Esperanza, patient group for women with gynaecological cancers (Dutch/French)
When cancer occurs in the cervix, which is the lower, narrow part of the uterus, it is called cervical cancer, and it distinguishes itself from uterine cancer in appearance as well as treatment.
There are two types of cervical cancer:
In Belgium, around 640 women are diagnosed with cervical cancer, with most patients being between the ages of 30 and 55. Annually, around 300 women die of the disease.
Cervical cancer is a relatively slow developing cancer, which means that symptoms often do not occur until the disease has reached a more advanced stage. Symptoms that may occur include:
In 80 percent of all cases of cervical cancer, the human papilloma virus (HPV) is present. There are over 100 HPV types known, and only a few of them are associated with causing cancer. When the immune system is unable to dispose of the virus, HPV can cause cell mutations in the cervix. In early stages, the mutated cells are relatively easy to remove, but after 10 to 15 years they can develop into cancer.
Since the presence of mutated cells in the cervix is undetectable, women in Belgium between the ages of 30 and 60 are invited every five years to have a pap smear test in order to diagnose a developing cervical cancer at an early stage.
Aside from the presence of HPV, there are other risk factors associated with cervical cancer.
When a GP suspects a patient may have cervical cancer, they will conduct a physical exam that will include a smear test. If this smear shows evidence of mutating cells in the cervix, the patient will be referred to a gynaecologist. The woman can also have been sent to the gynaecologist as a result of her 5-year test.
The gynaecologist may conduct a vaginal exam or perform a colposcopy during which some cervical tissue may be collected for further research.
If results point towards a tumorous growth, extra tests are needed in order to determine the extent of the growth and whether other organs have been affected. Among possible tests are thorax X-rays, further vaginal exams, CT scans, PET scans and MRI scans.
Cervical cancer has four stages. Determining at which stage the patient’s symptoms are greatly determines the therapeutic approach.
The differentiation of the tumour is an important factor in establishing a prognosis and treatment plan. This can be determined on the basis of a biopsy. A biopsy involves the removal of a small bit of tissue, which can be examined under a microscope. Differentiation determines the degree of mutation in the cancerous cells.
Once all tests have been conducted and the nature of the tumour has been established, a treatment plan is devised by the oncologist. Treatment options include operation, radiation, chemotherapy and hyperthermic therapy. The latter involves heating up the tumour area, thereby making the cancer cells more susceptible to other methods of treatment, or even destroying them completely.
If the cervical cancer is detected at an early stage, a conisation may be conducted. This involves the removal of a section of the cervix, leaving the womb itself intact. This is a relatively non-invasive type of surgery that can be done under epidural anaesthesia. If the woman no longer desires to have children, a full hysterectomy is often performed. When the patient wants to remain able to conceive, a trachelectomy is an option, a procedure in which only the cervix is removed.
If the cancer has moved to more advanced stages, radiotherapy, chemotherapy or a combination of the two is generally advised. Hyperthermic therapy is sometimes offered as an alternative to chemotherapy, its benefit being fewer side-effects for the patient. These therapies are sometimes combined with an operation. For patients who are ineligible for chemotherapy, targeted therapy with a VEGF inhibitor is indicated. Research into this therapeutic area is currently ongoing.
Top
