Radiation Therapy for Cervical Cancer
“When radium was first discovered in the late 1800s, headlines nationwide hailed it as “a substitute for gas, electricity, and a positive cure for every disease.” Johns Hopkins was using radium to treat cervical cancer since the early 1900s (Skloot, 2011). By the 1940s there was evidence to support that radium was safe and effective in treating invasive cervical cancer. In her biography The Immortal Life of Henrietta Lacks, Skloot outlines the process of the radium treatment for invasive cervical cancer: thin glass tubes filled with radium, called Brack plaques, were sewn into the cervical tissue after cervical dilation, then several rolls of gauze were placed in the vaginal canal to hold the plaques in place. A urethral catheter was threaded to not disturb the treatment during urination.
In the 1950s, intracavitary radiation is defined as “the application of radium to the surface of a lesion occurring in any hollow place or space (Bowing, 1947). According to Bowing, intracavitary radiation was not only the most effective treatment, but it was also the most conservative. Currently, there are two methods of cervical cancer treatment: external beam radiation therapy (EBRT), which aims x-rays at the cancer externally, while brachytherapy (explained above) otherwise known as internal radiation therapy puts the source of radiation in or near the cancer.
Modern technologies of radiation therapy have made external beam radiation therapy quite safe. The high energy rays (or beams) are carefully aimed outside the body into the tumor for careful delivery of radiation to the cancer source. Using three-dimensional conformal radiation therapy (3d-CRT) for instance, the radiation beams are directed in different directions to match the shape of the tumor to help reduce damage of normal tissues and better kill the cancer (American Cancer Society, 2019). Regarding Henrietta Lacks’s case however, the skin of her abdomen was burned so badly from the external radiation beams that her skin was black as tar:
“On the first day he tattooed two black dots with temporary ink on either side of her abdomen, just over her uterus. They were targets, so her could aim the radiation into the same area each day but rotate between spots to avoid burning her too much in one place…. One afternoon, she lifted her shirt to show what the treatments had done to her […] The skin from Henrietta’s breasts to her pelvis was charred a deep black from the radiation (Skloot, 2014).”
Although treatments for cervical cancer have much improved since the 1950s, women are still dying from cervical cancer and it is preventable! Each year more than 4000 U.S. women die from cervical cancer and it is the fourth leading cause of death worldwide (Garcia, 2019). Almost 99% of all cervical cancer cases are linked to infection with high-risk human papillomaviruses (HPV), an extremely common virus transmitted through sexual contact (World Health Organization, 2019). Engaging local partners and community health workers, the state health department, federally qualified health centers, with the CDC investment in early detection programs are instrumental in eliminating cervical cancer through community based cervical cancer prevention programs (Garcia, 2019). Vaccination against human papilloma virus (HPV) is also a critical component in prevention of cervical cancer. According to the World Health Organization, effective primary (HPV vaccination) and secondary prevention approaches (screening for and treating precancerous lesions) will prevent most cervical cancer cases (World Health Organization, 2019).
There is a vision of a world where cervical cancer is eliminated. The World Health Organization created a global strategy to accelerate the elimination of cervical cancer as a public health problem. No woman should die from cervical cancer.
Skloot, R. (2018). The immortal life of Henrietta lacks. Picador.
Garcia, F. (2019, January 15). Beyond the Data -Preventing Cervical Cancer in the 21st Century [Interview by 1196684544 893866122 T. Phoebe]. Retrieved February 15, 2021, from https://www.cdc.gov/grand-rounds/pp/2019/20190125-cervical-cancer.html
World Health Organization: https://www.who.int/health-topics/cervical-cancer#tab=tab_2
Bowing, H., 1947. Intracavitary Radium Therapy for Carcinoma of the Uterine Cervix. [online] Available at: <https://pubs.rsna.org/doi/pdf/10.1148/49.4.406#> [Accessed 15 February 2021].
American Cancer Society: https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/radiation/external-beam-radiation-therapy.html