How should cervical cancer be treated?

Although cervical cancer is dangerous, it also has its own "weaknesses" and is most easily detected and treated early. It takes 6 to 8 years for early inflammation to develop into malignant cancer. If you take advantage of this period of time, modern medical methods can completely detect cancer and take appropriate measures in time to ensure that women can live a healthy life again. The treatment of cervical cancer is divided into atypical hyperplasia, carcinoma in situ, early invasive cancer under the microscope, and the treatment of invasive cancer.

1. Treatment principles

1. Atypical hyperplasia: If the biopsy shows mild atypical hyperplasia, it should be temporarily treated as inflammation, and follow-up scrapings should be performed for half a year and biopsy should be performed if necessary. If the lesion persists, observation can be continued. For patients diagnosed with moderate atypical hyperplasia, laser, freezing, and electric ironing should be used. For severe atypical hyperplasia, total hysterectomy is generally recommended. If fertility is urgently required, regular and close follow-up can also be performed after cone excision.

2. Carcinoma in situ: It is generally recommended to perform a total hysterectomy and retain both ovaries; some people also advocate removing 1 to 2 cm of the vagina at the same time. In recent years, laser treatment has been used both at home and abroad, but close follow-up is required after treatment.

3. Microscopic early invasive cancer: Generally, extended total hysterectomy and removal of 1 to 2 cm of vaginal tissue are recommended, because the possibility of lymph node metastasis of microscopic early invasive cancer is extremely small, and there is no need to eliminate pelvic lymph tissue.

4. Invasive cancer: The treatment method should be based on the clinical stage, age and general condition, as well as equipment conditions. Commonly used treatment methods include radiation, surgery and chemotherapy. Generally speaking, radiotherapy is suitable for patients at all stages; the surgical effect of stages Ib to IIa is similar to that of radiotherapy; cervical adenocarcinoma is slightly less sensitive to radiotherapy, and a comprehensive treatment of surgical resection plus radiotherapy should be adopted.

(ii) Surgical treatment includes radical hysterectomy and pelvic lymph node elimination. The removal range includes the entire uterus, bilateral adnexa, upper vagina and paravaginal tissue, and spare groups of pelvic lymph nodes (paracervical, obturator, internal iliac, external iliac, and lower common iliac lymph nodes). The operation must be thorough and safe, with strict control of indications to prevent complications.

(III) Surgical complications and their treatment 1. Surgical complications include intraoperative bleeding, postoperative pelvic infection, lymphocele, effusion, urinary tract infection and ureterovaginal fistula, etc.

2. Treatment of surgical complications. In recent years, the incidence of the above complications has been significantly reduced due to improvements in surgical methods and anesthesia techniques, the use of preventive antibiotics, and the use of extraperitoneal negative pressure drainage after surgery.

(IV) Radiotherapy is the treatment of choice for cervical cancer and can be applied to cervical cancer of all stages. The radiation range includes the cervix and affected vagina, uterine body, parametrial tissue and pelvic lymph nodes. The irradiation method generally adopts a combination of internal and external irradiation. Internal irradiation is mainly aimed at the primary lesion of the cervix and its adjacent parts, including the uterine body, upper part of the vagina and its adjacent parametrial tissue (point "A"). External irradiation is mainly aimed at the area where pelvic lymph nodes are distributed (point "B"). The internal radiation source uses intracavitary radium (Ra) or 137cesium (137Cs), which is mainly aimed at the primary lesion of the cervix. The external radiation source uses 60 cobalt (60Co), which is mainly aimed at metastatic lesions outside the primary lesion, including the pelvic lymph node drainage area. The dose is generally 60Gy. At present, it is advocated to perform internal irradiation first for early cervical cancer, while for advanced cancer, especially those with huge local tumors, active bleeding, or concomitant infection, it is appropriate to perform external irradiation first.

(V) Chemotherapy: So far, cervical cancer is insensitive to most anti-cancer drugs, and the effective rate of chemotherapy does not exceed 15%. Advanced patients can adopt comprehensive treatments such as chemotherapy and radiotherapy. Chemotherapy drugs such as 5-fluorouracil and doxorubicin can be injected intravenously or locally.

The above is an introduction to "How should cervical cancer be treated?" For people who are related to the pathogenic factors of cervical cancer, it is recommended to take preventive measures against cervical cancer. If you have other questions about cervical cancer, please consult our experts online or call for consultation.

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