Stage 4 cervical cancer isseverity highest incidence of cervical cancer. In this condition, cervical cancer has entered an advanced stage. There are several symptoms of stage 4 cervical cancer that you should be aware of and treatment that can be done.
In stage 4 cervical cancer, metastases have occurred, which means the cancer cells have spread to other organs or tissues of the body. Cervical cancer or cervical cancer stage 4 is divided into two stages, namely stage 4A and stage 4B.
In stage 4A cervical cancer, the cancer spreads to organs that are located close to the cervix, namely the bladder to the rectum (the last part of the large intestine). Whereas in stage 4B cervical cancer, the cancer has spread to other more distant organs such as the bones, liver, lungs, and lymph nodes outside the pelvis.
The staging division for cervical cancer adapts the FIGO system, which is an international federation of obstetrics and gynecology specialists. This system divides the stage of cancer based on the depth of the tumor, the width of the tumor, and how far the cancer has spread.
The stages of cervical cancer or cervical cancer are divided into 4 stages, namely stages I, II, III, and IV and each stage is further divided into A and B. The higher the stage, the wider the spread of the cancer.
Stage 4 Cervical Cancer Symptoms You Need to Know
Generally, early symptoms of cervical cancer include changes in the menstrual schedule, foul-smelling vaginal discharge, and pain during sexual intercourse, as well as bleeding from the vagina outside the menstrual cycle after sexual intercourse or after menopause.
Symptoms of stage 4 cervical cancer are included in advanced symptoms. This symptom is usually experienced by people with stage IIB to IVB cervical cancer, when the cancer cells have come out of the cervix and uterus (womb).
In stage 4 cervical cancer, advanced symptoms appear which include:
- Pain in the lower back, lower abdomen, or in the bones
- Fatigue and lack of energy, loss of appetite, and weight loss
- Pale due to abnormal bleeding from the vagina
- Shortness of breath due to anemia or spread of cancer to the lungs
- Decreased urine output, bloody urine, or urinary incontinence
- Leaking of urine or stool into the vagina, which occurs due to the appearance of an abnormal passage (fistula) between the vagina, bladder, and rectum
- Swelling of one leg
Statistically, the life expectancy of cancer patients after diagnosis is described in 5-year survival rates. 5-year survival rates for stage IV cervical cancer is 16% for stage IVA and 15% for stage IVB. The figure of 16% means that 16 out of 100 people are still alive after five years of being diagnosed with stage IVA cervical cancer.
Therefore, it is important to carry out routine screening or early detection examinations, such as pap smears, to detect cervical cancer early. The lower the stage of cervical cancer when it is found, the higher the patient's life expectancy.
Stage 4 Cervical Cancer Treatment You Need to Know
Treatment of cervical cancer generally depends on the stage of the patient's cancer. Treatment also depends on the type of cancer, the location of the cancer, and the patient's health condition. The treatment for stage IV cervical cancer is:
Cervical cancer stages IIB to IVA are treated with combination therapy between chemotherapy and radiotherapy. In this case, external radiotherapy will be performed for 5 consecutive days per week, for 5 weeks. Thereafter, the patient will need to undergo internal radiotherapy (brachytherapy) at the end of treatment.
During radiotherapy, patients also have to undergo chemotherapy once a week or once every 2 or 3 weeks, depending on the chemotherapy drug given.
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Stage IVB cervical cancer with distant metastases, whether first discovered or relapsed from previous cervical cancer, is rarely curable. The recommended treatment options are chemotherapy or palliative treatment, which is treatment aimed at alleviating the symptoms of cancer and the side effects of treatment.
Usually chemotherapy at this stage is also part of palliative therapy and does not aim to cure.
Treatment for Recurring Cancer
Despite having undergone a series of treatments and the cancer has disappeared, cervical cancer may reappear. When it comes back, usually the cancer will approach the area around where the cancer was first found (local recurrence), or it will appear again in other parts of the body (metastatic cancer).
For cases like the one above, treatment usually depends on several things, such as the location of the cancer, previous treatments, the patient's health condition, and the patient's hopes for a cure.
If cervical cancer has not spread too far, surgical removal of the uterus and cervix or a total hysterectomy may be performed. Not only the removal of the uterus, if the cancer has spread to the lymph nodes, around the bladder and intestines, the procedure for removing cancer in these organs or tissues can also be done.
Generally, radiotherapy treatment cannot be re-administered to uterine cancer patients who have undergone radiotherapy previously because there are limits to the implementation of radiotherapy procedures for the body. So, possible treatment could be chemotherapy or a combination of chemotherapy and surgery.
To prevent uterine cancer, you can regularly check with your doctor through the Pap smear procedure and avoid the triggering factors for cervical cancer. In addition, the cervical cancer vaccine which is intended for women aged 11–26 years is also useful for building the immune system to protect themselves from infection human papillomavirus (HPV) which is the biggest cause of cervical cancer.
If you or a relative suffers from stage 4 cervical cancer, don't hesitate to ask your doctor about the course of the disease, treatment plans, treatment effectiveness, and also possible side effects.