Cervical cancer rates have declined, long-term screening and HPV vaccination key

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Although cervical cancer is one of the most preventable and treatable types of cancer, an estimated 12,000 women in the United States are diagnosed with the disease each year. Of those, more than 4,000 will die of the disease, according to the National Institutes of Health.

Early detection screenings—including the Pap test that has been in use since the 1950s and screening for certain strains of human papillomavirus (HPV) that are known to cause cervical cancer—have contributed to the decline of invasive cervical cancer cases.

In the past decade, the availability of an HPV vaccine, which is recommended for preteens—both male and female—has made the disease even more preventable.

While women are being diagnosed at younger ages, older women are still at risk. About 15 percent of cases are diagnosed in women 65 and older, which is the cut-off age for Pap screenings.

Surgical and Medical Advances in Care

Existing therapies and procedures for treating cervical cancer have been effective, but cancer experts are continually exploring additional treatment options that could benefit women diagnosed in all stages of the disease.

The new treatments come with less debilitating side effects than chemotherapy and radiation, says David M. O’Malley, MD, director of clinical research gynecologic oncology for The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).

The OSUCCC – James is participating in several clinical trials involving immunotherapies used to treat other cancers. These drugs have shown promise in treating cervical cancer. “The research is very exciting,” O’Malley says.

Immunotherapy uses the body’s immune system to fight cancer. These therapies are typically introduced when first-line treatments have failed and in some cases are used in combination with chemotherapy or radiation therapy.

The OSUCCC – James will soon launch a clinical study that uses adoptive cell transfer of tumor-infiltrating lymphocytes (TILs) that are removed from the cancerous tumor, grown outside of the body and reinserted into a person to attack the cancer, O’Malley explains.

The OSUCCC – James is one of a few cancer centers in the nation that have been invited to participate in the TILs clinical trial being conducted by Iovance Biotherapeutics .

The trial is based on technology developed at the National Cancer Institute. In a previous report, two of the nine patients who had participated in the NCI study are in remission, he says.

O’Malley says he expects to enroll the first patient at the OSUCCC – James within the first quarter of 2018.

In addition, emerging surgical procedures are much less invasive and, in many cases, preserve fertility for women of child-bearing age who wish to have children, O’Malley says.

There’s a movement to conduct less radical surgery in which only a part of the cervix is removed. “This should always be considered—performing smaller (fertility-sparing) surgeries when possible,” he says.

Minimally invasive procedures can also result in fewer complications after surgery, O’Malley explains. For example, many women experience postsurgical lymphedema, which causes a buildup and clogging of fluid in the lymph nodes and can be very painful, both physically and emotionally. Less invasive options appear to minimize the risk of lymphedema, infection and blood clots.

While screenings and emerging treatments show great potential in decreasing the number of women who die from cervical cancer, O’Malley stresses the importance of getting vaccinated for HPV.

“It’s ridiculously underutilized,” he says. “People should not think of it as an HPV vaccine, but rather as a cancer vaccine. We have found a way to prevent these types of cancers, but many people are still not getting vaccinated.”

To learn more about the gynecologic oncology team and clinical trials at the OSUCCC – James, visit cancer.osu.edu.