Cervical Cancer Treatment in Lucknow
HPV Screening & Treatment at Lucknow Cancer Institute
Cervical cancer is the second most common cancer among Indian women and is almost entirely preventable through HPV vaccination and screening. Human Papillomavirus (HPV) causes 70–80% of cases, making prevention and early detection highly effective. Dr. Sidharth Pant provides complete cervical cancer care from HPV screening to advanced chemotherapy and radiation therapy coordination.
Cervical Cancer Burden in India
India carries a disproportionate global burden of cervical cancer
Regional Variation Within India
Highest Incidence:
- North‑Eastern states (Assam, Meghalaya, Mizoram)
Lowest Incidence:
- Southern states (Kerala, Tamil Nadu)
Key Challenge
Critical Alert
India accounts for 1 in 5 global cervical cancer deaths despite representing only 17% of world female population. Early screening and vaccination can dramatically reduce this burden.
HPV – The Primary Cause (70–80% of Cases)
Human Papillomavirus (HPV) and prevention strategies
Human Papillomavirus (HPV)
- High‑risk types (HPV 16, 18) cause nearly all cervical cancers
- Transmitted through sexual contact
- 90% of infections clear naturally within 1–2 years
- Persistent infection over years leads to precancer → cancer
HPV Vaccination in India
- Introduced in 2009 through demonstration projects
- Target: 90% coverage of girls aged 9–14 years (before sexual debut)
- Available vaccines: Gardasil (quadrivalent), Cervarix (bivalent), Gardasil 9 (nonavalent)
- 2–3 dose schedule depending on age at first dose
Lucknow Cancer Institute HPV Vaccination Program
Catch‑up vaccination up to age 26 • School‑based vaccination camps • Affordable pricing for underserved communities
Risk Factors for Cervical Cancer
Understanding what increases your risk
Major Risk Factors
- HPV infection (70–80% of cases) – strongest risk factor
- Early marriage/childbearing (<18 years)
- Multiple pregnancies (≥3 full‑term)
- Poor genital hygiene
- Immunosuppression (HIV, transplant patients)
Socioeconomic & Behavioral
- Multiple sexual partners or partner with multiple partners
- Early sexual debut
- Smoking (increases persistence of HPV)
- Limited access to screening/healthcare
Protective Factors
- HPV vaccination
- Fewer lifetime sexual partners
- Condom use (partial protection)
- Regular screening
When to Seek Medical Attention
Recognizing symptoms of cervical cancer
Early Stage (Often Asymptomatic)
- Detected through screening programs
Symptomatic (Locally Advanced)
- Abnormal vaginal bleeding:
- Post‑coital bleeding
- Intermenstrual bleeding
- Post‑menopausal bleeding
- Vaginal discharge: Watery, blood‑stained, foul‑smelling
- Pelvic pain
- Leg swelling (lymphatic obstruction)
Advanced Disease
- Weight loss, fatigue
- Kidney failure (ureteric obstruction)
- Bowel/bladder fistula
Important
If you experience any of these symptoms, especially abnormal bleeding, seek medical evaluation immediately. Early detection saves lives.
Diagnosis & Staging
Diagnostic pathway and FIGO staging system
Screening → Diagnosis Pathway
Abnormal screening (Pap/VIA/HPV+) → Colposcopy ± biopsy → Cone biopsy (diagnostic + therapeutic)
Staging Work‑up
Examination under anesthesia (EUA) • Cystoscopy/proctoscopy (for bladder/rectum involvement) • Imaging: CT/MRI pelvis, chest X‑ray • PET‑CT (selected cases)
FIGO Staging (Simplified)
Stage I
Confined to cervix
Stage II
Upper 2/3 vagina/upper parametrium
Stage III
Lower vagina, pelvic wall, hydronephrosis
Stage IV
Bladder/rectum invasion, distant metastases
Stage‑Wise Treatment Protocol
Personalized treatment based on cancer stage
Early Stages
Stage IA1 (Microinvasive):
- Cone biopsy (if fertility preservation)
- Simple hysterectomy
Stage IA2–IB1 (<4cm):
- Fertility preserving: Radical trachelectomy + lymphadenectomy
- Radical hysterectomy (Type II/III) + pelvic lymphadenectomy
- Adjuvant radiation if high‑risk pathology
Advanced Stages
Stage IB2–IIA (>4cm):
- Concurrent chemoradiation (preferred):
- External beam radiation (45–50 Gy)
- Brachytherapy (high‑dose rate)
- Weekly cisplatin 40 mg/m²
Stage IIB–IVA:
- Chemoradiation (standard)
- Neoadjuvant chemotherapy (selected bulky stage IIB)
Stage IVB (Metastatic):
- Palliative chemotherapy: Cisplatin + paclitaxel
- Bevacizumab (anti‑angiogenic) in selected cases
- Symptom control
Addressing Cervical Cancer Challenges in India
Solutions at Lucknow Cancer Institute
| Challenge | Solution at Lucknow Cancer Institute |
|---|---|
| Limited screening access | Community VIA camps, mobile units |
| Delayed diagnosis | Rapid triage system |
| Inadequate treatment facilities | Modern brachytherapy suite |
| Lack of awareness | Patient education programs |
| Stigma | Support groups, counseling |
Overcoming Barriers
Single‑visit screen & treat
For VIA positive cases to reduce drop‑out rates
Free HPV vaccination
For underserved communities
Teleconsultation
For follow‑up and remote consultations
Financial counseling
For treatment affordability
Post‑Treatment Surveillance
Comprehensive follow‑up care
| Time Period | Follow-up Schedule |
|---|---|
| Year 1-2 | Every 3 months |
| Year 3-5 | Every 6 months |
| >5 years | Annually |
Follow‑up Includes
- Pelvic examination
- Pap smear (if hysterectomy not done)
- Imaging if symptoms
Survivorship Issues
- Vaginal stenosis (dilation therapy)
- Sexual health counseling
- Fertility options post‑treatment
- Osteoporosis prevention (radiation to pelvis)