Lead
Cervical cancer is a malignant tumor originating from cells of the uterus cervix. In most cases it starts in the transformation zone – a region between the internal and external cervix parts. Cells of the transformation zone multiply actively which increases the risk of atypia. This background process may proceed with the tumor formation. Without proper treatment tumor may spread outside the cervix and vagina, affecting the bladder, intestine, lymphatic nodes, etc.
Body
The disease typically reveals itself by the vaginal bleeding (other than menstruation), changes in the menstrual cycle regularity, unusual vaginal discharge or unpleasant odor in absence of sexually transmitted diseases. Other symptoms may include discomfort during the sexual intercourse and pelvic pain. Advanced cancer affects other organ systems, so urological and gastroenterological complaints join.
Signs of the cervical cancer are perfectly seen during the gynecological examination. Thus, simple visiting the gynecologist after noticing worrying symptoms will exclude or confirm the diagnosis. A patient can also visit a doctor without any complaints, just in order to undergo the annual check-up.
How the stages of cervical cancer are determined
If after the primary examination cervical cancer is suspected, treating physician will proceed to the further tests:
- Colposcopy – is the direct visual examination of the cervix with the colposcope and camera. Additional application of dilute acetic acid or / and iodine solution helps to reveal the atypical cells more effectively.
- Biopsy (during the colposcopy, endocervical scraping, or cone-shaped biopsy) – is taking the tissue sample for further cytological or histological examination. This is the most informative diagnostic test that allows making the final diagnosis.
- MRI or CT scan provide doctor with information about state of other internal organs which is important during the metastases search.
It is crucial to undergo careful examination in the good hospital, as this is the basis for determining the disease stage and planning therapy in diagnosed cervical cancer. The following medical stages are distinguished:
- Stage 0, carcinoma in situ, is the initial cancer stage. Atypical cells are located superficially, not invading even the cervix itself.
- Stage 1 tumors are limited by the boundaries of cervix, not reaching corpus uteri.
- Stage 2 tumors spread beyond the cervix and affect top part of the vagina and / or paracervical tissues.
- Stage 3 tumors invade lower part of the vagina, perimetrium or the pelvic wall.
- Stage 4 tumors are diagnosed in presence of the distant metastases, rectum or bladder invasion.
Types of treatment
Type of therapy is basically determined by the cancer stage. Nevertheless, in case of cervical cancer, a patient is actively involved in the process of selecting the treatment scheme. Wish of a woman to have children in the future is always considered, as in some types of surgical treatment this becomes impossible. The same is about radiation therapy and chemotherapy – if a woman wants to preserve the reproductive function, ovaries tissue or separate eggs should be harvested in advance, before the course starts.
Surgery includes a number of options, from cryosurgery or laser surgery in women with carcinoma in situ to hysterectomy in women with stage 2-3 tumors. Each surgical intervention pursues few aims: removing of all cancer cells, preserving healthy organs (e.g. ovaries where the female hormones are synthesized) and the reproductive potential (if necessary).
Radiation therapy includes external irradiation and brachytherapy (the internal one). It may be performed as a part of a complex treatment scheme or as an independent technique. Radiation therapy is especially effective in recurrent cancer.
Chemotherapy is mainly used as an addition to the radiation therapy, as their simultaneous administration mutually enhances the treatment effect. Chemotherapy prevents tumor from spreading and helps to consolidate results of surgery.
Administration of the immunotherapy in patients with advanced cervical cancer is also considered. Immune checkpoint inhibitors, like the pembrolizumab (Keytruda), are used for this purpose. The targeted therapy, like the angiogenesis inhibitor Bevacizumab (Avastin), is another therapeutic option.
Follow-up after the treatment of cervical cancer
Once the main treatment phase is successfully completed, the follow-up period starts. It has few aims:
- Managing possible long-term symptoms and late treatment side effects. This concerns women who need to take maintaining drugs or go through the repeated courses of chemotherapy. Also, this may include plastic surgeries for the correction of pelvic organs position after the hysterectomy.
- Monitoring the health state and preventing the disease relapse. During the first 2 years after receiving curative treatment women should visit their treating physician for the check-up each 3-4 months.
- Undergoing rehabilitation. This includes restoring function of pelvic organs, physical therapy and work with the psychotherapist or in the cancer support groups.
Thorough follow-up is performed during 3-5 years. After this a woman visits her doctor annually.
Cost of treatment and principles of selecting the hospital
It is always better to undergo the treatment of cervical cancer in a specialized hospital with modern equipment and good success rates. Timely curative treatment and appropriate supportive therapy are essential for the complete recovery. Insufficient treatment poses significant relapse risks and increases risks of complications. Leading in cervical cancer treatment hospitals are located in Europe, namely in Germany.
German hospitals offer precise diagnostic tests, full range of minimally invasive surgeries, all modalities of radiation therapy, chemotherapy, immunotherapy and targeted therapy with innovative drugs. In addition, patients have chance to participate in clinical trials which is especially important in advanced non-curable cancer.
Approximate costs of medical services in the leading German clinics are the following:
- Comprehensive diagnostics – from 1,700 €.
- Conization of the cervix (minimally invasive curative surgery) – from 5,000 €.
- Extensive surgical intervention – from 14,300 €.
- Radiation therapy and chemotherapy (for 6 cycles) – from 18,800 €.
If you are planning treatment abroad for the first time, it will be more safe and convenient to use help of Booking Health. Booking Health is a full-service certified medical tourism operator. Medical specialists of Booking Health assist in choosing the best exactly for your case clinic and elaborate a preliminary treatment plan. Coordinators promptly book the necessary appointment date, help to apply for visa, book tickets and accommodation. Medical interpreters translate available medical reports into German (in order to avoid the repeated examination) and assist in communication with the treating physician.
Should you leave the request for medical help on the BookingHealth.com, the official website of the company, a specialist will contact you the same day and guide through all steps of treatment in the best foreign hospital. We will keep in touch 24/7 and provide help in all medical and non-medical issues.