The most efficient and cost-effective method to combat cervical cancer is to prevent it. Prevention may be primary, eg HPV vaccination, or secondary, ie surgical ablation of low grade precancer ie Squamous Intraepithelial Lesions (SILs) detected during screening programs.  An integrative multidisciplinary approach by Ayurvedic, Allopathic, Cell Biology, Biochemistry and Pharmaceutic experts has been developed for noninvasive integrative management of SILs with the potential to prevent cervical cancer. We will describe the background experience and the evolution of clinical protocols based on Reverse Pharmacology concurrent with advances in scientific knowledge. The principle is to alleviate the associated inflammation with standard antimicrobials and follow this by oral treatment of standardized extract of Curcuma longa (turmeric), which has been shown to have anticancer activity.  Objective methods like Papanicolaou smears and colposcopy are used for diagnosis and efficacy, and clinical examination and biochemistry for demonstration of safety. The unique features are i) protocol involving multidisciplinary team ii) development of standardized formulation iii) Standard of care for associated reproductive tract infections  iv) clinical and biochemical examination for safety v) freedom from trauma, expenditure, or complications associated with surgery  vi) feasibility in places where surgical treatment is not possible/accessible  vii)  potential for repeating noninvasive treatment viii) Ethics committee approval.

In Low-Grade SIL (LSIL) cases, treated with antimicrobials (single dose) followed by turmeric extract for 10-12 weeks there was no progress in the cervical lesions as assessed by Pap smears and colposcopy in 41/41 cases. There was a regression of LSIL in 36 /41 of cases. The benefit of integrative treatment persisted in 34 cases followed up at 6 months after discontinuation and another 14 cases followed up to 3 years. Two initial clinical studies have been published (APJCP, 2011; APJCB, 2020) and a third study is planned. The protocols will be discussed briefly.  

Dr. Jayashree Joshi is a gynecologist (MD in Ob/GYN) and a clinical researcher (PhD in Biochemistry-Clinical Pharmacology). She was earlier Deputy Director, ICMR Institute (NIRRCH). She has designed and conducted studies on gynecologic cytology; efficacy, and bioavailability of oral, injectable, and implantable contraceptive steroids in women; drug interactions with antitubercular, antimalarial, analgesic and other drugs. She has also conducted studies on Phase 1 to 4 of clinical trials of hormonal and nonhormonal contraceptives. She has also reported on the diagnosis and prevalence of common Reproductive Tract Infections (RTIs) in different groups of women and their association with cervical cancer and precancer. She has conducted some rural service based research for contraceptive utilization and anemia in pregnancy. Subsequently, Dr. Joshi joined Kasturba Health Society-Medical Research Centre’s team and participated in endocrine and integrative research. Her areas of interest have been RTIs, prevention of cervical cancer, drug interactions, heavy menstrual bleeding, subclinical hypothyroidism, menopause and medicinal plants. Currently, she is involved in research projects on plant products for nonalcoholic fatty liver disease, cancer complementary therapy, and iron supplements. She has over 130 publications with more than 830 citations.