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Cervical cancer

Cervical cancer
Cervical cancer


This is the commonest female malignancy in developing countries, with ~ 33% of all cancer patients attending at ORCI. It is caused by persistent infection with human papilloma Virus (HPV). Risk factors include early coitus and childbirth, multiple sexual partners, smoking and HIV infection. It is preventable through avoiding risk factors, screening and vaccination. When detected early, it is curable by surgery or radiotherapy hence regular screening is required for all women at risk.

Signs and Symptoms

Diagnostic criteria

• Asymptomatic in early stages of the disease.
• Majority present with abnormal vaginal bleeding (post coital, inter-menstrual or postmenopausal vaginal bleeding).
• Foul smelling discharge, pain and incontinence (VVF or RVF) are symptoms of late disease


• Full Blood Count (FBC), Liver Function Test (LFTs), Creatinine, Urea and HIV test.
• CXR.
• Abdominal and pelvic Ultrasonography.
• Pelvic MRI, CT Scan of the abdomen and pelvis.
• Biopsy of cervix for histology or abnormal Papanicolaou smear for cytology.
• Bimanual Examination under Anesthesia (EUA).


  • Pharmacological

    Management by disease stage.
    • please refer to image number 1

    Chemotherapy is given as a radiotherapy sensitizer or on palliative intent.
    Cisplatin 40 mg/m2 IV to max of 70 mg is given weekly during radiation therapy.

    o If patient is HIV positive or has mild renal impairment consider 30 mg/m2 to max of 60 mg weekly.
    o Available and preferred palliative chemotherapy drugs for metastatic, recurrent or persistent cancer after RT, given in single or combination regimen include: Cisplatin, paclitaxel, bevacizumab, carboplatin, docetaxel and gemcitabine.
    • Do FBC, urea and creatinine before each cycle of chemotherapy

    Follow up:

    First visit at 4–6 weeks post treatment then 3–6 months in the first 2 years, there after yearly.
    *This follow-up schedule applies to all malignancies with few exceptions*

    ● All patients suspected or confirmed to have cervical cancer should be referred to cancer specialized centers for definitive management ● All women aged 25 years and above are advised to have regular cervical screening with VIA and VILI or Pap smear
  • Non-pharmacological


Updated on,

5 Novemba 2020 09:22:24



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