Cervical Cancer Treatment Hospital in Delhi, India

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• Dr. Satinder Kaur
• Consultant Gynae Oncologist
• Dharamshila Hospital And Research Centre

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• Opening of the uterus (womb) into the vagina
• The cervix connects the uterus and vagina
• Only Gynae cancer that can be prevented through
  routine screening.

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• Cervical cancer is the most common cancer in
  Indian women.
• 1,32,000 new cases/ year 74,000 deaths/year.
• Every 7 min one woman dies of Cervical cancer!
• 1 out of 4 woman who dies due to Cervical cancer
  in the world is an Indian!!

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• The central cause of cervical cancer is a virus.
• This virus is called
• human papillomavirus or HPV
• HPV is sexually transmitted

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In India, these 5 HPV types are responsible for
90 - 95 of Cervical Cancers
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• Any women who ever had sexual intercourse

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• About 50 of sexually active women are infected
  with HPV within 3 years of onset of sexual
  activity
• If I have HPV, does it mean I will get cancer?
• NO!
• In most cases HPV goes away
• Only women with persistent HPV (where the virus
  does not go away) are at risk for cervical cancer

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• Multiple sexual partner
• Sexual intercourse at young age
• Poor diet, and other infections.
• Cigarette smoking.
• Immune defenses are low (e.g., AIDS.

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• Abnormal vaginal bleeding (e.g., spotting after
  sexual intercourse, bleeding between menstrual
  periods, increased menstrual bleeding).
• Abnormal (yellow, odorous) vaginal discharge,
  often of a yellow or green color and foul
  smelling.
• Low back pain
• Cervical Pain, noted when a tampon, finger or
  penis is inserted into the vagina.
• Painful sexual intercourse
• Painful urination is seen with advancing disease
• Some women have no symptoms at all.

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• PAP SMEAR
• COLPOSCOPY
• CERVICAL BIOPSY

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• Three years after the onset of sexual intercourse
  
• How often do I need a Pap test?
• Atleast three yearly

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• I feel fine, so why do I need a Pap test?
• A Pap test can find treatable changes of the
  cervix (precancer) before you have a symptom or
  notice a problem
• Once a problem is symptomatic, it is harder to
  treat
• Why do I need to keep getting tested?
• Changes (abnormalities) may occur since the last
  test
• It may take many years for changes to develop or
  be detected
• Your risk changes if you have new partners

It is the easiest gynecologic cancer to prevent
through screening
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• Schedule your Pap when you are not having a
  menstrual period
• It is best to abstain from intercourse and avoid
  use of tampons or douches for two days before
  your Pap test
• If you have an abnormal result, it is extremely
  important to follow-up for the recommended
  testing

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• If you had treatment for pre cancer or cancer of
  the cervix, you may need a Pap test
• If the cervix was left in place at the time of
  your hysterectomy, you will still need Pap tests

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• A test sometimes used to determine if you need
  further evaluation
• Cells are collected just like a Pap test
• It checks for high-risk HPV

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• May feel like getting a Pap test or like a
  menstrual cramp that lasts a few seconds

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• Surgery (hysterectomy)
• Radiation Therapy
• Chemotherapy

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FIGO Stage 5-Year Survival
Stage I 81-96
Stage II 65-87
Stage III 35-50
Stage IVA 15-20
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• Bivalent vaccine (CERVARIXTM )
• - Against HPV types 16 18
• Quadrivalent vaccine (GARDASIL)
• - Against HPV types 6,11, 16 18
• Both are licensed for use in gt 100 countries
• are approved by the Indian FDA

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What is the optimal age for vaccination?
Prophylactic vaccine - Immunization before
onset of sexual activity
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• Gardasil 9-11 yrs
• Cervarix 10-12 yrs
• Can be given 13-26 yrs
• Cervarix can be given upto 45 yrs but the role is
  doubtful

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• Intramuscular injection of 3 doses/0.5mL each
• 1st dose 0
• 2nd dose at 1 month (Cervarix)
• at 2 months (Gardasil)
• 3rd dose at 6 months

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• People who get vaccinated will still need Pap
  tests because the vaccine will not prevent all
  types of HPV that can cause cervical cancer.

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• Local reactions commonest
• (pain, swelling)
• Syncope Give vaccine in sitting / lying down
  position, and observe for 15 minutes after
  vaccination
• No serious adverse reactions reported

similar to reports in placebo recipients (9)
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• Cervical cancer causes significant morbidity/
  mortality
• HPV vaccine to be offered to all appropriate
  females who can afford the vaccine
• Vaccine should be given prior to sexual debut

www.fogsi.org/hpv vaccine
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• Delay onset of sexual activity
• Know your sexual partner
• Do not smoke
• Maintain a healthy diet and lifestyle
• Practice safe sex

Get your Pap test
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Cervical cancer treatment and surgery in India is
available at Dharamshila Hospital And Research
Centre (DHRC). Based in India, Delhi NCR, DHRC is
the first cancer hospital of India established
with an aim at making cancer treatment available,
accessible and afforadable. At DHRC, a
multidisciplinary team (MDT) of oncologists is
always available to treat cervical cancer and
tailor the treatment programme for the cancer
patients. Besides this, DHRC is well-equipped
with advanced treatment technologies and world
class infrastructure. And, this may be the reason
why patients from over 30 countries around the
world choose DHRC for the treatment.
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Thank You