Cervical Cancer: Initial symptoms and treatments

Inputs by Dr. Richa Bansal, Consultant Gynec-Oncosurgery, Robotic Surgery and HIPEC Specialist at Apollo Hospitals Navi Mumbai.

Many women with cervical cancer don’t realize they have the disease early on, because it usually doesn’t cause symptoms until the late stages. When symptoms do appear, they’re easily mistaken for common conditions like menstrual periods and urinary tract symptoms (UTIs).

Typical cervical cancer symptoms are:

• unusual bleeding, such as in between periods, after sex, or after menopause
• vaginal discharge that looks or smells different than usual
• pain in the pelvis
• needing to urinate more often
• pain during urination
• Diagnosis of Cervical Cancer

Whenever a woman with symptoms like abnormal vaginal bleeding or discharge which could be suggestive of a possible cervical cancer presents to us, we perform a complete pelvic examination in the Outpatient department. This pelvic examination is painless and does not cause much discomfort to the patient. If there is any suspicious lesion or growth on the cervix, we take a small biopsy from the lesion and again this procedure is painless and can be performed in the OPD itself.

If the diagnosis of cervical cancer is confirmed on biopsy, an imaging like CT scan or MRI scan depending upon the clinical examination findings needs to done for further treatment planning.

Treatment of cervical cancer

Treatment of cervical cancer depends on the stage in which it is diagnosed. Stage is confirmed based on the pelvic examination findings by a Gynec Oncosurgeon and on imaging (CT / MRI scan) findings.

Cervical cancer when diagnosed at stage 1 is potentially curable with the surgery alone. The standard surgical procedure is radical abdominal hysterectomy with pelvic lymph nodal dissection. This surgery is not just removal of the uterus and cervix but is a more radical procedure where all the supporting tissues surrounding the uterus and cervix are removed from the pelvis.

Cervical cancer when diagnosed in more advanced stages of the disease, requires Radiation therapy and Chemotherapy. As the stage of the disease at the time of the diagnosis advances and the cancer is diagnosed late, the treatment protocols become more complicated requiring combination of radiation and chemotherapy and also the chances of cure decreases.

Hence it is very important that cervical cancer is picked up early and is treated appropriately.

Cervical cancer symptoms

When present, common symptoms of cervical cancer may include:

Vaginal bleeding: This includes bleeding between periods, after sexual intercourse or post-menopausal bleeding.

Unusual vaginal discharge: A watery, pink or foul-smelling discharge is common.

Pelvic pain: Pain during intercourse or at other times may be a sign of abnormal changes to the cervix, or less serious conditions.

All of these cervical cancer symptoms should be discussed with your doctor.

Signs of advanced stages of cervical cancer

Cervical cancer may spread (metastasize) within the pelvis, to the lymph nodes or elsewhere in the body. Signs of advanced cervical cancer include:

• Weight loss
• Fatigue
• Back pain
• Leg pain or swelling
• Leakage of urine or feces from the vagina
• Bone fractures

Usually, there are no signs and symptoms of cancer at a very early stage. For most women, within the early stage of cervical cancer, early signs do typically appear depending on the severity of the issue and to which level the disease has spread. Potential symptoms of cervical cancer are as follows:

• Infrequent spotting or light bleeding between or after periods
• Menstrual bleeding exceeds the usual number of days.
• Abnormal bleeding after intercourse, douching or after a pelvic examination
• Increased vaginal flow or discharge
• Bleeding after complete menopause
• Chronic back pain, Persistent Pelvic Pain

Various treatment options are available at the best cervical cancer hospitals such as Chemotherapy or subjected therapies, Radiation therapy, Surgeries, Hormone therapy, Immunotherapy, and Bone marrow or stem-cell therapy.

Cryosurgery: A type of surgery that is performed by expert surgeons. Under this surgery, the abnormal tissues are destroyed by using extremely cold temperatures. It involves the usage of liquid nitrogen, carbon dioxide, and argon.

Laser ablation: This is the process of removing abnormal cervical cells through laser therapy so that healthy cells can grow back in its place.

Simple Hysterectomy: Some parts of the woman’s reproductive system, namely the cervix, womb, ovaries, and fallopian tubes, are removed.

Radical Hysterectomy: Preferred mode of treatment only when the cancer reaches stage 1 or an early stage 2 cervical cancer. The cervix, womb, top of the vagina, surrounding tissues, lymph nodes, fallopian tubes, and if advised, ovaries are all removed.

Radiotherapy can be delivered either:

Externally: A machine with high-radiative energy is used to beam waves into the pelvis to remove cancerous cells.

Internally: In such cases, a radioactive implant is planted beside the tumor inside the vagina. This treatment is known as Brachytherapy, which aims to lessen the harm to the surrounding tissue by administering the radiation closer to the tumor.

Trachelectomy: During this procedure, the cervix and the upper section of the vagina are removed. The womb sits at its original place and will be reattached to the lower section of the vagina.

Large Loop Excision of the Transformation Zone (LLETZ): Under this cancer treatment, the cancerous cells are removed by using a fine wire with an electric current. This treatment is done by giving local anesthetic and can be performed at the same time as a colposcopy.

Cone Biopsy: During this surgery, surgeons remove a cone-shaped area of the abnormal tissue. This is usually performed under general anesthetic.

Pelvic Exenteration: This cancer treatment option is usually recommended when cervical cancer hits back after its first treatment and diagnosis. This surgery is performed if the cancer returns to the pelvis but has not started to spread beyond that area.

If you are suffering or having the same symptoms, get in touch with the specialist Apollo hospitals of cervical cancer, which is India’s leading hospitals.