28 January 2023
A 45-year-old woman had been experiencing persistent vaginal discharge and postcoital bleeding (bleeding after sexual intercourse). She found no relief from treatment taken from other doctors. The patient recently approached Dr Shweta Tahlan, Consultant, Gynae Onco-Surgery, Fortis Hospital Mohali.
Medical investigations including cervical biopsy revealed that the patient was suffering from invasive squamous cell carcinoma. The MRI of the pelvis and contrast-enhanced computed tomography (CECT) of the thorax and abdomen showed that the cancer was in Stage 1. As the cancer had been diagnosed at an early stage, Dr Tahlan performed Radical Hysterectomy (total surgical removal of the uterus along with the surrounding tissue and pelvic lymph nodes). She did not require any adjuvant treatment.
The patient had a smooth post-operative recovery and was discharged on the fifth day of the surgery. She has recovered completely and leading a normal life today.
Emphasizing on early detection of cervical cancer, Dr Tahlan, said, “Every woman should be careful to notice any unusual changes in her body and seek a consult immediately in case of any symptoms. Early stage of cervical cancer may not produce any symptoms. However, symptoms may include postcoital or intermenstrual vaginal bleeding, irregular periods, postmenopausal bleeding, persistent or foul-smelling vaginal discharge and pelvic pain. Early cervical cancer can be treated through surgery alone, and one may avoid undergoing chemotherapy and radiotherapy. Imaging such as CT scan, MRI or PET-CT as per requirement, besides tissue biopsy is done while managing a patient with cancer.
On the benefits of regular screening, which is recommended for all women between 25 years and 65 years of age, Dr Tahlan, added, “Before cervical cancer develops, there is a long pre-cancerous stage wherein abnormal cells are present in the body, but the cancer has not formed yet. Patient usually has no symptoms in precancer stage and this can be detected by screening only. At this stage, simple surgical procedures like Loop Electrosurgical Excision Procedure (LEEP) and Cone Biopsy (surgery to remove abnormal tissue from the cervix) can treat the patient completely without the need of Radical Hysterectomy and uterus and ovaries can be saved.”
Dr Tahlan further highlighted the importance of HPV vaccination in beating cervical cancer. “The ideal age for vaccination of girls is 9-14 years of age, though the catch-up vaccination can be done till 26 years of age. Vaccination done in childhood or adolescence helps to prevent against cervical cancer in later years of life.”
Giving information on various screening tests for cervical cancer, Dr Tahlan, added, the tests include pap smear, High-Risk Human Papillomavirus (hrHPV) test, visual inspection of the cervix with acetic acid (VIA) and visual examination after VIA (VILI). Colposcopy is done to detect cervical pre-cancer stage which is curable through simple surgical procedures. For other gynae cancers, no routine screening tests are available. It is therefore important to consult a doctor at the earliest in case of any warning signs.”
The Cervical Cancer Screening Clinic is being headed by Dr Shweta Tahlan at Fortis Hospital Mohali.