Treat CIN

I came across an interesting study that claims that topical application of trichloroacetic acid was highly successful in sending CIN into remission.

241 women participated in the study with CIN1, 2, and 3. High-grade lesions (CIN 2-3) were in remission in 80.3% of women (and 87.7% showed regression). For low-grade lesions, 82.3% of lesions were in remission. No major side effects were reported, besides bleeding and discharge for 2 weeks.

This study shows a promising alternative treatment for women who have CIN.

It shocks me how many alternative treatments are available for CIN, yet doctors refuse to treat their patients any way other than standard surgical procedures.

I was diagnosed with CIN2 in 2018 and since then I'm constantly looking for new studies and statistics regarding the rates of regression, persistence and progression of precancerous lesions.

I came across a study that extrapolated cytological data from 3,160 women who participated in 36 studies between 1973 to 2016.

The pooled results were as follows:

50% regressed
32% persisted
18% progressed

A subgroup was analyzed including 1,069 women under 30 years old and results were even better:

60% regressed
23% persisted
11% progressed

During the 24 months of follow-up, none of these women's lesions progressed to cervical cancer.

Keep in mind that regression doesn't necessarily mean complete clearance of the virus in this study. Regression was defined as either the absence of lesions, or the regression to CIN1.

Researchers concluded that active surveillance of CIN2 lesions is an acceptable outcome for patients who want to avoid invasive and risk-prone high-grade cervical dysplasia treatments such as the LEEP and conization procedures.

It is recommended patients remain vigilant about getting pap smears and colposcopies every 6 months should they choose active surveillance over treatment.

This study was overseen by Dr. Maria Kyrgiou, of the Imperial College of London.

Source: MedPage and BMJ

At 22, I was diagnosed with LSIL. At the time, the "wait and see" approach was taken due to my age. Women below the age of 25 have a high chance of clearing the HPV infection that causes low-grade cervical dysplasia on their own. But not all of them do.

I wish my doctor had stressed the importance of clearing the infection before it became HSIL. Yet, she never did. She said, Oh, come back in a year and I'm sure it'll be fine. Needless to say, it wasn't. That LSIL developed into HSIL and today I'm forced to make the decision between cutting off part of my cervix and remaining cancer-free, according to western gynecological recommendations for treatment.

If only my doctor had stressed the importance of taking a multivitamin, and verifying that the infection was clear, perhaps I wouldn't be faced with that decision. But I am.

I was shocked to learn today that women under the age of 25 cannot get screened for cervical cancer in the UK due to regulations set forth by the NHS (the UK's national healthcare system). A young woman named Amber Rose Cliff even died due to this outrageous law, when doctor after doctor refused to screen her for cervical cancer. It's clear that this measure was taken to save money for the failing English national healthcare system, at the expense of young women's lives.

What are the chances that untreated CIN will progress to a worse stage?

Here are a few charts showing the rates of progression vs. regression with each type of CIN:

Is it possible to treat cervical dysplasia using photodynamic therapy? There is evidence of complete remission of CIN by photodynamic therapy treatment. Results of several studies show promising hope that non-surgical treatment of precancerous cervical lesions is indeed possible. Just take a look at the following examples:

1. Korea

In a 2016 Published Study, Ye-Kyu Park and Choong-Hak Park showed promise in their trial.

Department of Obstetrics and Gynecology, Dankook University College of Medicine, Cheonan, Korea.

Choong-Hak Park. Department of Obstetrics and Gynecology, Dankook University College of Medicine, 119 Dandae-ro, Dongnam-gu, Cheonan 31116, Korea. Tel: +82-41-550-3941, Fax: +82-41-555-6335, rk.ca.kooknad@01hcp

"Conclusion: Our data showed that CR rate was fantastic in CIN group (95%). This study suggests that PDT can be recommended as new optimistic management modality on the patients with pre-malignant CIN lesions including carcinoma in situ and relatively early invasive cancer of the uterine cervix. Combined chemo-photodynamic therapy is essential in case of invasive cervical cancer. For the young age group who desperately want to preserve their fertility and have a healthy baby, PDT can be a beacon of hope."

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120067/

2. Moscow, Russia

The only practicing doctor I have found who offers patient treatments for cervical dysplasia is Dr. Maxim Afanasev who treats patients in Moscow. While shares many positive testimonials on his Instagram page, I have yet to find any external mention of his claims.

I did find a Russian study which had 90%+ success rates in treating cervical dysplasia caused by HPV infections using photodynamic therapy.

3. Mexico

Dr. Eva Ramón Gallegos has used photodynamic therapy to treat Mexican women with HPV and cervical dysplasia lesions. Her research has led to the eradication of HPV in 100% of the HPV positive patients without precancerous lesions, 64.3% of patients with HPV and precancerous lesions, and 57.2% of patients without HPV, but with precancerous lesions.

Source: https://www.eluniversal.com.mx/english/mexican-scientist-cures-human-papilloma-virus

4. Brazil

Researchers in Brazil showed long-term effectiveness in using photodynamic therapy for CIN treatment.

"Results: 75% (n = 42) of CIN 1 patients presented a complete response to PDT and only 23.2% (n = 13) of recurrence, progression, and/or lesions remaining two years after PDT.

For CIN 2/3 patients, 90% were observed to be cured after one and two years of follow up. (4) Conclusions: PDT presented best results two years after a non-invasive, fast, and low-cost procedure and in comparison with the placebo group, preventing the progression of cervical intraepithelial neoplasia and preserving the cervix."

Source: https://www.ncbi.nlm.nih.gov/pubmed/31336848

5. Norway

In perhaps the most promising instance of photodynamic therapy used to treat cervical dysplasia, Norwegian pharmaceutical company Photocure ASA has developed an intravaginal device called Cevira® that delivers one two doses of a proprietary drug directly to the cervix. The device is inserted by the gynecologist and is later removed by the patient. There is no downtime for the treatment and patients can go about their day as normal. It is a completely non-surgical treatment that preserves the cervical anatomy and function.

The product has been in development for many years. Clinical trials have moved along successfully, and in July 2019 a partnership was reached with Chinese biotechnology company Asieris to manufacture and distribute the device. A final round of clinical trials is scheduled to be completed in China. As soon as 2022, the product could be available in key markets: Asia, Europe and the US.