HPV infection and cervical cancer: Treatment, management, and aftercare options
Cervical cancer is a type of cancer that arises in the cervix of the human reproductive tract in women and spreads to other parts of the body. According to the reports published by the American Cancer Society, more than 13,000 new invasive cervical cancer cases are detected annually. It is estimated that nearly 0.6% of the women in the country will be diagnosed with cervical cancer at some point in their lives.

It usually tends to be diagnosed in the middle age, but being a slow-growing cancer, the early stages often begin in the 20s and 30s. It has been established that there is a clear and strong link between the human papillomavirus (HPV) infections and cervical cancer. Below is some information to help one understand the disease better.

How is cervical cancer diagnosed?

• Cervical cancer is usually very slow to progress. In many women, no clear symptoms are seen but in some, there may be warning signs at an advanced stage. Abnormal vaginal bleeding and discharge is a common symptom of cervical cancer.
• A colposcopic examination is conducted for checking the presence of abnormal cells.
• A Papanicolaou (Pap) test is used to detect cervical cancer. The test gets its name from the discoverer of the test, George Papanicolaou. Regular Pap smears after 30 are recommended in high-risk women. If the Pap test shows abnormal cells, one needs to get a biopsy. A small portion of the cervix is removed and tested for cancer cells.
• Ultrasound scans cannot detect precancerous cell changes.
• HPV DNA testing is an option for women in the 30+ age group, as there is a clearly established link between an HPV infection and cervical cancer.

What are the different stages of cervical cancer?

• If cervical cancer is detected in the biopsy report, further testing is needed to establish the stage to which cancer has progressed (Stages 1-4).
• In stage 1, cancer is restricted to the cervical area only. Stage 2 cancer progresses beyond the cervix into the upper region of the vagina. In stage 3, the cancer moves into the pelvic region and the lower portion of the vagina. In stage 4 (final), cancer spreads to the rectum, bladder, and other parts of the body like the lungs, liver, brain, etc.
• It’s important to determine the stage of the cancer because the treatment methods differ according to each stage.
• Stage detection helps doctors and patients form a reasonable prognosis.

Can HPV infection causing cervical cancer be treated?

• HPV infections have been directly linked to the prevalence of cervical cancer.
• Detecting this infection early enough helps prevent progression into cancer.
• Lesions caused by persistent HPV are treated with cold knife surgery, cauterization, etc.
• Cervical cancer treatment options are based on the diagnosed stage of cancer.
• Radical hysterectomy is the most common treatment in the early stages of the cancer.
• Radiation therapy and chemotherapy are an alternative to surgery.
• Very early stages of cancers can be treated with conization or simple hysterectomy (removal of the cervix and the uterus only).
• Treatment is provided by gynecologists, gynecologic oncologists, and medical and radiation oncologists.
• A multidisciplinary approach involving nurses, social workers, psychologists, rehabilitation professionals, etc. is needed to treat the cancer effectively.

How to choose the right treatment method?

• Doctors discuss available treatment options with patients based on the diagnostic reports.
• Age, health status, and preferences of the patient and the doctor’s experience, knowledge, and expertise determine the line of treatment.
• Cervical cancer diagnosis and treatment affects the patient’s present and future ability to maintain a sexual life and/or have children. Therefore, second opinions must be taken.
• Staying well-informed about treatment options but not getting obsessed or trying to control them is important.
• Doctors provide comprehensive information about the side effects and the risks associated with the various treatment options.
• Participating in clinical trials gives access to the latest treatment methods.
• Complementary and alternative treatment options are not usually suggested by physicians.
• However, these may help relieve symptoms, provide pain relief, and offer peace of mind.
• Palliative care is essential in the terminal stages of the cancer.

What are the management and aftercare options?

• Treatment is not the end of the process of cervical cancer. Recurrence of cervical cancer is a possibility that should not be taken lightly or ignored.
• The patient’s healthcare team needs to be in a state of constant vigilance for recurring signs and symptoms.
• Supportive care is also essential for managing the side effects of chemotherapy.
• New, targeted, and advanced chemotherapy treatment options should be explored.
• Biological therapies stimulate the body’s own immune system to destroy cancer cells.
• Complete physical examination every 3-4 months for the first two years and 4-6 times every six months thereafter is essential.
• Annual Pap smear test must be conducted.