Cervical Cancer – Causes, Signs, Diagnosis, Treatment, Surgery and Cost

Cervical cancer ranks as the fourth most prevalent cancer among women. It begins in the cervix, which is the bottom region of the uterus attached to the vagina. Cervical cancer is caused mainly by the human papillomavirus (HPV), which is transmitted through sexual contact. Here we are going to discuss about cervical cancer surgery and treatment.

In 2020, there were around 604,000 new cases of cervical cancer worldwide, with approximately 342,000 deaths. Cervical cancer is most commonly diagnosed in individuals aged 35 to 45. The disease is increasingly common in low- and middle-income nations, and women with HIV are at a much higher risk. Cervical cancer is six times more common in HIV-positive women.

Medical professionals in India are developing new methods for cervical cancer surgery. Cervical cancer surgery in India focuses on improving women’s health by providing minimally invasive treatments as well as fertility-preserving options. These ground-breaking treatments give hope to countless women. Cervical cancer surgery in India has shown good success rates and comprehensive care for patients with cervical cancer.

Types of Cervical Cancer

Squamous Cell Carcinoma: This is the most common type of cervical cancer, accounting for 80-90% of all cases. It begins in the cervix’s lining, specifically at the point of the transition zone where the exocervix joins the endocervix.
Adenocarcinoma: Adenocarcinomas account for 10-20% of all cervical cancer cases. These tumors originate in glandular cells in the endocervix that produce mucus.
Adenosquamous Carcinoma or Mixed Carcinoma: Some cases have characteristics of both squamous cell carcinomas and adenocarcinomas; hence they are classified as adenosquamous carcinomas or mixed carcinomas.

Although the majority of cervical cancers fall into the first two categories, additional rare cancers such as melanoma, sarcoma, and lymphoma can also attack the cervix, though more rarely.

Symptoms of Cervical Cancer

Early-stage cervical cancer is usually asymptomatic, emphasizing the importance of regular cervical cancer tests to detect it early. However, as it develops, it can cause a number of signs and symptoms, such as:

Abnormal Vaginal Bleeding: This might happen between periods, after sexual intercourse, or after menopause. Periods may also become heavier and longer than usual.
Unusual Vaginal Discharge: Some women may have continuous vaginal discharge that is pale, watery, pink, brown, bloody, or have a bad smell.
Pelvic Pain: As the cancer progresses, it may produce pelvic pain or discomfort, which can be experienced during intercourse.
Pain during Intercourse
Back pain
Bone pain or fractures
Fatigue
Urinary or fecal leakage
Leg pain
Loss of appetite
Unexplained weight loss
Swelling in the legs

Causes of Cervical Cancer

Cervical cancer is caused mostly by chronic infection with high-risk variants of the human papillomavirus (HPV), including HPV types 16 and 18. These viruses are spread by sexual contact and can cause the formation of abnormal cells in the cervix, which can progress to cancer if left untreated. Some factors that increase the risk of cervical cancer include:

Smoking: Cigarette smoking raises the risk of developing cervical cancer.
Weakened Immune System: A weakened immune system can reduce the body’s ability to defend against HPV infections.
Oral Contraceptive Use: Long-term usage of oral contraceptives is associated with an increased risk.
Multiple Sexual Partners: Having multiple sexual partners can increase risk of acquiring HPV.
Early Sexual Activity: Starting sexual activity at a young age may increase the risk.
Family History: A family history of cervical cancer may increase risk.

Risk Factors of Cervical Cancer

HPV Infection: The major risk factor is infection with high-risk variants of the human papillomavirus (HPV).
Sexual History: HPV exposure is increased by early sexual activity and having multiple sexual partners.
Smoking: Tobacco use raises the risk of cervical cancer.
Weakened Immune System: HIV and immune-suppressing drugs increase the risk of cervical cancer.
Chlamydia Infection: This common bacterial STI may raise the risk of cervical cancer.
Long-term Oral Contraceptive Use: The use of birth control tablets for a longer duration of time is associated with an increased risk of cervical cancer.
Multiple Full-term Pregnancies: A history of three or more full-term pregnancies may raise the risk.
Young Age at First Pregnancy: Pregnancy before the age of 18 can increase the risk.
Diethylstilbestrol (DES) Exposure: Your risk of acquiring cervical cancer may be increased if your mother used DES during her pregnancy.

Prevention of Cervical Cancer

HPV Vaccine: HPV vaccine can lower the risk of cervical cancer and other HPV-related cancers significantly. To protect against high-risk HPV types, HPV vaccination is often recommended for eligible individuals.
Routine Pap Tests: Regular Pap tests should be performed beginning at the age of 21 and repeated every few years. Pre-cancerous cervical abnormalities detected by Pap tests can be monitored or treated to prevent cervical cancer.
Safe Sex Practices: To lower the risk of HPV and other sexually transmitted diseases (STIs), use condoms during sexual activity. Limit the number of sexual partners and avoid those who engage in risky sexual activities.
Smoking Cessation: If you smoke, you should consider quitting because it increases the chances of acquiring cervical cancer.
Limit Exposure to HPV: HPV spreads through skin-to-skin contact, even in the absence of sexual interaction. While limiting contact is difficult, being aware of potential exposure might be helpful.
Get Tested for STIs: Test for other sexually transmitted infections including Chlamydia, gonorrhea, and syphilis on a regular basis. If you are at high risk, consider being tested for HIV at least once.
Maintain a Healthy Lifestyle: Eat a well-balanced diet high in fruits and vegetables to reduce the risk of cervical cancer.

Stages of Cervical Cancer

Stage I: Cancer is only detected in the cervix, and it is usually in its early stages.
Stage II: The cancer has spread beyond the cervix but has not yet reached the pelvic wall or the upper section of the vagina.
Stage III: Cancer has spread to the bottom region of the vagina and could damage the pelvic wall, ureters (tubes that carry urine), and lymph nodes.
Stage IV: Cancer has spread to other parts of the body at this stage, including the bladder, rectum, bones, and even the lungs.

Screening of Cervical Cancer in India

Cervical cancer screening is of vital importance for early diagnosis of precancerous alterations and cervical cancer. In India, the following primary screening tests are used for cervical cancer surgery:

Pap test (Pap smear): A Pap test is one of the most used screening procedures in India. During this test, a healthcare provider removes cells from the cervix, which are then examined in a laboratory for any abnormal or precancerous changes. If found early, these changes can be treated before they progress to cancer.
HPV DNA Test: An HPV DNA test may be used in combination with or after an abnormal Pap test result in some cases. This test looks for high-risk types of human papillomavirus (HPV) that are most likely to cause cervical cancer. Early diagnosis of these HPV infections enables quick treatment to avoid cancer development.

India has adopted the Cervical Screening Test, which is associated with the HPV vaccination program; giving women aged 25-74 the option of self-collected or clinician-collected samples, hence increasing access to screening. These screening activities, together with vaccinations, play an important role in the prevention of cervical cancer.

Diagnosis of Cervical Cancer in India

The tests and procedures used in India for cervical cancer diagnosis are:

Colposcopy with Biopsy: A colposcope is used to magnify the cervix, and if any abnormalities are found, a tissue sample (biopsy) is taken for a microscopic analysis.
Large Loop Excision of the Transformation Zone (LLETZ): This type of procedure may be used to remove cervical tissue for the purpose of examining and treating precancerous abnormalities.
Cone Biopsy (Conization): To gather deeper layers of cervical tissue for biopsy, a cone-shaped wedge of cervical tissue is removed.
Additional Tests for Staging: If cervical cancer is identified, more tests are performed to determine the stage and extent of the disease. These tests may include:
- Chest X-ray
- CT Scan of Abdomen and Pelvis
- Cystoscopy – To inspect the bladder and urethra.
- Intravenous Pyelogram (IVP) – To examine the urinary tract.
- MRI of Abdomen and Pelvis
- PET Scan

Treatment of Cervical Cancer in India

Cervical cancer surgery treatment in India is difficult and depends on a variety of factors, including the stage of the cancer, and the patient’s overall health. Different types of treatment include:

Surgery:
- Cone Biopsy: A cone biopsy may be performed in early-stage cervical cancer to remove cancerous tissue while preserving fertility.
- Radical Trachelectomy: The cervix and some surrounding tissue are removed during this treatment, but the uterus is left in place. It is an effective choice in some cases where fertility preservation is desired.
- Hysterectomy: The majority of cervical cancer cases are treated by radical hysterectomy, which involves the removal of the cervix, uterus, a portion of the vagina, and adjacent lymph nodes. This, however, eliminates the chance of pregnancy.
Radiation Therapy:
- External Beam Radiation Therapy (EBRT): This approach sends radiation beams from outside the body to the affected area.
- Brachytherapy: Radioactive implants are implanted into or near the cervix, providing precise radiation delivery to the tumor.
Chemotherapy: For cervical cancers that have spread beyond the cervix, low-dose chemotherapy is sometimes combined with radiation therapy. Higher chemotherapy dosages may be recommended to control advanced cancer symptoms or reduce tumor growth before surgery.
Targeted Therapy: Specific molecules or proteins within cancer cells are targeted by targeted therapy. They are used in combination with chemotherapy.
Immunotherapy: Immunotherapy uses the immune system of the body to recognize and destroy cancer cells. It is considered in the case of advanced cervical cancer when other treatments are ineffective.
Recurrent Cervical Cancer: Recurrent cervical cancer treatment often focuses on reducing cancer growth, relieving symptoms, and increasing quality of life. Surgery, radiation, chemotherapy, immunotherapy, and targeted therapy are all the available alternatives.
Cervical Cancer in Pregnancy: When cervical cancer occurs during pregnancy, the approach to treatment is very personalized and depends on aspects such as the cancer stage and pregnancy stage.

Cervical Cancer Doctors in India

The medical team that treats cervical cancer in India may consist of:

Gynecologist: They perform initial diagnosis and specialize in the female reproductive system.
Gynecologic Oncologist: They are very skilled in the surgical and chemotherapeutic treatment of cervical cancer.
Radiation Oncologist: They administer radiation therapy.
Medical Oncologist: They plan and execute targeted therapies and chemotherapy.

Cervical Cancer Survival Rate in India

When cervical cancer is detected early, the five-year relative survival rate can surpass 90%. Fortunately, more than fifty percent of all cervical cancer cases are detected at an early stage.

For white women aged 50 and older, the five-year survival rate is 71%.
For young women under the age of 50, the five-year survival rate is 78%.
For black women aged 50 and older, the five-year survival rate is 46%.
For young women under the age of 50, the five-year survival rate is 58%.

This survival rate data emphasizes the importance of early detection and the potential for successful cervical cancer treatment results.

Cervical Cancer Surgery Cost in India

The general cost of cervical cancer treatment in India ranges between:

Trachelectomy for early-stage cervical cancer: Approximately $5,000 to $7,000.
Hysterectomy for more advanced cases: Starting from $3,000.
Chemotherapy: Between $500 to $1,000 per cycle.

The costs can vary depending on the patient’s condition, additional tests, post-surgery treatment, and hospital stay length. Overall, cervical cancer surgery in India is significantly less expensive than in many other countries, up to 50%, making it a preferred option for many patients.

Best Hospital for Cervical Cancer Surgery in India

Finding the best hospital for cervical cancer surgery in India is essential for successful treatment. India has various world-class hospitals that specialize in cervical cancer treatment. These hospitals have cutting-edge technology and a staff of highly qualified medical professionals who specialize in cervical cancer surgery. Patients looking for the top hospital in India for cervical cancer surgery may expect specialized treatment choices such as surgical treatments, chemotherapy, and radiation therapy.

Artemis Hospital, Gurgaon
Indraprastha Apollo Hospitals, New Delhi
Medanta – The Medicity, Gurgaon
Fortis Memorial Research Institute, Gurgaon
BLK Super Speciality Hospital, New Delhi
Gleneagles Global Hospital, Perumbakkam, Chennai
Lilavati Hospital, Mumbai
Sanar International Hospital, Gurgaon

Top Doctors for Cervical Cancer Surgery in India

Patients considering cervical cancer surgery in India can put their trust in the best doctors who have expertise in this field. These top cervical cancer doctors in India are well-known for their significant expertise and experience in the field of cervical cancer treatment. They offer a wide range of modern medical treatments using cutting-edge technology to ensure the best possible patient outcomes.