What are the treatments for cervical cancer? How to treat cervical cancer

Cervical cancer is one of the most common malignant tumors and ranks second among female tumors. About 200,000 women die from this disease every year in the world. So what is the treatment for cervical cancer? Let's take a look!

1. Treatment principles

1. Atypical hyperplasia: If the biopsy is mild atypical hyperplasia, it is temporarily treated as inflammation, and the scraping is followed up for half a year, and biopsy is performed if necessary. Those whose lesions remain unchanged can continue to be observed. The diagnosis of moderate atypical hyperplasia should be applicable to laser, freezing and electric ironing. For severe atypical hyperplasia, total hysterectomy is generally advocated. If fertility is urgently needed, regular close follow-up can also be performed after cone resection.

2. Carcinoma in situ: It is generally recommended to perform a total hysterectomy and retain both ovaries; it is also recommended to remove 1~2cm of the vagina at the same time. Laser treatment has been useful in recent years at home and abroad, but close follow-up is required after treatment.

3. Microscopic early invasive cancer: generally, extended total hysterectomy and 1-2 cm vaginal tissue are recommended. Pelvic lymphatic tissue does not need to be eliminated because the possibility of lymphatic metastasis of microscopic early invasive cancer is very small.

4. Invasive cancer: Treatment is based on clinical stage, age, physical condition and equipment conditions. Common treatment methods include radiotherapy, surgery and chemotherapy. Generally speaking, radiotherapy is suitable for patients at all stages; the efficacy of surgery for stage Ib to IIa is similar to that of radiotherapy; cervical adenocarcinoma is slightly less sensitive to radiotherapy and should be treated with a combination of surgical resection and radiotherapy.

(2) Extensive hysterectomy and pelvic lymph node resection are used for surgical treatment. The scope of resection includes the entire uterus, bilateral adnexa, upper vagina and paravaginal tissues, and pelvic lymph nodes (paracervical, obturator, internal iliac, external iliac, and lower common iliac lymph nodes). The surgery needs to be thorough, safe, with strict indications and prevention of complications.

(3) Complications and surgical treatment

1. Complications such as intraoperative bleeding, postoperative pelvic infection, lymphocele, retention, urinary tract infection, ureterovaginal fistula, etc.

2. 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 adoption of postoperative extraperitoneal negative pressure drainage.

(4) Radiotherapy is the first choice for the treatment of cervical cancer and can be applied to all stages of cervical cancer, including the cervix and affected vagina, uterine body, parauterine 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, the upper part of the vagina and its adjacent parauterine tissue (point "A"). External irradiation is mainly aimed at the pelvic lymph node distribution area (point "B"). The internal radiation source uses intracavitary laser (Ra) or 137 cesium (137Cs), which is mainly aimed at the primary lesion of the cervix. The external radiation source is 60 cobalt (60 cobalt) Co), which is mainly used for metastatic lesions other than the primary lesion, including the pelvic lymph node drainage area. At present, internal irradiation is mainly advocated for early cervical cancer. For advanced cancer, especially those with huge local tumors, active bleeding, or accompanied by infection, external irradiation should be performed first.

(5) So far, cervical cancer is insensitive to most anticancer drugs, and the chemotherapy efficiency does not exceed 15%. Advanced patients can be treated with a combination of chemotherapy and radiotherapy.