Cancer of the cervix is one of the leading sources of death due to cancer in women. Read this article to know more about cervical cancer, its causes, symptoms, diagnosis, treatment plan, and how to conquer cervical cancer.
Virtually all types of cervical cancers are caused by high-risk types of HPV (Human papillomavirus), which is usually spread through sexual contact. Hence, in effect, the HPV vaccines can prevent 70 percent of cervical cancers before exposure to HPV (during sexual activity). The risk of developing cervical cancer can be decreased by performing screening tests regularly and getting vaccinated against HPV infection.
The cervix comprises the lower part of the uterus. Cervix connects the body of the uterus to the vagina. It is differentiated into two parts:
Endocervix is the opening of the cervix which leads into the uterus, and it is covered with glandular cells.
It is the outer part of the cervix, and it is covered with squamous cells. The location where both types of cells meet in the cervix is called the transformation zone. Cervical cancers arise in the cells lining the cervix. Most cervical cancers start in this transformation zone. The cells in the transformation zone do not directly become cancerous, but instead, these normal cells undergo some abnormal changes and become precancerous lesions and later turn cancerous. Not all precancerous lesions change into cancer. Only some become cancerous. Other precancerous lesions go away without any treatment.
The development of normal human cells depends on the information present in the DNA. The DNA contains all the information and instructions the cell needs to perform. Normal healthy cells grow, multiply and eventually die over time. But in the case of cancer, the cells grow abnormally out of control and form a mass. Then they may even spread to various parts of the body. In the case of cervical cancer, HPV (human papillomavirus) plays a major role. But not all people infected with HPV develop cancer. There are also other factors like environmental and lifestyle factors that contribute to the development of cervical cancer.
Cervical cancer symptoms include:
Heavy vaginal bleeding.
Bleeding in between cycles.
Watery, blood-stained, or pus-like vaginal discharge.
Pain during intercourse.
The major risk factors for developing cervical cancer are:
Multiple sexual partners.
Having sex at an early stage.
Sexually transmitted diseases (STDs) like chlamydia, gonorrhea, syphilis, and HIV/AIDS.
Weak immune system.
Exposure to Diethylstilbestrol (miscarriage prevention drug) during pregnancy.
Cervical cancers are classified based on how they appear under the microscope. Some of the types of cervical cancer are:
Squamous cell carcinoma.
Squamous Cell Carcinoma:
In most instances, cervical cancers are squamous cell carcinomas. The squamous cell carcinomas begin in the transformation zone between the exocervix and the endocervix.
Cancers that develop from the glandular cells are the adenocarcinomas. Cervical adenocarcinomas arise from the mucus-producing gland cells of the endocervix.
Cancers having features of both squamous cell carcinoma and adenocarcinomas are called mixed carcinomas. It is also called adenosquamous carcinomas. Mixed carcinomas are less common.
Screening tests are recommended to detect cervical cancer and other precancerous cells that can change into cervical cancer over time. Some of the screening tests include:
HPV DNA test.
Simple, quick, and painless tests called Pap smear tests done in the clinic can pick up early cancers and precancer while they are still asymptomatic (silent). This involves a gynecological internal examination and testing at the same time.
Pap smear is often confused with cervical biopsy, a test where a small bit of tissue is taken from the cervix. There can be some bleeding during the biopsy, and is done under local anesthesia, so that there is no pain. On the other hand, Pap tests are not painful.
Women are recommended to get Pap smear tests done yearly right after three years from the onset of sexual activity. If three consecutive annual smears are normal, then they can be done once in 3 years until the age of 50 years, after which they can be done once in 5 years till the age of 65 years.
HPV DNA Test:
This HPV DNA test is done to check for infections with any type of HPV, which are more likely to develop into cervical cancer.
Other recommended tests are:
Electric wire loop.
If cervical cancer is diagnosed, then the doctor may recommend few other tests to determine the stage in which the cancer is progressing. The tests include:
Imaging tests like X-ray, CT (computed tomography) scan, MRI (magnetic resonance imaging), and PET (positron emission tomography). These diagnostic tests are performed to check whether cancer has spread beyond the cervix.
Visual examination using special scopes to check inside the bladder and the rectum.
Cervical cancers are treated depending on several factors like the stage of cancer, health condition of the individual, age, and other factors. The common treatment options are:
Based on the extent to which the cancer has spread, surgery can be performed to remove,
Only Cancerous Growth - In this surgery, cervical cancer is removed entirely with a cone biopsy. In this surgical procedure, a cone-shaped piece of cervical tissue is cut, leaving the rest of the cervix intact.
The Cervix - The surgery in which the cervix and some surrounding tissues are removed called the trachelectomy is done.
Both the Cervix and the Uterus - The surgery in which the cervix and the uterus are removed is called the hysterectomy. This surgery involves the removal of the cervix, uterus, part of the vagina, and some nearby lymph nodes.
In radiation therapy, high-powered energy beams such as X-rays or protons are used to kill the cancer cells. Radiation therapy is mostly used along with chemotherapy as a combination therapy. It can also be used after the surgical procedure.
Chemotherapy means treating cancer using drugs. Drugs are administered either through a vein or given in pill forms. In certain cases, both forms are used.
The chances of developing cervical cancer can be lowered by following these ways:
1) Getting Vaccinated With the HPV Vaccine:
These vaccines can be taken from the age of 9 years to 45 years. The course consists of three injections given over a period of 6 months. The only situation where the injection is to be avoided is during pregnancy. If you have had allergic reactions to the previous HPV vaccine, subsequent doses should be avoided.
2) Having a routine Pap test.
3) Practicing safe sex.
4) Avoiding habits like smoking.
The best and effective way to prevent cervical cancers is by getting screened regularly, as screening picks up the precancerous cells before they turn into cancer. Getting vaccinated can also help lower the risk of developing cervical cancer. Also, cancers diagnosed earlier have a chance of better prognosis and are well treatable.
- Spotting between periods.
- Heavy and more extended menstrual bleeding.
- Vaginal discharge.
- Bleeding and pain after sexual intercourse.
- Unexplained pelvic and back pain.
Genetic mutations in the DNA cause the normal cells to multiply and grow invariably and prevent cell death, resulting in tumor mass growth. The Humanpappiloma virus plays a role in developing cervical cancer, but it is not always associated with it. In addition to this, lifestyle choices also increase the chance of developing cervical cancer.
Cervical cancer is the fourth widely prevalent type of cancer in women, and around 99% of cervical cancer are attributed to high-risk human papillomavirus infection.
Cervical cancer is a typically slow-growing tumor that usually takes several years to develop into a metastasizing cervical cancer.
Cervical cancer does not present with symptoms during the early stage. If it occurs, it includes the following symptoms, which need medical attention to rule out cancer or diagnose cancer in the early stages.
- Mid-cycle spotting.
- Prolonged and heavy menstrual bleeding.
- Increased vaginal discharge.
- Spotting after menopause.
- Pain and bleeding after intercourse.
Bleeding after sexual intercourse, mid-cycle spotting, foul-smelling, watery, bloody vaginal discharge are the alarming signs of cervical cancer.
If diagnosed at an early stage, cervical cancer can be cured entirely. However, its progression can be slowed down, associated symptoms can be relieved, and the longevity of the individual can be prolonged with proper treatment.
Cervical cancer is associated with abdominal discomfort and pain, loss of appetite, loss of weight, and abdominal swelling called ascites.
Cervical cancer is highly predominant in women aged between 35 and 44, with an average age being 50 years. Cervical cancer is sporadic in young women.
Metastasis of cervical cancer into the surrounding organs and tissues results in pain in the pelvis and lower back region.
Cancer spreading into the bladder can result in changes in the urinary habits which may cause increased frequency of urination or bleeding during urination.
Vaginal discharge with a malodor is associated with cervical cancer, which is due to lack of oxygen supply, cell death, and infection of the tumor.
Hormonal contraceptive pills, HIV, smoking, multiple pregnancies, multiple sexual partners, etc., increase the risk of developing cervical cancer.
For prophylactic measures, cervical cancer vaccines should be given to girls before puberty around the age of nine to ten years.
The cervical cancer vaccine helps prevent human papillomavirus infection, which reduces the risk of developing cervical cancer. Although vaccines prevent cervical cancer, regular cervical screening is necessary.
Recent reports of research carried out for a period of ten years show that there is no decreasing protection over time and the vaccine provides long-lasting protection.
Last reviewed at:
11 Oct 2022 - 5 min read
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