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Written By: Agencies | Published : June 3, 2014 12:53 PM IST
Aricca Wallace knew she was nearly out of time. For over three years, she had suffered cramping and irregular bleeding, which her doctor thought was a side effect of her birth control implant, known as an intrauterine device, or IUD. Her pap smears were normal so no one suspected cancer. Except it was cancer, and by the time the 34-year-old mother of two had the IUD removed and was finally diagnosed, her tumours had reached stage three and the disease was spreading through the lymph nodes in her abdomen and chest.
'I was told by a specialist that there wasn't any chemo that could kill it,' Wallace said. 'And that I'd be gone in a year.' That was in February 2012. A few months later, Wallace's doctor told her about an immunotherapy trial at the National Institutes of Health Clinical Center, a research hospital outside the US capital. Wallace enrolled. Doctors removed one of her tumours and collected some of the immune cells that were surrounding it. They selected specific T-cells that would attack human papillomavirus. Some 70% of cervical cancers are caused by HPV types 16 and 18. The idea behind HPV-targeted adoptive T-cell therapy is to boost the body's immune response to HPV in the tumours. Wallace first endured a weeklong regimen of strong chemotherapy to knock out her immune system. Then the infusion aimed to rebuild her defences with over 100bn of her lab-grown T-cells targeting tumours. She got two doses of aldesleukin, to help immune cells grow. The treatment can lead to side effects like bleeding, vomiting, low blood pressure, fluid retention, confusion, fever and infection. (Read: Patient's own immune cells used to shrink her tumours)
Her tumours grew steadily smaller. Four months after the infusion, all the tumours were gone. On May 29, Wallace visited the NIH Clinical Center again for scans, which showed no disease, marking 22 months since the start of her treatment. 'It is a miracle, honestly,' said Wallace, now 37. Immunotherapy is a promising field that has shown some early successes against the deadly skin cancer melanoma and a handful of other cancers. Wallace is the first person with cervical cancer on whom this novel approach has worked. A second US woman has also seen her metastatic cervical cancer disappear completely and is still disease-free one year later. But they are just two of nine patients in total. A third woman responded for a short time, but then her cancer returned. The treatment did not help the other six women in the study. 'With only nine patients, we can't even say with any reliability how well it works,' said Christian Hinrichs, assistant clinical investigator at the National Cancer Institute. 'All we know is that it can work,' she said. (Read: Immune cells could mend broken hearts)
What is cervical cancer?
Cervical cancer has beaten breast cancer as the leading cause of cancer deaths in women in India; it kills around 33,000 women every year in India. Cervical cancer is known to occur because of a virus called theHuman Papilloma Virus (HPV) transmitted through sexual contact. Bad local hygiene, too many children, not enough spacing between children, low nutrition levels and early marriage all contribute to the risk factors. The high risk group includes girls who have had premature sex as teenagers, those who have had multiple pregnancies or multiple sex partners and don't use contraceptives. The disease remains asymptomatic for a long time till it starts invading neighbouring tissues.
Precancerous changes in the cervix may be treated with cryosurgery, laser surgery. Cryosurgery is a method in which a metal probe is cooled with liquid nitrogen and placed directly on the cervix. This freezes the abnormal cells and thus kills them. Laser surgery involved vapourising abnormal cells with a focused laser beam, directed through the vagina. This method is also used to remove a small piece of tissue for study.
The treatment options for women with cervical cancer are surgery, radiation therapy, chemotherapy or a combination of two or more of these methods. The choice of treatment depends mainly on how big your lesion is, whether your cancer has spread and whether you would like to become pregnant someday. Radical trachelectomy is an option is for women with small tumors who plan a pregnancy later on. It allows them to be treated without losing their ability to have children. The surgeon removes the cervix, part of the vagina and the lymph nodes in the pelvis. Hysterectomy: In total hysterectomy the cervix and uterus are removed. In radical hysterectomy, the cervix, some tissue around the cervix, the uterus and part of the vagina are removed. Women no longer have menstrual periods after a hysterectomy and cannot become pregnant.Menopause occurs at once when the ovaries are removed.
After the treatment have regular check-ups after treatment for cervical cancer. Check-ups may include a physical exam, Pap tests and chest x-rays. Any changes in your health are noted during check-ups and treated if needed. It's important for you to eat well and stay as active as you can.
Source: AFP
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