Cervical cancer is one of the most common cancers in women. It occurs when the cells lining the cervix undergo mutation and begin to grow uncontrollably.
Globally, every year about half a million women are diagnosed with cervical cancer, and over 3,00,000 resultant deaths are reported. In the year 2018, about 5,70,000 cervical cancer cases were diagnosed and about 3,11,000 deaths were reported.
However, since the introduction of screening tests, the incidence and mortality of cervical cancer have decreased by more than half in developed countries.
Every treatment has its side effects, likewise, the cervical treatment also has its side effects depending upon the modality used.
The side effects can be acute which appear during or immediately after treatment. Long-term side effects usually appear gradually, long after completion of the treatment. Here, we would discuss only the acute side effects and their management.
Cervical cancer treatment is complex and requires a multidisciplinary approach. Depending on the overall health, age, and extent of cancer at the time of diagnosis, cervical cancer can be treated with the following treatment modalities.
At this stage, the cancer is localized in the cervix. The treatment is considered based on whether the woman wants to preserve fertility or not and whether the cancer has spread into blood and lymph vessels.
The treatment modalities at this stage include:
The cancer in these stages is localized to the cervix and upper vagina and has not spread to the nearby lymph nodes.
Treatment for cervical cancer at this stage can be done with:
The cancer in these stages is locally advanced and might also have spread to nearby lymph nodes and pelvic organs.
The treatment at this stage may include:
The cancer in this stage has become metastatic and spread to distant body parts.
The treatment modalities at this stage may include:
For cervical cancer that has come back after successful treatment, the following treatment options may be considered depending on the extent of disease & previous treatment received:
The main aim of cancer removal surgery is to remove all the cancer cells without causing any much damage to the surrounding healthy tissues.
In most cases, the patient may receive radiation therapy and chemotherapy after the surgery to destroy the remaining cancer cells depending upon the risk features on surgical specimen.
Cervical cancer in its very early stages can be removed through cryosurgery (creating freezing temperature by using liquid nitrogen, to destroy the cancer cells) or laser surgery (using high-energy beams to burn and destroy the cancer cells).
These minor procedures may cause side effects such as:
These side effects are mild and may subside on their own.
Some women may have to undergo a procedure called LEEP (loop electrosurgical excision procedure), also called conization. In this procedure, electric current is passed through a thin wire to excise the cancer tissue.
Women who have stage 1 cervical cancers may need to undergo removal of cervix with surrounding lymph nodes (radical trachelectomy) or removal of the uterus (hysterectomy).
After any of these procedures, they may experience:
The surgery may involve a very mild risk of damage to nearby organs, like the bladder, ureters, or rectum.
Trachelectomy, usually performed in women with early cancers who wish to preserve the uterus for bearing a child, may lead to long term problems such higher risk for miscarriage and pre-term delivery.
Women who undergo hysterectomy cannot become pregnant.
You can read more about pregnancy after cervical cancer treatment here.
Radiation therapy uses high-energy radiation beams to destroy cancer cells. For treating cervical cancers, radiation therapy can be given in two ways:
In this type of radiation therapy, the radiation beams are passed onto the cancer from a machine present outside the body.
For cervical cancer treatment, the radiation therapy is usually combined with low-dose chemotherapy.
In this type, a device containing a radioactive source is placed in the vagina or the cervix to kill the cancer cells without causing much damage to the surrounding tissue.
In cervical cancer, brachytherapy may be combined with EBRT.
Radiotherapy for cervical cancer can cause side effects, which may manifest during or immediately after radiotherapy (acute) or many weeks, months or even years (delayed) after radiotherapy.
The acute side effects include the following:
Radiotherapy can cause many chemical changes in the body that may manifest as fatigue. In addition, dehydration may contribute to fatigue if the fluid intake is not taken care of.
Increase in frequency, urgency, or burning sensation are common side effects, and may subside with time.
Increased motility, watery stools or even constipation can happen as a side effect of radiation therapy.
Due to radiotherapy, the skin may appear red, and sore, and may even peel off leaving raw areas.
The pelvic area that received radiotherapy, may lose hair, including the pubic area; it may grow back after the treatment.
There may be unusual vaginal discharge, and can be blood-stained or foul smelling.
There could be some delayed effects of radiotherapy and may include the following:
The radiation can affect the drainage of lymph fluid causing its accumulation in the legs, leading to swelling.
Bladder and bowel issues mentioned above may even arise months or years after completing the radiation.
Radiation therapy may cause the vagina to narrow down, as a result, sexual intercourse or pelvic examination may become painful or uncomfortable.
If the ovaries are removed, or are severely affected by the radiotherapy, you may no longer produce hormones, resulting in menopause.
It uses specific drugs either alone or in combination to destroy the cancer cells. Most often these drugs are given orally or administered in the form of intravenous injection.
The following are the common acute side effects associated with chemotherapy:
It uses certain medicines to boost a person’s immune system in order to identify and kill the cancer cells.
The following are the acute side effects of immunotherapy
It involves the use of drugs or other substances to target specific genes, proteins, or tissues that contribute to the growth of cancer cells.
These drugs inhibit the growth and spread of cancer cells without damaging the surrounding tissues.
High blood pressure, fatigue, and nausea are a few common side effects of targeted therapy.
The following tips can help in managing some common side effects of cervical cancer treatment effectively.
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