‘Advanced cervical cancer needs chemo-radiotherapy, not surgery’

MUMBAI: An eleven-year-long trial by the Tata Memorial Hospital (TMH) has established that women with advanced cervical cancer should not be treated with surgery, which is widely offered the world over. Instead, a combination of chemotherapy and radiotherapy increases five-year survival chances.

The findings assume significance in India, where 60 per cent of cervical cancer cases are detected at an advanced stage. The trial highlights the need for India to vastly increase radiotherapy centres from the meagre 530 that exist today, that too mostly in metro cities.

The five-year disease-free survival rate in women with second-stage cervical cancer who received chemo-radiotherapy combo was 77 per cent against 70 per cent in those who underwent cycles of chemo and surgery, clearly established non-surgical treatment as the better plan. The study was published in the February edition of Journal of Clinical Oncology.

Apart from saving valuable time, experts said the findings should save scores of women from undergoing botched-up, unnecessary surgeries. Across India, every year, nearly 1.3 lakh women are detected with cervical cancer, while 70,000 succumb to it.



Oncologist and principal investigator Dr Sudeep Gupta said the study has put to rest one of the longest standing controversies about the best way to tackle locally advanced cervical cancer. "If a tumour is more than 4 cm, surgery is absolutely not an option. There is a tendency among doctors to shrink the tumour first with chemotherapy and then attempt surgery. Our study has proved that it’s not ideal and the standard way is a combination of radiotherapy and chemotherapy," he said.

Another sister study led by Dr Shyam Srivastava and Dr Umesh Mahantshetty, radiation oncologists of TMC, found that even in advanced cervical cancer — stage 3, radiotherapy with simultaneous chemotherapy is superior that giving patients radiotherapy alone. It showed that addition of once per week chemotherapy to radiotherapy achieved significant reduction in cancer relapse and death in women.