Cervical Cancer - Treatment

Cervical cancer treatment involves multimodal approaches including surgery, radiotherapy, chemotherapy, and targeted therapy, depending on the stage, histology, and patient factors.

Definition

Cervical cancer treatment involves multimodal approaches including surgery, radiotherapy, chemotherapy, and targeted therapy, depending on the stage, histology, and patient factors.

Epidemiology

Cervical cancer is the fourth most common cancer in women worldwide
Higher incidence in low- and middle-income countries due to limited screening and vaccination
Peak incidence occurs between ages 35–55
Early detection significantly improves survival rates
Squamous cell carcinoma is the most common histologic type (~70–80%), followed by adenocarcinoma (~20–25%)

Etiology

Persistent high-risk HPV infection (types 16, 18, 31, 33, 45) is the primary cause
Co-factors: smoking, immunosuppression (HIV), long-term oral contraceptive use, early sexual debut, multiple sexual partners
Genetic susceptibility and chronic cervical inflammation may contribute
Histologic progression: CIN 1 → CIN 2–3 → invasive carcinoma

Pathophysiology

HPV infects basal epithelial cells and integrates its DNA into host genome
Viral oncoproteins E6/E7 inactivate p53 and Rb tumor suppressors, leading to uncontrolled proliferation
Local invasion into stroma, parametria, and adjacent organs occurs in advanced disease
Lymphatic and hematogenous spread to pelvic lymph nodes, lungs, liver, and bone in late stages
Treatment aims to remove, destroy, or control malignant cells and prevent metastasis