Challenges in Prevention and Care Delivery for Women with Cervical Cancer

February 22, 2021

Internationally, women lack knowledge about this disease, limiting their self-care ability, creating unfavorable psychosocial effects that include marital problems. Usually, cancer screening is conducted in primary care, and in case of positive results, the patient is assigned to specialized care for follow-up and further treatment.

HPV (Human papillomavirus infection) is one of the most common sexually transmitted diseases globally and is the cause of all cervical cancer cases. Presently, cervical cancer prevention is based on vaccination against HPV infection and screening to identify precancerous cervical lesions, known as CIN (cervical intraepithelial neoplasia). Women with CIN experience anxiety, fear of cancer, guilt, shame, and stigmatization, and they also have problems in their social and intimate relationships as they don’t know about their A margin of 7%condition. Its also shown that there is not sufficient flow of data and education flow between health care providers and patients and that health care providers have knowledge gaps about infection, testing, and HPV vaccination. Many recommendations are based on expert consensus because of a lack of high-level evidence for treatments feasible in more resource-limited settings. Although resource-limited areas suffer most of the disease burden, cervical cancer research is conducted disproportionately in resource-rich settings. Therefore, a significant challenge to extending access to cervical cancer treatment—particularly alternatives suitable for resource-limited environments—is a strong evidence base. Planned studies with appropriate sample size and the ability to evaluate the effectiveness and feasibility of recommended treatment choices for early-stage cervical cancer are necessary. There is an urgency to start implementing innovative treatment strategies in the interim because women having potentially curable cancer remain to die because of lack of treatment.

Cervical Cancer
 

How Access To Palliative Care Helps The Patients:

Globally, lack of access to care services and effective pain medications limit the quality of care patients with difficult or end-stage cervical cancer can receive—a significant number of women in low resource settings have developed cervical cancer(advanced). At the time of treatment, cervical cancer symptoms of pain, bleeding, or urinary dysfunction can be debilitating. Almost 40% of women diagnosed with cervical cancer in India’s tertiary center were staged III and IV. Besides, delay in diagnosis and time to initiate treatment can be significant, resulting in the disease’s progression and associated symptoms. Patients allocated to the palliative care group experienced the most significant delay in care. The loss of quality of life attached to a cervical cancer diagnosis is not limited to end-stage disease. Patients with early-stage cervical cancer undergoing curative-intent treatment undergo significant anxiety or depression, sexual dysfunction, and side effects of the treatment, best managed by a multidisciplinary team approach.
Pain-relief care services can be implemented in every resource setting. The team approach to palliative care is therapeutic to the patient, family, and healthcare provider. A doctor, nurse, and social worker are essential to the team. As resources allow, physical therapists, pain and palliative care physicians, and oncologist skills enhance palliative care services. Palliative cancer care improves the quality of life with reduced healthcare utilization when implemented early in cancer management. Cervical cancer patients may also undergo loss of appetite, fatigue, hemorrhage(vaginal bleeding), and pelvic pain. As this cancer advances, pain, renal dysfunction, and fistulas can sign the disease.
WHO pain ladder remains the standard pain management in utilization with an incremental increase from non-narcotic to narcotic drugs. Few global health priorities outmode the essential shortage for pain management in low resource settings. A margin of 7% of medical use of opioids occurs in the middle- and low-income countries, thus increasing palliative cervical cancer care.
 

Requirements To Provide The Adequate Care To Patients In The Future:

It may take some time to improve the human resources, execute adequate care systems, and obtain the supplies required to provide the current resource-intense model of care for cervical cancer in some still-developing countries. Even in settings where assistance may be available, access continues to be a challenge, and inadequate access leads to delays in care and more unfortunate outcomes. For example, a New Delhi study listed a median of 41 days from registration to radiation therapy initiation; 25% of those patients did not complete the therapy. Like Rwanda, Cameroon, and South Africa, many African countries have reported an interval of up to 7 months between care requests due to symptoms and treatment of cancer. Although most people in less-developed countries live in rural areas, oncology( tumor treatments) services tend to be in urban areas. This causes many patients to travel long distances for treatment and face battling among travel and treatment costs, family obligations, and work.

At the specialized consultative health care level, multidisciplinary management will be necessary to ensure the continuation of care, appropriate treatment protocols, and management of adverse effects and complications from treatment. When a patient comes for care, systems should be put in place to make sure that patients get a timely diagnosis, are not lost to follow-up because of confusion about multiple treatment modalities, receive referrals for therapy promptly, and benefit from counseling to understand the nature of the illness and the rationale for treatment.

Content Reviewed by – Asian Hospital Medical Editors