Tag Archive for: cervical cancer treatment

Is Cervical Cancer Preventable? Screening and HPV Vaccination Insights

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Dr. Abigail Zamorano of McGovern Medical School at UT Health Houston discusses key prevention strategies for cervical cancer, focusing on the importance of cervical cancer screening and the HPV vaccine. She explains how screening can detect pre-cancers, preventing progression to cancer, and highlights the role of the HPV vaccine in reducing the risk of cervical cancer and other HPV-related cancers.

[ACT]IVATION TIP

“…to not only think about cervical cancer treatment but also cervical cancer prevention.”

See More From [ACT]IVATED Cervical Cancer

Download Resource Guide Download Spanish Resource Guide

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Exploring Antibody Drug Conjugates in Cervical Cancer Treatment

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 Cervical Cancer Disparities | Key Factors for Black and Latinx Patients

Cervical Cancer Disparities | Key Factors for Black and Latinx Patients

 Understanding Antibody Drug Conjugates (ADCs) in Cervical Cancer

Understanding Antibody Drug Conjugates (ADCs) in Cervical Cancer

Transcript:

Lisa Hatfield:

Dr. Zamorano, are there ways to prevent cervical cancer?

Dr. Abigail Zamorano:

There are ways to prevent cervical cancer. This is one of the really exciting things about cervical cancer in general is that we have not only great treatments, but we also have ways of preventing the cancer from ever occurring. So one of those is through cervical cancer screening. Cervical cancer screening is important because it gives us the opportunity to diagnose and treat pre-cancers to keep them from ever becoming a cervical cancer.

The other great way of preventing cervical cancer is with the HPV vaccine or the vaccine for the human papillomavirus virus. This is a vaccine that can be given to individuals, both boys and girls as early as age nine and has really done remarkable things around the world to decrease the prevalence of HPV and also to decrease the incidence of cervical cancers. HPV is linked and causes most cervical cancers as well as many other cancers of the genital tract and also the oropharyngeal or mouth and throat tract. The HPV vaccine has been really remarkable because it not only will decrease that individual’s risk of obtaining a high-risk strain of HPV, but also decreases their ability to have a high-risk strain and then spread it to others.

HPV is a sexually transmitted disease. But the way I discuss it with my patients is that it’s not an STD like they might traditionally think of. It’s one that is not tested and then treated like many others. But it is many times actually managed by our body’s own immune system and treated by our body’s own immune system. But sometimes patients acquire a high-risk strain of HPV that lingers that our bodies are not able to get rid of.

And it’s these high-risk strains that linger that can cause cell changes that can lead to pre-cancer and cancer such as cancer of the cervix. So my [ACT]IVATION tip for this question is to not only think about cervical cancer treatment but also cervical cancer prevention. That one of the things that I speak to my patients about because they always ask me what they can do for themselves and then also their family and friends is to talk about cervical cancer screening with them, to talk about the HPV vaccine with them, to encourage them to have their family and friends, their children vaccinated, go through screening so that we can try to prevent as many cervical cancers as possible.

Lisa Hatfield:

There are some guidelines for when the HPV vaccine should be given. Is there a maximum age for the HPV vaccine?

Dr. Abigail Zamorano:

So the maximum age is listed as 45. This is in conversation with a physician. So the set maximum age is 26. However, it can be given between the ages of 26 and 45 after a conversation between the patient and the provider. This is typically a good idea, but it’s always important to have this shared decision-making.

Understanding Antibody Drug Conjugates (ADCs) in Cervical Cancer

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Dr. Abigail Zamorano of McGovern Medical School at UT Health Houston explains essential details about antibody drug conjugates (ADCs) for cervical cancer, including benefits, side effects, and their impact on quality of life. She discusses the importance of maintaining a strong patient-provider relationship, especially when navigating side effects like ocular issues and neuropathy, and emphasizes the role of regular eye exams.

[ACT]IVATION TIP

“…maintain close communication between provider and patient in order to share the experience of receiving an antibody drug conjugate.”

See More From [ACT]IVATED Cervical Cancer

Download Resource Guide Download Spanish Resource Guide

Related Programs:

Exploring Antibody Drug Conjugates in Cervical Cancer Treatment

Exploring Antibody Drug Conjugates in Cervical Cancer Treatment

 Cervical Cancer Disparities | Key Factors for Black and Latinx Patients

Cervical Cancer Disparities | Key Factors for Black and Latinx Patients

 Is Cervical Cancer Preventable_ Screening and HPV Vaccination Insights

Is Cervical Cancer Preventable? Screening and HPV Vaccination Insights

Transcript:

Lisa Hatfield:

Dr. Zamorano, for patients and care partners learning about antibody drug conjugates for the first time, what key information should they know about the benefits, the potential side effects, and overall impact of these treatments on quality of life?

Dr. Abigail Zamorano:

So I think that you touched on something really important here, and that is quality of life. Antibody drug conjugates are really amazing. They’re a really great way of delivering really high doses of chemotherapy targeted to cancer cells. They do have side effects. One of the most significant side effects that we see with our ADCs in cervical cancer are ocular or eye side effects. So we work very closely with an ophthalmologist or an optometrist, some eye doctor, for very frequent exams during this treatment phase.

It’s really important for both the provider and the patient to understand how, what symptoms might result, when to bring up symptoms to the provider, the oncologist, or the eye doctor, and then what they can do to help prevent any symptoms from occurring. There’s a lot of eye drops involved. It can feel very tedious. But it’s important, because we want to both treat the cancer, but also maximize their quality of life.

There are other side effects that can come up, such as neuropathy, which is numbness and tingling of the hands or the feet. This can be very common with these ADCs. Again, it’s just important for a patient to know that this could be a possibility and then to bring it up with their provider so that they can talk about management strategies. Because ADCs are given in the recurrent disease setting, I do counsel patients that I have a lot of hope in ADCs and their ability to treat cancer, but this is still recurrent cancer, and I can’t take away that fact.

And so I am very hopeful that this treatment will work, and we will see that the cancer stabilizes or shrinks, goes away in the best scenario. But that might not happen. And I really want to maximize quality of life during this treatment process in the off chance that it’s not working and that these are the last, you know, months to years that this patient has.

I always keep that type of conversation open with my patients, because I want them to tell me really how they’re feeling in order to maximize quality of life. So my [ACT]IVATION tip for this question is to maintain close communication between provider and patient in order to share the experience of receiving an antibody drug conjugate. Both the experience of going through the various eye exams and using the eye drops to any symptoms that the patient is receiving and how the treatment is impacting their quality of life.

Lisa Hatfield:

So let’s say you have a patient that comes in, has recurrent cancer and is considering antibody drug conjugate. We might have a patient watching this who is going through this, trying to consider if they want to start this therapy. Can you explain from say day one, what that might look like?

They’re trying to organize their schedule with work and kids. What will that patient experience starting on the first day of that treatment and maybe the subsequent months of treatment? How often do they have to come in? How is that dose delivered? How much time will that take away from their work or their family? Can you explain that a little bit, what the course might look like?

Dr. Abigail Zamorano:

So this is delivered not unlike other more traditional chemotherapies. So it is delivered in an infusion suite with an infusion nurse with an oncologist available if there are any issues or questions. Similarly to when the patient has had chemotherapy for, they get labs beforehand to make sure that the chemotherapy is delivered at an appropriate dose and that they’re safe enough to receive the dose of chemotherapy. What is unique about receiving antibody drug conjugates is that the patient also does need a close relationship with an eye doctor. Either an optometrist or an ophthalmologist.

And so we and many other centers have developed very close relationships with local eye doctors to help facilitate this. It doesn’t need to be an ophthalmologist in the medical center. A lot of optometrists that could be local to the patient could see the patient, which are sometimes a little bit easier to get into. Also the company that provides the antibody drug conjugate has really great resources for providers that are, and also for patients that are just starting on this journey to help make it as easy, as seamless as possible. They provide a lot of literature, they are there to answer questions.

They have lists of eye doctors that other providers have worked with. So there, there are ways of making this a little bit easier for the patient. There are also start kits that the patient can receive that again help them navigate this a little bit better. In terms of the patient experience, it is an infusion every few weeks just like other chemotherapies. The typical feelings afterwards, there can be again some nausea, predominantly there’s fatigue afterwards. I do counsel patients that the first cycle is their learning experience.

They’re learning how, what symptoms to think about. They’re learning how the regimen of the eye drops, and then they’re learning how they’re going to feel on each day. The second cycle in my experience, working with patients is typically a little bit easier. And this is not unique to ADCs, this is any chemotherapy. Because they’ve already been through one cycle, they kind of know which days are going to be their low days and then which days are going to be their high days. Typically, they’re feeling kind of fatigued for about 10 days, and then they start to feel better.

So the second half of the treatment cycle, they’re more able to get back to their routine activities and can kind of reinsert themselves into their usual life. But every patient is different. Sometimes, they need a little bit of extra help, or sometimes patients are feeling really great. These ADCs are designed to be continued until toxicity or progression. And so patients are potentially on these for quite a long time depending on their response both cancer-wise and then other body side effect-wise. And so this could be something that someone is on for some time.

What Steps Can Patients Take to Combat Cervical Cancer Disparities?

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Cervical cancer disparities persist, but how can patients help improve disparities? Expert Dr. Shannon MacLaughlan from University of Illinois discusses the value of patient advocacy, elevating patient voices, and proactive patient advice for self-care. 

[ACT]IVATION TIP

“…focus on yourself. I take care of women almost exclusively, and they’re the mamas and the sisters and the daughters, and they’re the caregivers, and they are focusing on everyone else. And now it’s time to focus on yourself and get yourself through this and then circle back, and we’ll start taking care of everybody else together.”

See More From [ACT]IVATED Cervical Cancer

Related Programs:

Does Cervical Cancer Care Differ Between Academic and Non-Academic Centers?

Does Cervical Cancer Care Differ Between Academic and Non-Academic Centers?

 Disparities in Cervical Cancer Treatment: The Role of Poverty and Systemic Barriers

Disparities in Cervical Cancer Treatment: The Role of Poverty and Systemic Barriers

 How Does Insurance Status Impact Cervical Cancer Diagnosis?

How Does Insurance Status Impact Cervical Cancer Diagnosis?

Transcript:

Lisa Hatfield:

Dr. MacLaughlan, what are the next steps in addressing the disparities you’ve identified in cervical cancer diagnosis and management, and how can patients be involved in this process?

Shannon MacLaughlan:

The most important thing that a patient can do is take care of themselves and get through your treatment successfully. You are a survivor of that cancer the moment you hear the word cancer. The moment you get that diagnosis, you are a survivor, and you focus on that. Try not to isolate yourself, because this is a team, it’s a team sport. Your medical team should have a team, and you should have a team.

Then, when you are feeling healthy, and when you are energized, I need you to spread the word. The most impactful way a patient can contribute to breaking down barriers is to start from the inside, to share your story, to talk about it. Advocacy can be as simple as going home and talking to your family about the kind of cancer that you have, how it started, what they can do to prevent it, what they can do to prevent it in their kids. Just start there, and then when we get you healthy again, then it’s time to elevate your voice.

I feel strongly that when we see disparities in outcomes related to cancer, it is the fault of the system, and it’s a little too easy and maybe not realistic to tell a patient to advocate for yourself with your doctor, because you might not have a choice in your doctors, and that’s just easier said than done. The system has to take ownership. We have to take ownership, and we have to learn from you.

And so those of us trying to break down these inequities and introduce some justice, particularly in the world of cervical cancer, we aim to elevate the voices of the people with the lived experiences and the communities who are experiencing it, because most often patients come to my office and they say, even though this was a thing, I didn’t even know we had our own ribbon. I hand out ribbons to patients with cervical cancer because they’re survivors. I need them to talk about it.

I need them to talk about it in their communities so that they know it’s a thing, and they hold us accountable. So my action item is, one, focus on yourself. I take care of women almost exclusively, and they’re the mamas and the sisters and the daughters, and they’re the caregivers, and they are focusing on everyone else. And now it’s time to focus on yourself and get yourself through this and then circle back, and we’ll start taking care of everybody else together.

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Why Does Access to Care Matter in Cervical Cancer Treatment?

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What is the role of socioeconomic status in advanced cervical cancer treatment? Expert Dr. Shannon MacLaughlan from University of Illinois discusses impacts of socioeconomic status and psychosocial determinants of health on cervical cancer care, the importance of clinical trials, and proactive patient advice to optimize care.

[ACT]IVATION TIP

“…no matter what your experience may be, when you go to a doctor or other provider with cervical cancer, whatever that experience is, I want you to know that one, you are not alone. You are not the only person experiencing this. It is not your fault. You are not to blame for this. And so whatever you may feel or experience in the clinical encounter or the encounter with the academic centers or the cancer center or the front desk or in radiology, whatever you experience, know that you are a survivor, know that you are strong and resilient, and please do not feel shame.”

See More From [ACT]IVATED Cervical Cancer

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Does Cervical Cancer Care Differ Between Academic and Non-Academic Centers?

Does Cervical Cancer Care Differ Between Academic and Non-Academic Centers?

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Advancements in Cervical Cancer Treatment: Targeted Therapies and Immunotherapy

 How Does Insurance Status Impact Cervical Cancer Diagnosis?

How Does Insurance Status Impact Cervical Cancer Diagnosis?

Transcript:

Lisa Hatfield:

Dr. MacLaughlan, how does socioeconomic status impact treatment and outcomes in advanced stage cervical cancer?

Shannon MacLaughlan:

So, first of all, I’ll say that cervical cancer is as largely a preventable cancer, and socioeconomic status and other psychosocial determinants of health are usually contributing to an individual’s ability or access to get preventative care. And so our patients who are presenting with advanced disease, or even most patients who were diagnosed with cervical cancer have not had adequate screening. And so socioeconomic status and other social determinants of health really play a role in whether or not the cancer can be prevented to begin with.

The best cure is to never let it happen. Now, when it comes to outcomes in advanced stage, there are two things that I would point out. Number one, we do have some qualitative research, not my work, but some really important work that demonstrates that when reviewing a medical record, you’re much more likely to identify negative language coming from a provider as a descriptor for a patient. If the patient is from a vulnerable community or from a lower socioeconomic status or is not white.

And that doesn’t necessarily mean your provider is saying bad things about you. What it’s saying is, this is my least favorite, but I still see it, this unfortunate patient. Another example would be, this patient is noncompliant. And the word noncompliant, what a provider should mean by that is that that person is not able to do everything we ask of them. Well, that could be because we are asking too much and not listening to them for what their goals are and what they needed. So an alternative of describing that would be, these are the things that the patient can do as opposed to emphasizing what we’re telling them to do that they’re not doing.

All of that is evidence of implicit bias, and implicit bias and systemic racism are things that are really hard to undo unless you go back to the beginning. And in this case, that means research. So when it comes to outcomes in treatment for advanced cervical cancer, I have to point out that though we have had some exciting advances in treatment of recurrent and metastatic cervical cancer, I have to point out that there are very few patients of color on those clinical trials. Most of them are done in Europe or in predominantly white-privileged communities in the United States.

And that has to do with ease of participation in clinical trials, because it’s hard enough to get yourself through cancer treatment. We are extremely demanding of our patients and survivors. And then you add to that a clinical trial protocol, it’s even harder. There are more visits, there’s more. And so those coming from marginalized, underrepresented communities aren’t represented in the research being done to find cures.

So that means we may find something that we think works. We don’t know if it’s going to work in a patient who has no one similar to them who participated in the treatment before. And so until we can really be inclusive in the clinical trial research, and even not just clinical trial research, but all kinds of research, meaning learning more about tumors that grow in particular communities and what’s going on in community levels or at the community level with extrinsic sources of stress or exposures or pollution or health outcomes or food insecurity, all of those things are going to play a role in someone’s health. And the healthiest people are most successful at surviving cancer treatment, let alone the cancer itself.

My [ACT]IVATION tip for this is no matter what your experience may be, when you go to a doctor or other provider with cervical cancer, whatever that experience is, I want you to know that one, you are not alone. You are not the only person experiencing this. It is not your fault. You are not to blame for this. And so whatever you may feel or experience in the clinical encounter or the encounter with the academic centers or the cancer center or the front desk or in radiology, whatever you experience, know that you are a survivor, know that you are strong and resilient, and please do not feel shame.

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Does Cervical Cancer Care Differ Between Academic and Non-Academic Centers?

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What are key points about advanced cervical cancer treatment in academic versus non-academic settings? Expert Dr. Shannon MacLaughlan from University of Illinois discusses patient care at academic versus non-academic cancer centers, multidisciplinary care, support services, clinical trials, and the importance of second opinions. 

[ACT]IVATION TIP

“…there’s always a role for a second opinion, and insurance providers are mandated to provide coverage for a second opinion. And that can be an important door for you to open to make sure that your case is reviewed at one of those academic centers.”

See More From [ACT]IVATED Cervical Cancer
 

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How Does Insurance Status Impact Cervical Cancer Diagnosis?

How Does Insurance Status Impact Cervical Cancer Diagnosis?

 Why Does Access to Care Matter in Cervical Cancer Treatment?

Why Does Access to Care Matter in Cervical Cancer Treatment?

 Advancements in Cervical Cancer Treatment: Targeted Therapies and Immunotherapy

Advancements in Cervical Cancer Treatment: Targeted Therapies and Immunotherapy

Transcript:

Lisa Hatfield:

Dr. MacLaughlan, what role do academic centers play in the treatment of cervical cancer? And how might patients at these centers receive different care compared to those at non-academic centers?

Shannon MacLaughlan:

An academic cancer center, or a cancer center that has been designated as a comprehensive cancer center, or a National Cancer Institute cancer center, is going to have a certain, they’re required to provide multidisciplinary care that meets the highest standard of care. So an academic center or an NCI-designated center will, by definition, have the internal quality metrics, ensuring that they are doing the right thing, which you shouldn’t have to guess whether or not your team is doing the right thing.

But one of the biggest contributors to cervical cancer existing is and/or recurring and women dying from it is that we don’t always do the right thing. So, an academic center, number one is going to provide for you a multidisciplinary team. You need to make sure that that team includes a gynecologic oncologist.

You may need a radiation oncologist. The best multidisciplinary care of the patient with cervical cancer also includes a palliative care team that can manage pain control and other symptom management effectively. And these centers are required to screen patients for other needs than just treating the cancer. So if you go to an oncologist, wherever we are, we are going to be experts in the cancer and how to treat it.

And hopefully, we are keeping up with the latest and greatest and most effective treatment options. And if you go to a cancer center that has NCI designation or is an academic center, then that should come with it…the understanding that taking care of a patient with cancer is more than just killing the tumor.

It’s about taking care of the patient and taking care of that patient’s family and taking care of that patient and their family in the context of their community. We see often in patients with cervical cancer, the need for transportation services, for social work support, not only to cope with the diagnosis, but to cope and navigate with the treatment that we lay out for you and how to plug it into your life and deal with the financial toxicities that come along with it. And those academic centers are going to be equipped with the teams who can connect you with smoking cessation and assist with food security and other things that contribute to your wellness.

The other important thing about academic centers is access to clinical trials. And in the world of cancer care, access to clinical trials is a marker of quality and better outcomes for patients. We are also starting to see, now that we’re looking for it, we’re starting to see that we can, oftentimes we see survival outcomes diverge based on things that it shouldn’t. Diverges for Black women, not as effective as white women.

We can close those gaps when patients participate in clinical trials. It doesn’t necessarily mean that a clinical trial is available to a particular individual and that they may not be eligible for anything in that moment, but access to those clinical trials is a critical big picture for successful treatment of cervical cancer or any kind of cancer.

And then finally, I would say that academic centers have the mandate of educating the next generation of providers, and we need to do better. So, for several years, I ran a clinic specifically for patients with cervical cancer. And just doing that, spending a day seeing patients, only patients, dealing with cervical cancer, was such an important learning opportunity for the residents and the medical students because I hate to tell you, but we are often taught in medical school that cervical cancer isn’t a problem anymore and that we cured it with successful screening.

But we didn’t. We haven’t actually made any headway meaningful in incidence of cervical cancer in a couple decades. So, it is important that we educate our next generation of providers that cervical cancer is, in fact, a problem. The treatment that we provide for cervical cancer is in and of itself very tasking and somewhat traumatic thing for a patient to experience. And providers need to learn how to provide culturally-accessible, empathic care for patients coming to the table with this particular kind of cancer.

So, that’s more of an ask than a recommendation. I ask you to go to an academic center so that you can teach the next generation. That’s really important to me. Now, my [ACT]IVATION tip for this topic is that you always have an opportunity for a second opinion.

Why does that matter? It matters because not everyone has access to an academic center for cervical cancer or any kind of cancer. You might not live near an academic center. You may not, even if you do live near one, you might not be able to get into one. But there’s always a role for a second opinion, and insurance providers are mandated to provide coverage for a second opinion. And that can be an important door for you to open to make sure that your case is reviewed at one of those academic centers.

Lisa Hatfield:

Okay, thank you. And I’m also a big advocate for getting an expert opinion, somebody who just sees those types of cancers. So, do you recommend if a patient is diagnosed with cervical cancer, they are not near an academic center, would you recommend that they do that at the time of diagnosis to try to seek out a second opinion or a consult at least once right at diagnosis? Is that the best time for that, do you think?

Shannon MacLaughlan:

Absolutely. The most effective time for a second opinion is before you start treatment. Once you initiate a treatment, there are very few certain…because you’ve started it, it’s almost always the best thing to continue doing it. Even if it’s not what I would have recommended to you to begin with. If you’ve already initiated it, you’re committed. So it’s tricky when you have a new diagnosis. It can be anxiety-provoking to have to wait for a second opinion or wait to get in for one or wait to start your treatment. But if at all possible, that’s the most effective time.

I would also add that many centers offer community doctors access to their tumor boards. I hate the term tumor board, but because it’s universal, I can’t change it. A tumor board is a multidisciplinary conference in which providers of each subtype gather and review cases. And so many academic and comprehensive cancer centers will offer that service to community physicians so that you may, if you can’t physically get to an academic center for a second opinion, then you may be able to have your case reviewed. There could be a telehealth option. Sometimes that’s an option when crossing state lines is necessary. And then finally, if all else fails, getting a second opinion on the pathology can be helpful.

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Advancements in Cervical Cancer Treatment: Targeted Therapies and Immunotherapy

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Advancements in cervical cancer treatments have created a new landscape for patient care. Expert Dr. Shannon MacLaughlan from University of Illinois discusses immunotherapy, targeted therapies, antibody drug conjugates, and proactive advice for patient care. 

[ACT]IVATION TIP

“…ask your team about clinical trial opportunities, because clinical trials are how we discover the next best treatment. And if you are eligible for a clinical trial, then that means you could gain access to that treatment early. So ask your provider about clinical trial opportunities.”

See More From [ACT]IVATED Cervical Cancer
 

Related Programs:

Does Cervical Cancer Care Differ Between Academic and Non-Academic Centers?

Does Cervical Cancer Care Differ Between Academic and Non-Academic Centers?

 How Does Insurance Status Impact Cervical Cancer Diagnosis?

How Does Insurance Status Impact Cervical Cancer Diagnosis?

 Why Does Access to Care Matter in Cervical Cancer Treatment?

Why Does Access to Care Matter in Cervical Cancer Treatment?

Transcript:

Lisa Hatfield:

Dr. MacLaughlan, what exciting advancements in cervical cancer treatment are on the horizon? For example, how do targeted therapies like antibody drug conjugates fit into the broader future landscape of cervical cancer therapies?

Shannon MacLaughlan:

There are a lot of exciting developments in cervical cancer. And it’s exciting as a gynecologic oncologist because earlier in my career when I talked with someone diagnosed with stage IV cervical cancer or who had a recurrence, there were basically no treatment options that would work, and now we have so many options for patients, and I am starting to see complete responses in situations I’ve never seen before.

So some specific advances, I would say, one, would be in the surgical approach of cervical cancer. We are getting much better at taking care of patients who have surgeries and minimizing the impact of the surgery on their body. With regard to systemic treatment options, I would say the most, the biggest impact I’ve seen so far is the addition of immunotherapy for the treatment of cervical cancer such that I have seen patients with stage IV disease have complete responses to their treatment, and I’ve seen patients who have had recurrences in their spine get complete responses and get to another remission, and that’s exciting. That’s the lease on life that we could not talk about just a few years ago.

Targeted therapies are an important phenomenon and movement in all cancer care, because it represents thinking about cancers differently. If we think about cancers based on where they start, where in the body they are started so if we think of cervical cancers just as a cancer that starts in the cervix, then we can only lean on experience from other patients who have cervical cancer, and it puts our thinking into a very narrow box. Targeted therapy means that we’re looking at the cancer, not where it started, but what that tumor is doing under the microscope. What proteins is it producing, what mutations does it have? And those mutations are usually a clue to how the cancer is surviving. And if we can have that kind of a clue, then we can choose a treatment that can target that particular mutation, no matter where the cancer started in the body.

It’s a very new kind of drug called an ADC or an antibody drug conjugate. What that means is the antibody targets the mutation. All it does is bind to the cancer cell, but it’s got attached to it, a little molecule of chemo, and so it sneaks itself into the cancer cell and the chemo can kill the cancer cell from the inside, instead of the outside. And that can improve efficacy. It definitely changes the side effect profile and toxicity profile. And so that has opened up additional doors for patients with cervical cancer that weren’t previously available. 

My [ACT]IVATION tip for this topic is to ask your team about clinical trial opportunities, because clinical trials are how we discover the next best treatment. And if you are eligible for a clinical trial, then that means you could gain access to that treatment early. So ask your provider about clinical trial opportunities.

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Disparities in Cervical Cancer Treatment: The Role of Poverty and Systemic Barriers

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Cervical cancer treatment disparities exist, but what role do poverty and systemic barriers play? Expert Dr. Shannon MacLaughlan from University of Illinois discusses the impact of poverty and systemic barriers and proactive patient advice for improving your care and reducing cervical cancer disparities. 

[ACT]IVATION TIP

“…for someone who is diagnosed for the first time, bring someone with you, bring someone with you, every time you see any kind of provider, when at all possible, because the health care system has not been designed for you, obviously, because we failed you. Bringing someone with you helps you close that gap.”

See More From [ACT]IVATED Cervical Cancer
 

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How Does the Stage of Cervical Cancer Impact Treatment and Prognosis?

How Does the Stage of Cervical Cancer Impact Treatment and Prognosis?

 How Does Cervical Cancer Differ From Other Gynecological Cancers?

How Does Cervical Cancer Differ From Other Gynecological Cancers?

 Understanding Metastatic and Recurrent Cervical Cancer: Diagnosis, Staging, and Surveillance

Understanding Metastatic and Recurrent Cervical Cancer: Diagnosis, Staging, and Surveillance

Transcript:

Lisa Hatfield:

Dr. MacLaughlan, what are the noted disparities you’ve observed in the treatment of cervical cancer among different demographic groups?

Shannon MacLaughlan:

This is a tough question to answer, not because I don’t know the answer, but because the answer requires taking ownership of the problem as a provider. Cervical cancer is preventable, because we have a very effective vaccine against the HPV virus, and because we have tools to screen for cervical cancer, including Pap smears, including HPV testing, and when patients are diagnosed with cervical cancer, it means the system failed them. It means that everything we think we’re doing to prevent something bad from happening to a person, we are not doing effectively.

And so when I think about a preventable cancer and who gets it, it’s the people who fall through the cracks. And the people who fall through the cracks are the people who are coming from vulnerable communities, where perhaps their biggest existential threat is not whether or not they get a Pap smear, but whether or not they can put food on the table, or whether or not they have a roof over their heads, or whether or not they can keep their children safe. So disparities and inequities tend to align with poverty and systemic racism and implicit biases and just flat-out marginalization.

So that the demographics that are experiencing the highest mortality, and experiencing the highest incidence of cervical cancer are women of color, Native American and Alaska Native patients, patients of Hispanic backgrounds, and immigrants. So my action tip for this, for someone who is diagnosed for the first time, bring someone with you, bring someone with you, every time you see any kind of provider, when at all possible, because the health care system has not been designed for you, obviously, because we failed you. Bringing someone with you helps you close that gap.

For our Hispanic patients, a huge barrier is a language barrier, and we’re required, if we don’t speak the language, we’re required to provide interpreters in the context of the clinic visit, but the clinic visit is actually only a very small part of a treatment journey. The moment you have to navigate getting to the campus of a medical center, you have to navigate the medical center itself. You may have to ask for directions. You’re going to have appointments with a gynecologic oncologist or radiation oncologist, nuclear medicine, radiology, an infusion unit. Come with another set of eyes and ears. It’s a great idea to bring your own interpreter, if you can.

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How Does the Stage of Cervical Cancer Impact Treatment and Prognosis?

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Early stage versus advanced stage cervical cancer are different, but how does the stage impact treatment and prognosis? Expert Dr. Shannon MacLaughlan from University of Illinois discusses how the diagnosis changes treatment approaches and proactive advice for patient care. 

[ACT]IVATION TIP

“…understand with your provider how your stage influences your treatment…ask about if it’s pertinent to you are one, is there a role you are a candidate for surgery, ask what kind of surgery is best for you? Should it be a minimally invasive surgery, or should it be a traditional surgery with a larger incision?…depending on how old you are at the time of diagnosis and where you are in building a family, ask about fertility preservation options…in the case of early disease or early stage, there can be fertility preservation options that you may need to ask about, rather than wait for your oncologist to volunteer the information…if your doctors say that radiation is right for you, please ask them if the radiation doctors also do something called brachytherapy.”

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Transcript:

Lisa Hatfield:

Dr. MacLaughlan, what does it mean to be diagnosed with cervical cancer at an early stage versus advanced cervical cancer?

Shannon MacLaughlan:

So any cancer will be assigned a stage at the time of diagnosis. And the stage construct is really for providers and researchers to put clinical scenarios into boxes. An oversimplification is that a stage I cancer is confined to the organ where it starts. In this case, the cervix is its own organ. Even though it’s technically part of the uterus, it is its own organ for purposes of staging. The highest, it’s always on a scale of I to IV. So stage IV cancer is a metastatic disease where it has spread to multiple locations. In general, a stage I cancer has a higher survival rate than a stage IV cancer. And that’s true for any cancer that you look at.

So in the case of cervical cancer, someone in an early stage, which typically when we’re talking about early stage cervical cancer, it’s usually stage I. We might clump I and II together, but in simpler terms, in simpler normal language, that means that the tumor is small and it’s confined to a specific location, which makes it easier to deal with, frankly. So the difference between being diagnosed at early stage and late stage means one, the chances of cure are higher, and two, how you and your clinical team move forward with treatment is going to be different.

There’s broadly speaking, there are three different tools that we use in cancer care. One is surgery, radiation, chemotherapy, or I shouldn’t say chemotherapy, I should say systemic therapy or treatment that treats the whole body. And there can be a role for any of those things or a combination of those things in treatment. A very small, early stage I cervical cancer may be cured with surgery alone, whereas an advanced cervical cancer is not, that patient is not likely to receive surgical excision as part of their treatment for curative intent.

My [ACT]IVATION tip is to understand with your provider how your stage influences your treatment. The specific things I want you to ask about if it’s pertinent to you are one, is there a role you are a candidate for surgery, ask what kind of surgery is best for you? Should it be a minimally invasive surgery, or should it be a traditional surgery with a larger incision? Related to that, depending on how old you are at the time of diagnosis and where you are in building a family, ask about fertility preservation options. There aren’t options for everyone.

But in the case of early disease or early stage, there can be fertility preservation options that you may need to ask about, rather than wait for your oncologist to volunteer the information. And then the third piece, the third specific question is if your doctors say that radiation is right for you, please ask them if the radiation doctors also do something called brachytherapy. Brachytherapy is a specific kind of radiation that it’s an integral part of successful treatment for cervical cancer.

Lisa Hatfield:

Okay, thank you. So just to follow up on that point that you made about possibly needing systemic therapy, maybe surgery, maybe radiation, for patients watching this, does that mean that a patient could possibly have a medical oncologist, a radiation oncologist, and a surgeon? Could it…is it possible to have a team of doctors working with them on their cervical cancer treatment?

Shannon MacLaughlan:

Not only is it possible, it’s important. A gynecologic oncologist like myself is someone who is trained…we train in obstetrics and gynecology first, and then we do subspecialty fellowship training in gynecologic oncology so that a gynecologic oncologist who is board-certified is trained and capable of doing the surgeries for gynecologic malignancies as well as the chemotherapy or systemic treatment.

Now, oftentimes we partner with a medical oncologist to give the systemic therapy, but the most important piece is that a gynecologic oncologist evaluates you at some point early in your diagnosis before treatment begins. The second part of your question is that radiation oncology is its own subspecialty. And so, oftentimes gynecologic oncologists and radiation oncologists work together. Unfortunately, sometimes that means going to multiple different locations to get the different kinds of doctors, but we do know that a multidisciplinary approach is an important approach for success.

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