Архив хирургической онкологии

A multipronged novel approach to prevent cervical cancer through non-invasive integrative management of cervical precancerous lesions

Abstract

Dr Jayashree Joshi,

Background: Cervical cancer is a preventable disease. Yet in India more cases are detected in advanced stages and the morbidity and mortality in women due to this cancer is high. Objective: To use our experience of Pap smear screening and integrative medicine to promote prevention of cervical cancer through early detection of cervical precancer and non-invasive integrative management (NIIM) when possible. Methods: i) Screening with conventional Pap smears of all women above 30 years of age in a general charitable hospital serving under-privileged women ii) Identification of cervical cancer, and precancerous lesions, other gynaecological cancers iii) Advocacy for colposcopy, sonography, when necessary and appropriate referrals iv) Innovative non-invasive integrative management (NIIM) of Low-Grade Squamous Intraepithelial Lesions (LSIL) using knowledge base of Traditional Ayurvedic medicine. Results: i) Cases in the Ayurvedic general hospital have been screened since1999 but the program for NIIM for precancer started in 2008 ii) Review of spontaneous or induced regression of cancer, in vitro, in vivo, anticancer activity of medicinal plant extracts of Curcuma longa (CL) and Inspira cordifolia (TC) iii) Preclinical, Volunteer studies for safety iv) Exploratory clinical studies on activity and safety of NIIM of LSIL with oral extracts of CL following standard antimicrobials for genital infections. These confirm the role of NIIM in inducing regression in abnormal Pap smears. Conclusions: In view of persistence, recurrences and some complications after surgical treatment of cervical precancerous lesions (e.g., cervical stenosis or incompetence, premature deliveries) we propose the use of safe, non-invasive integrative treatment of cervical precancer lesions with antimicrobials and standardized Curcuma longa extracts as a feasible option. This is clinically important because many of these women are in younger age group (childbearing), and many women do not have the monetary or community means to access surgical treatment by trained personnel due to expenses or nonavailabilit