Prof. Dr. Rehana Aamer Khan is treating cervical cancer patient from fifteen years. She is the first gynecological Laparoscopic and robotic surgeon of Pakistan. Most of the patient that she has treated have survived and living happy life
What is Cervical Cancer?
Cervical cancer is a specific form of cancer that develops in the cells of the cervix, which is the lower portion of the uterus connecting to the vagina.
The majority of cervical cancer cases are caused by various strains of the human papillomavirus (HPV), a sexually transmitted infection.
Normally, when exposed to HPV, the body`s immune system effectively clears the virus, preventing harm. However, in a small percentage of individuals, the virus persists over time, contributing to the cellular changes that lead to the development of cervical cancer.
To minimize the risk of developing cervical cancer, it is advisable to undergo screening tests and consider receiving an HPV vaccine, which offers protection against HPV infection.
Symptoms of Cervical Cancer
In most cases, precancerous changes in cervical cells do not produce noticeable symptoms. The best way to identify abnormal cells that have the potential to develop into cancer is through cervical screening tests. However, if early cell changes progress to cervical cancer, the following signs are commonly observed:
- Vaginal bleeding between periods
- Menstrual bleeding that is longer or heavier than usual
- Pain during sexual intercourse
- Bleeding after sexual intercourse
- Pelvic pain
- Changes in vaginal discharge, such as increased discharge, unusual color, or strong odor
- Vaginal bleeding after menopause
It`s important to note that these symptoms can also be caused by other conditions. If you have concerns or if the symptoms persist, it is recommended to consult your doctor for further evaluation. Prof. Dr Rehana Aamer Khan is treating Cervical Cancer patients from last fifteen years. She is the first Gynecological & laparoscopic and robotic surgeon of Pakistan. She can identify with the help of robot, hysteroscope or laparoscope which is not possible to identify with naked eyes.
Causes of Cervical Cancer
There are multiple factors that cause cervical cancer. Some of the factors contribute to the risk of developing cervical cancer, including:
Multiple sexual partners: Having a higher number of sexual partners, as well as having partners with a greater number of sexual partners, increases the likelihood of acquiring the human papillomavirus (HPV).
Early sexual activity: Engaging in sexual activity at a young age raises the risk of HPV infection.
Other sexually transmitted infections (STIs): Contracting other STIs like chlamydia, gonorrhea, syphilis, and HIV/AIDS increases the risk of HPV infection.
Weakened immune system: If your immune system is compromised due to another health condition, it can increase the chances of developing cervical cancer if you have HPV.
Smoking: Smoking is associated with an elevated risk of squamous cell cervical cancer.
Exposure to diethylstilbestrol (DES): If your mother took the drug diethylstilbestrol (DES) during pregnancy in the 1950s, you may have an increased risk of a specific type of cervical cancer known as clear cell adenocarcinoma.
It`s important to note that while these factors can influence the risk of cervical cancer, they do not guarantee the development of the disease. Regular cervical screenings and HPV vaccinations are essential for early detection and prevention.
Diagnosis of Cervical Cancer
The following procedures are utilized for the diagnosis of cervical cancer:
Colposcopy:
During a colposcopy, a healthcare provider employs a speculum to gently open the vagina and visualize the cervix. A vinegar solution is applied to the cervix to enhance the visibility of abnormal areas. Using a colposcope—a device with a bright light and magnifying lens—the healthcare provider closely examines the cervix. Typically, a colposcopy involves a biopsy.
Biopsy:
A biopsy involves the removal of a tissue sample from the cervix, which is then examined under a microscope by a pathologist to identify signs of cancer. Several types of biopsies are performed to assess cervical cancer:
Punch biopsy: A small, round piece of tissue is extracted using a sharp, hollow circular instrument. Punch biopsies may be conducted in multiple areas of the cervix. This procedure is commonly performed in a doctor`s office.
Endocervical curettage: This procedure involves collecting cells or tissue from the cervical canal using a curette, a spoon-shaped instrument. Only a small amount of tissue is removed, and the procedure is typically conducted in a doctor`s office.
Loop electrosurgical excision procedure (LEEP): LEEP utilizes a thin wire loop through which an electrical current is passed to remove tissue from the cervix. LEEP can be used for diagnosing cervical cancer and treating precancerous or early-stage cancer. It is usually performed in a doctor`s office under local anesthesia and takes only a few minutes.
Cone biopsy: A cone-shaped piece of tissue is surgically removed from the cervix and cervical canal. Cone biopsy can be used for diagnosing cervical cancer or treating precancerous or early-stage cancer. Also known as conization, this procedure is conducted at a hospital under general anesthesia.
It is important to discuss the expected process and post-procedure care with your healthcare provider. Some individuals may experience bleeding, discharge, or cramp-like pain after a biopsy. To understand the information provided in a pathologist`s report regarding the biopsy, refer to Pathology Reports.
Staging of Cervical Cancer
Tests and procedures are employed to determine the stage of cervical cancer after diagnosis. You will be referred to a gynecologic oncologist, a specialist in treating cervical cancer and other female reproductive system cancers. The oncologist will recommend tests to assess the extent of the cancer, which is known as staging. This information is crucial for developing an optimal treatment plan.
To determine the stage of cervical cancer, the following procedures may be utilized:
Imaging tests:
PET-CT scan: This scan combines positron emission tomography (PET) and computed tomography (CT) images to provide a detailed picture of the body. A small amount of radioactive glucose is injected, and the scanner captures images showing the glucose uptake. Malignant tumor cells, being more active, appear brighter in the image. CT scans use X-ray pictures taken from various angles, often with the assistance of a contrast dye, to enhance visibility.
Magnetic resonance imaging (MRI): This procedure employs a magnet, radio waves, and a computer to generate detailed images of the body`s internal structures.
Ultrasound: High-energy sound waves are used to produce echoes that create a sonogram, providing a visual representation of internal tissues or organs.
Chest X-ray: An X-ray of the chest organs and bones is taken, allowing for the visualization of potential abnormalities.
Lab tests:
Complete blood count (CBC): This blood test measures red and white blood cell counts, platelet count, hemoglobin levels, and other components to assess overall blood health.
Blood chemistry study: This test analyzes the levels of various substances in the blood, such as electrolytes, lactate dehydrogenase, uric acid, blood urea nitrogen, creatinine, and liver function values. Deviations from normal levels may indicate cancer spread or other conditions.
Visual examination:
Cystoscopy: A cystoscope, a thin instrument with a light and lens, is inserted through the urethra into the bladder and urethra to inspect for abnormal areas. Tissue samples may be taken for microscopic examination.
Sigmoidoscopy: This procedure utilizes a sigmoidoscope, inserted through the rectum into the lower colon, to examine the rectum and sigmoid colon for any irregularities. Tissue samples can also be collected for further analysis.
Consult with Prof. Dr Rehana Aamer Khan provider to understand the specific details and expectations related to these diagnostic procedures.
Treatment of Cervical Cancer
The treatment of cervical cancer is influenced by various factors, including cancer stage, concurrent health conditions, and personal preferences. Treatment options encompass surgery, radiation, chemotherapy, or a combination of these approaches.
Surgery
Surgery is commonly employed for early-stage cervical cancer, and the specific operation depends on factors such as cancer size, stage, and future pregnancy considerations. Surgical options may include:
Cancer resection: For small cervical cancers, complete removal can be achieved through a cone biopsy, where a cone-shaped section of cervical tissue is excised while preserving the rest of the cervix. This procedure allows for potential future pregnancy.
Trachelectomy: A radical trachelectomy involves removing the cervix and some surrounding tissue, while preserving the uterus. This procedure may be suitable for early-stage cervical cancer and retains the possibility of pregnancy.
Hysterectomy: Most early-stage cervical cancers are treated with a radical hysterectomy, involving removal of the cervix, uterus, part of the vagina, and nearby lymph nodes. This procedure effectively cures early-stage cancer but eliminates the ability to conceive.
Minimally invasive hysterectomy most of the time known as Laparoscopic Hysterectomy, conducted through several small abdominal incisions, is an alternative for early-stage cervical cancer. It generally allows for quicker recovery and shorter hospital stays.
Radiation
Radiation therapy, utilizing high-energy beams such as X-rays or protons, is frequently combined with chemotherapy for locally advanced cervical cancer. It may also be administered after surgery to mitigate the risk of cancer recurrence. Radiation therapy can be delivered externally (external beam radiation therapy), internally (brachytherapy), or both.
Chemotherapy
Chemotherapy involves using drugs to destroy cancer cells and can be administered intravenously or orally. Low-dose chemotherapy is often combined with radiation therapy for locally advanced cervical cancer, while higher doses may be recommended for advanced cancer symptoms control.
Targeted therapy
Targeted therapy targets specific vulnerabilities within cancer cells, leading to their demise. This approach is typically combined with chemotherapy and may be an option for advanced cervical cancer.
Immunotherapy
Immunotherapy enhances the body`s immune system to combat cancer. It disrupts the mechanisms employed by cancer cells to evade detection by the immune system. Immunotherapy may be considered for advanced cervical cancer when other treatments have proven ineffective.
Palliative care
Palliative care provides specialized medical support to alleviate pain and manage symptoms associated with serious illnesses. Palliative care professionals collaborate with you, your family, and other healthcare providers to enhance overall support and well-being. When integrated with appropriate treatments, palliative care can enhance quality of life and potentially extend survival.
Palliative care is delivered by a multidisciplinary team of doctors, nurses, and specialists who aim to improve the well-being of individuals with cancer and their families. This form of care can be provided alongside curative or ongoing treatments.