What to do if you are HPV negative but have cervical cancer

HPV-negative patients with cervical cancer can be intervened through surgery, radiotherapy, chemotherapy, targeted therapy, immunotherapy, etc. Cervical cancer may be related to genetic mutations, long-term inflammatory stimulation, abnormal hormone levels, smoking, immune deficiency and other factors.

1. Surgical treatment

Patients with early-stage cervical cancer can choose cervical conization or total hysterectomy, which is suitable for cases where the tumor is limited to the cervix and has no distant metastasis. HPV and TCT tests need to be reviewed regularly after surgery to monitor the risk of recurrence. For patients with fertility needs, uterine-sparing radical trachelectomy may be considered.

2. Radiotherapy

External radiation combined with intracavitary brachytherapy can be used for patients with moderate to advanced disease, especially for those with large local lesions or lymph node metastasis. Radiation therapy may cause radiation proctitis or cystitis, and drugs such as recombinant human granulocyte stimulating factor injection need to be used to alleviate side effects.

3. Chemotherapy

Cisplatin injection combined with paclitaxel injection is a commonly used solution, suitable for postoperative adjuvant treatment or patients with recurrence and metastasis. Myelosuppression may occur during chemotherapy, and blood routine monitoring is required. For HPV-negative cervical cancer, chemotherapy sensitivity may be lower than for HPV-positive patients.

4. Targeted therapy

Bevacizumab injection can be used to inhibit tumor angiogenesis, and combined with chemotherapy can prolong the survival of advanced patients. Risks such as hypertension and proteinuria need to be assessed before taking medication. This treatment may be more effective for patients with PIK3CA gene mutations.

5. Immunotherapy

Pembrolizumab injection is suitable for patients with relapse and metastasis with PD-L1 positive expression and kills tumors by activating T cells. Biomarker testing is required before treatment, and adverse reactions such as immune-related pneumonia or colitis may occur.

Patients with HPV-negative cervical cancer should maintain a balanced diet, supplement appropriate amounts of high-quality protein and vitamins A/C/E, and avoid high-fat diets. Aim for 150 minutes of moderate-intensity aerobic exercise per week, such as brisk walking or swimming. Strictly quit smoking and reduce passive smoking, and conduct regular gynecological examinations and imaging reviews. During treatment, you can use warm water sitz bath to relieve discomfort, and avoid using irritating lotions to clean the perineum. If abnormal vaginal bleeding or pain worsens, you should seek medical attention promptly.