Cervical cancer is on the rise.
Among the medical research, rates of cervical cancer in women aged 20-24 in England is seen to double, and the latest 2019 report published by Medscape revealed increase in cervical cancer among young women in Japan.
Virtually all cases of cervical cancer are caused by Human Papillomavirus (HPV), with high risk HPV types 16 and 18 cause about 70% of the cervical cancers and precancerous cervical lesions.
This post gives an overview of cervical cancer symptoms, treatment guideline / options, and survival rate by stage.
Stage 0 Cervical Cancer and Treatment
Stage 0 cervical cancer means the cancer is confined to the surface of cervix without growing into deeper tissues. If left untreated, these abnormal pre-cancerous cells may become cancer and spread to nearby normal tissue.
This stage is sometimes called Carcinoma in situ (CIS), Cervical Intraepithelial Neoplasia grade III (CIN III), moderate/severe cervical dysplasia, or High-Grade Squamous Intraepithelial Lesion (HSIL).
Recommended Read: Natural HPV Remedies as Complementary Cervical Dysplasia Treatment
The conventional Stage 0 cervical cancer treatment options include:
- Cryosurgery: Uses chemical to freeze abnormal cells off so that normal ones can grow back.
- Laser Surgery: Sometimes called laser ablation, utilize high-intensity laser light (eg. Carbon Dioxide CO2 laser) to destroy abnormal cervical cells.
- Cold Knife Cone Biopsy or Conization: Uses a scalpel to remove abnormal cervical tissue.
- Cold Coagulation: Applies heat source to burn away abnormal cervical cells.
- Loop Electrosurgical Excision Procedure (LEEP/LEETZ): Use wire loop heated with electric current to remove abnormal cervical cells.
|Type||Treatment||Pro and Con|
|Excision Treatment||LEEP / LLETZ|| LEEP is treatment of choice for CIN
Produce biopsy specimen for lab examination
Simple and well tolerated
Less expensive and technically easier
May be done in the office
Spotting and vaginal discharge may occur and persist for up to several weeks
LEEP has been associated with preterm labor in a subsequent pregnancy and may require careful follow-up
|Cone Biopsy||Produce biopsy specimen for lab examination
Cone biopsy should be done instead of a LEEP in certain circumstances
Need to be done as a day surgery
High cost and high level of technical difficulty
Significant intraoperative and postoperative bleeding
Substantial peri-operative infectious risk
|Ablative Treatment||Cryosurgery||Easy to perform
Can be done in office setting
Involves less recovery time
No biopsy specimen
Patients may have profuse discharge
May cause cramping, bleeding, or pain
Cryotherapy can make colposcopic assessment afterward more difficult
|Laser Therapy||Works well for destroying abnormal cervical tissue
Able to destroy or remove abnormal tissue that is too high in the cervix to be destroyed with cryosurgery
No biopsy specimen
Requires a short day surgery procedure
Patients may have some cervical bleeding up to 7 to 10 days after laser surgery
In video below, M.D. Alessandro Feo shows an outpatient LEEP surgery which was done under local anesthesia (WARNING: Video contains graphic content that may not be suitable for all viewers)
Stage 1 Cervical Cancer and Treatment
Based on International Federation of Gynecology and Obstetrics (FIGO) staging system, Stage 1 means the cancer is confined within the neck of womb/cervix, and it has not spread to nearby tissues or other organs.
Stage 1 cervical cancer is divided into two groups:
- Stage IA: Less than 5 mm deep and less than 7 mm wide cancer visible only under microscope.
- Stage IB: Cancer with 4 cm or less, or the cancer can only be seen under microscope and measures more than 5 mm deep and 7 mm wide.
According to Stage 1 cervical cancer treatment guideline, the treatment depends on the patient’s desire to have children, type of cancer (type of cells the cancer started in), exact location of the cancer, and other health conditions:
The conventional Stage 1 cervical cancer treatment options include:
- Surgery: Surgical procedures like Simple/Radical Hysterectomy to remove uterus and cervix (and pelvic lymph nodes) with cancer.
- Radiation: Can be given by using External Beam
- Radiation therapy, or Brachytherapy by placing a device filled with radioactive material inside vagina.
- Chemoradiotherapy: Combines Chemotherapy and Radiotherapy to kill cancer cells and stopping them from spreading.
- Cone Biopsy: Cone-shaped wedge of tissue is removed from the cervix. May need to follow up with repeat cone biopsy or radical trachelectomy.
- Trachelectomy: Surgery to remove most of cervix and upper part of vagina.
Below is a cervical cone biopsy video by M.D. Ajit Virkud, with the treatment was done using a cold knife. (WARNING: The video contain graphic content not suitable for all viewers)
Some doctors may use the following terms:
- Early stage cervical cancer: Refer to Stages IA, IB and IIA.
- Locally advanced cervical cancer: Stages IIB, III and IVA.
- Advanced stage cervical cancer: Usually means Stage IVB.
Stage 2 / 3 / 4 Cervical Cancer and Treatment
Stage 2 means the cancer has grown beyond the cervix and uterus, and begun to spread outside the neck of cervix:
- Stage IIA: Cancer spread down into the upper part of vagina, but not spread into the parametria next to cervix.
- Stage IIB: Cancer has spread into the tissues next to the cervix, the parametria.
Stage 3 means the cancer has spread to the lower part of the vagina or the walls of pelvis:
- Stage IIIA: Tumour has grown into the lower part of vagina but not into the pelvic walls.
- Stage IIIB: Tumour has grown into the pelvic walls, and/or blocks ureter causing enlarged kidney. Or the cancer has spread to the lymph nodes.
Stage 4 means the cancer has spread to organs or other parts of the body outside the cervix and womb:
- Stage IVA: Cancer has spread to nearby organs such as the bladder, rectum, or outside of pelvis.
- Stage IVB: Cancer has spread to distant organs beyond the pelvis, such as the lungs or liver. This is also called metastatic cervical cancer.
The 3D medical animation video below shows a detailed explanation of the criteria doctors use to stage cervical cancer, with staging refers to the extent of the spread of the disease.
According to medical professionals, Stage 2 and stage 3 cervical cancers are currently best managed by Chemoradiotherapy, which is a combination of radiation therapy and chemotherapy.
Stage 4B patient might receive a combination of treatment that includes radiation chemotherapy and surgery, while the patient may also be asked if she wants to join clinical trial for experimental cervical cancer treatment.
Watch the video below to learn more about the different cervical cancer treatment procedures and options by stage.
Cervical Cancer Survival Rate and Life Expectancy
5-year survival rate is commonly cited in cancer statistics that estimate the prognosis of a disease, means percentage of people who live at least 5 years after being diagnosed with cancer.
As shown below, the cancer survival rates and life expectancy depend on a variety of factors, with the key is the cervical cancer stage of the patient when the disease is diagnosed.
Recommended Read: Research Shows Mushroom Extract AHCC Helps To Eradicate HPV
According to research by American Cancer Society and Cancer Research UK etc –
The 5-year Stage 0 cervical cancer survival rate is about 91% to 93%, and Stage 1 is about 80% to 93%. Cancer survival rate significantly drop if detected late.
as such, regular cervical health screening is very important, while a good convenient option is Cervical Cancer HPV Screening Home Test Kit.
The Signs and Symptoms of Cervical Cancer
Here are 8 alarming signs and symptoms of cervical cancer that you must not ignore. Normally, abnormal vaginal bleeding is the first noticeable sign of cervical cancer.
The cervical cancer symptoms are not always obvious, and it may not cause any symptoms at all until the cervical cancer has reached an advanced stage.
As such, it is very important to attend cervical screening appointments with your doctor.