Cervical cancer: prognosis
Doctors distinguish several factors that affect the survival rates for cervical cancer:
- stage of the disease;
- location of the cancer within the cervix;
- the type of cancer (squamous cell or adenocarcinoma);
- is there metastasis in the lymph nodes;
- weather tumor has grown into other tissues.
The determining factor is the stage of the disease and the state of the lymph nodes.
After a radical hysterectomy at stages I and II, the five-year survival rate is:
- 88 - 99% if lymph nodes are intact;
- 50 - 74% if there are metastases in the lymph nodes of the pelvis.
The survival rates are lower if cancer has affected the para-aortic lymph nodes. Also, the prognosis depends on the number of affected lymph nodes.
Prognosis regarding stage
If the cervical cancer treatment was done right (according to international protocols), it increases the patient's chances of returning to normal life after the surgery. The five-year survival rate ranges from 5 to 85%, depending on the stage of the disease. Over the past 10 years, the life expectancy of patients with I and II stages of cervical cancer has increased significantly.
Five-year survival rate
- Stage 1 - 85 – 90 %
- Stage 2 - 70 – 75 %
- Stage 3 - 30 – 35 %
- Stage 4 - 5 – 7 %
Within 3 years after the treatment, 70-75% of patients have a relapse. Relapse occurs if a few of the cancer cells survived the initial treatment. It happens because they spread to other parts of the body and are too small to be detected during the follow-up after treatment. Often cervical cancer affects vagina (40-45%), the lymph nodes of the pelvis (25-30%) and the distant organs (25-30%).
In 25% of cases, pelvic radiation therapy helps to get rid of recurrence. If the tumor metastasizes, the positive result is only 10%.
Life after illness
Cervical cancer and its treatment, of course, negatively affect the quality of life of patients. The consequences can be observed for many years after the end of treatment.
A study was conducted in which took part 120 women after the operation with subsequent (adjuvant) cancer treatment and without it. None of them showed any relapse after the surgery for 7 years. These were patients with the early stages of cancer.
In another study (98 women participated) where surgery was conducted 5 to 15 years ago, patients suffered symptoms of intoxication, pelvic pain, sexual and intestinal disorders, urinary incontinence.
Treatment of cervical cancer leads to impairment of ovarian function. However, about 40% of patients are women younger than 45 years. Many of them want to have children in the future, so the issue of preserving the reproductive function is crucial.
In a radical hysterectomy, the ovaries usually stay intact, but after surgery, there is a chance that their function will die out due to a blood supply disorder. Radiation therapy negatively affects ovulation due to high doses. Problems with ovulation can lead to infertility, early menopause, sexual disorders.
Before starting treatment, it is essential to consult with a doctor about the desire to maintain a childbearing function. The doctor determines the possibility of performing an organ-preserving surgery.
In case of menopause that began due to cervical cancer treatment, hormone replacement therapy is prescribed. The drugs help cope with such undesirable symptoms as dryness in the vagina, pain during intimacy.
Hysterectomy and irradiation often lead to a change in the structure of the vagina, its length, the elasticity of tissues, which affects the quality of sexual life. After a series of studies, doctors found the following patterns in sexual disorders:
- patients who underwent irradiation after the operation had lower quality of life compared to those who did not have subsequent treatment;
- patients treated with cervical cancer without subsequent adjuvant chemotherapy had the same quality of life as healthy women;
- the most common complication - lack of vaginal discharge;
- there was no problem in achieving orgasm;
- the majority of patients felt pain within 3 months after the surgery. After radiation therapy, pain may persist for up to 2 years after the course of treatment.