55% to 65%;
• With cervical cancer stage 3 — 30-35%;
• At stage 4 of cervical cancer, up to 16% pass the five-year milestone.

A multidisciplinary approach increases the effectiveness of therapy and gives a favorable prognosis for the patient. Cervical cancer requires competent treatment under the supervision of a gynecologist, surgeon, radiologist, and oncologist. To get medical help from a qualified team of specialists, leave a message on the MedTour website. The coordinating doctor will help you choose the best clinic for the diagnosis and treatment of cervical cancer.

Stages of cervical cancer

Oncologists diagnose the stage of cancer based on the size of the tumor and how widespread it is in the body.

Stages of development of the disease, depending on the stage:

• Stage 1: the tumor is limited to the cervix;
• Stage 2: the neoplasm penetrates beyond the uterus, but does not spread to the pelvic wall or the lower third of the vagina;
• Stage 3: the tumor spreads to the pelvic wall and / or affects the lower third of the vagina, causing hydronephrosis (dropsy of the kidney);
• Stage 4 cervical cancer: the neoplasm extends beyond the pelvis, affects the mucous membrane of the bladder or rectum. There are distant metastases.

Histologically, there are two main types of cervical cancer:

• Adenocarcinoma (glandular cancer) — about 10% of cases. It develops from cells of the glandular epithelium, which secretes secretions into the uterine cavity.
• Squamous cell carcinoma — up to 90% of all cases of cervical cancer. It arises from that part of the epithelium that interacts with the environment.

Clinically, both types of cancer are not different, but require a different approach to treatment.

Cervical cancer in situ can be glandular or squamous. This term characterizes the earliest stage at which it is difficult to distinguish severe dysplasia from the initial first stage of cervical cancer.

Undifferentiated cervical cancer also occurs. In this case, doctors cannot determine from which tissues it originated. With this diagnosis, the prognosis for the patient is less favorable.

Cervical cancer treatment

Most often, treatment for cervical cancer involves surgery and a combination of therapies. With a relapse of the disease, ascites (accumulation of fluid in the abdominal cavity), doctors perform exenteration of the pelvic organs. This is a complex operation to remove a recurrent tumor and pelvic organs. In a modern clinic, such an operation can be performed laparoscopically — through minimal incisions in the abdomen.

Surgical methods for the treatment of cervical cancer

Surgical intervention allows the doctor to completely remove the cancerous tumor from the organ. There are several treatment options for cervical cancer.

Conization for cervical cancer

The procedure is aimed at removing a tissue cone (taper excision) from the cervix and cervical canal. The type of conization depends on where the cancer is located and on the type of disease.

Oncosurgeons perform conization in one of the following ways:

• Cold knife conization is a surgical procedure in which a scalpel is used to remove abnormal tissue;
• Loop electrosurgical excision — the doctor passes an electric current through a loop of thin wire, which is used as a knife to remove a tumor;
• Laser surgery — during surgery, a laser beam (a narrow beam of intense light) is used as a knife to cut bloodless tissue. This is how the doctor removes superficial lesions and the tumor itself.

At stage 1 of cervical cancer, young patients can undergo organ-preserving surgery. Such conization can only be carried out by a surgeon with extensive clinical experience who works in a specialized center. To make an appointment with the best oncosurgeon, leave a message on the MedTour website.

Total hysterectomy

This is an operation to remove the uterus. If the cervix and the organ itself are removed through the vagina, the operation is called vaginal hysterectomy. If the cervix and organ are removed through a large incision in the abdomen, this is a total abdominal hysterectomy. If the organ and cervix are removed through a small incision in the abdomen using a laparoscope, the operation is called total laparoscopic hysterectomy.

Extended hysterectomy

Surgery to remove the body of the uterus, cervix, part of the vagina and a large area of ​​ligaments and tissues around these organs. The surgeon removes the ovaries, fallopian tubes, and regional lymph nodes.

Modified radical hysterectomy

The doctor removes the uterus, cervix, the upper part of the vagina, as well as the ligaments and tissues that surround these organs. Nearby lymph nodes may also be removed. This type of surgery does not remove as much tissue as with radical hysterectomy.

Radical trachelectomy

Surgical removal of the cervix, nearby tissues, lymph nodes and the upper part of the vagina. The uterus and ovaries are not removed.

Exenteration of the pelvis

The surgeon removes the lower part of the colon, rectum, and bladder. The cervix, vagina, ovaries, and nearby lymph nodes are also removed. Artificial holes (stoma) are designed to allow urine and feces to flow into the collection bag. After this surgery, plastic surgery may be required to form an artificial vagina.

Non-surgical treatment for cervical cancer

Radiation therapy

A technique for the treatment of cervical cancer, in which the oncologist uses high-energy X-rays or other types of radiation to destroy or slow down the growth of cancer cells. There are two types of this treatment:

• External beam therapy — a device is used outside the body to direct radiation to the tumor. This eliminates radiation damage to nearby healthy tissue.

This type of radiation therapy includes intensity modulated radiation therapy (IMRT). This is a type of 3D radiation therapy that uses a computer to image the tumor. The doctor directs beams of radiation of different intensities at the neoplasm at different angles.

• Internal radiation therapy is a radioactive substance sealed in needles, special grains, or catheters that a doctor inserts directly into or near a tumor.

How radiation therapy is administered depends on the type and stage of cervical cancer. This therapy is often used as palliative care to relieve symptoms and improve the quality of life of patients.

Chemotherapy

It is a medicamentous treatment for cervical cancer. At the same time, drugs are used that can stop the growth of cancer cells, or completely destroy the tumor. During chemotherapy, the patient takes medication in tablet form, intravenously or intramuscularly. Medicines enter the bloodstream and can reach cancer cells throughout the body. The way chemotherapy is administered depends on the type and stage of the disease.

Chemoradiation therapy

The doctor can use this therapy as an independent method of treatment or additionally after surgery. Compared with conventional radiation therapy, simultaneous chemotherapy and radiation therapy reduces the rate of disease progression by up to 50%.

Brachytherapy

This is a method of local irradiation of the cervix. The doctor irradiates the tumor with a high dose of radiation without harming the adjacent healthy tissues. Most often, brachytherapy is part of a course of radiation therapy.

Targeted therapy

It is a type of treatment that uses drugs to identify and attack only cancer cells without harming healthy tissue.

Monoclonal antibody therapy is a type of targeted therapy that uses antibodies obtained in a laboratory from a single cell type of the immune system. These antibodies can identify abnormal cells. Antibodies attach to them and gradually destroy the tumor.

Immunotherapy

Such therapy involves using the patient’s immune system to fight cancer. Substances produced by the body or in the laboratory are used to strengthen and restore the body’s natural defenses against cancer. This cancer treatment option is also called biotherapy.

Foreign methods of cervical cancer treatment

The result of treatment is influenced not only by the experience of the doctor, but also by the equipment on which he works. Modern foreign clinics have all the necessary equipment to ensure that operative and non-surgical treatment is as comfortable and safe for the patient as possible.

The most effective methods of cervical cancer treatment, which are used by foreign oncologists:

• Surgery with a Da Vinci robot. It is a robotic system for precise operations with minimal tissue damage. The doctor controls the robotic unit sitting at a special console. He controls the progress of the surgical intervention using a 3D visualization system. Surgery on Da Vinci in patients with cervical cancer minimizes the risk of complications. Tissue healing is faster than after abdominal surgery.
• CyberKnife Radiosurgery. It is a robotic system for precise irradiation of tumors. The doctor uses the system as an alternative to traditional surgery when the tumor cannot be removed surgically. With CyberKnife radiation therapy, patients can achieve complete remission.
• Radiation therapy with a hybrid apparatus. Tomotherapy is performed on a hybrid machine that combines the capabilities of a computer tomograph and a linear accelerator. Using the built-in CT scanner, the doctor visualizes the radiation area. This allows the doctor to control the changes in the tumor and regulate the radiation intensity. This technology significantly reduces side effects and helps to achieve long-term remission.

Modern methods of surgery and radiotherapy allow doctors of foreign clinics to supplement the treatment regimens for patients with cervical cancer. All innovative techniques are aimed at reducing the symptoms of the disease in the course of treatment and contribute to a complete cure. To sign up for the best clinic for the treatment of cervical cancer, leave a message to the MedTour coordinating doctor.

Treatment for cervical cancer by protocols according to stages

Access to innovative drugs allows foreign doctors to expand the treatment regimen in each case individually. With a competent approach, doctors can preserve the patient’s reproductive functions thanks to organ-preserving surgery.

In foreign cancer centers, doctors use modern methods of treatment. This makes it possible to improve the prognosis in the later stages, and a complete cure is possible in the early stages of the development of the disease. To go for treatment to a progressive clinic for the treatment of cervical cancer, leave a request on the MedTour website.

How much does cervical cancer treatment cost

The following factors influence the formation of the final cost of cervical cancer treatment:

• Complex of diagnostic procedures;
• The stage of cancer, the condition and age of the patient, the presence of concomitant diseases;
• Treatment methods that can combine surgery, radiation, chemotherapy, targeted and immunotherapy;
• Expenses for additional services. Depending on the clinic, services such as an interpreter, transfer and meals are included in the price or are provided for a fee (according to the terms of the medical institution);
• Postoperative rehabilitation. The patient receives the help of a psychologist, the clinic’s specialists develop instructions for her to monitor her health.

The cost of a basic program for diagnosing cervical cancer abroad will cost from $1 000 (analyzes and histology), with additional biopsy and immunohistochemistry, the minimum price will increase to $2 200.

The price for treatment abroad depends on the type of operation, the prescribed therapy and its duration:

• Surgical intervention — from $8 000;
• Chemotherapy — from $1 000;
• Radiation therapy — from $6 000;
• Targeted therapy — from $1 500;
• Immunotherapy — from $2 000.

In order to choose a country and a clinic for the treatment of cervical cancer, it is important to focus on the specifics of providing medical services to foreign patients. A key role in the prognosis for recovery is played by the ability to organize a trip on time. To get the full range of medical services in the best hospital for the treatment of cervical cancer, leave a request on the MedTour website.

Frequently Asked Questions

1

Stage 1 cervical cancer

At stage 1A, without signs of vascular invasion, conization of the cervix. When vascular invasion is less than 1 cm, tumor size is less than 2 cm, radical hysterectomy or trachelectomy is indicated (in this case, the uterus with appendages remains).

1

Stage 2 cervical cancer

At stages 1B and 2A, radical hysterectomy with pelvic lymph node dissection.

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Stage 3 cervical cancer

At stage 3, with the spread of cancer outside the uterus, surgical treatment is contraindicated. The standard treatment regimen for these patients includes radiation and chemotherapy.

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Stage 4 cervical cancer

Stage 4 cervical cancer — radiation and palliative therapy to improve the patient’s quality of life.

Published: 17.08.2021

Updated: 25.08.2021

Medical expert:

PhD. Olexandr Voznyak

Medical author:

Ilona Baidiuk

Information on this webpage verified by the medical expert

Medical Doctor, oncologist, PHD student

Kateryna Maliarchuk