Palliative interventions for controlling vaginal bleeding in advanced cervical cancer

Abstract

BackgroundThis is an updated version of the original Cochrane review published in Issue 5, 2015.Cervical cancer is the fourth most common cancer among women worldwide, with estimated 569,847 new diagnoses and 311,365 deaths per year. However, incidence and stage at diagnosis vary greatly between geographic areas and are largely dependent on the availability of a robust population screening programme. For example, in Nigeria, advanced-stage disease at presentation is common (86% to 89.3% of new cases), whereas in the UK, only 21.9% of women present with International Federation of Gynaecology and Obstetrics (FIGO) stage II+ disease. Women with advanced cancer of the cervix o en need palliation for distressing symptoms, such as vaginal bleeding. Vaginal bleeding can be life threatening in advanced disease, with an incidence ranging from 0.7% to 100%. Bleeding is the immediate cause of death in 6% of women with cervical cancer and its management o en poses a challenge. Thus, vaginal bleeding remains a common consequence of advanced cervical cancer. Currently, there is no systematic review that addresses palliative interventions for controlling vaginal bleeding caused by advanced cervical cancer. A systematic evaluation of the available palliative interventions is needed to inform decision-making. ObjectivesTo evaluate the e icacy and safety of tranexamic acid, vaginal packing (with or without formalin-soaked packs), interventional radiology or other interventions compared with radiotherapy for palliative treatment of vaginal bleeding in women with advanced cervical cancer.

<p>Knowledge, Attitude and Practice Towards Cervical Cancer Screening Among Women and Associated Factors in Hospitals of Wolaita Zone, Southern Ethiopia</p>

“…Therefore, the presentation of malignancy in late-stage is vaginal bleeding, invasion, metastasis, and poor prognosis. 3,4 In addition to presenting a significant burden in terms of morbidity and mortality, cervical cancer also increases economic risk, which imposes very high direct costs on health systems, communities, households and lost the productivity of patients, premature death, and disability. 5 The occurrence of cervical cancer-related death is rare in high-income countries.…”

Access to Breast Cancer Care in Jos, North Central

“…This inadequate access to radiotherapy may not be unconnected to the high population of Nigeriawith over 200 million people who depend on only six low capacity radiotherapy centers spread across the country. As such, the radiotherapy machines are overstretched frequently developing faults with associated long waiting lists and patient frustration [18,19]. Consequently, many patients fail to access radiotherapy as and when needed.…”

Evaluation of pap smear screening history in patients with cervical cancer in Isfahan province during 2014-2016

“…Eleje et al, reported that women in advanced stage of cervical cancer usually suffer from vaginal bleeding. Moreover, bleeding is considered as the immediate cause of death in 6% of women and vaginal bleeding management is often associated with challenges, particularly in developing countries, because access to radiotherapy is limited (19). Chen et al, reported that vaginal bleeding is a life treating in advanced stages and endovascular therapy should be done in patients with advanced cervical cancer for the control of active vaginal bleeding (20).…”