Introduction:
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.
What Is Cervical Cancer?
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:
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Endocervix.
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Exocervix (ectocervix).
Endocervix:
Endocervix is the opening of the cervix which leads into the uterus, and it is covered with glandular cells.
Exocervix:
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.
What Are the Causes of Cervical Cancer?
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.
What Are the Symptoms of Cervical Cancer?
Cervical cancer symptoms include:
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Heavy vaginal bleeding.
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Bleeding in between cycles.
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Watery, blood-stained, or pus-like vaginal discharge.
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Pain during intercourse.
What Are the Major Risk Factors For Cervical Cancer?
The major risk factors for developing cervical cancer are:
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Multiple sexual partners.
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Having sex at an early stage.
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Sexually transmitted diseases (STDs) like chlamydia, gonorrhea, syphilis, and HIV/AIDS.
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Weak immune system.
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Exposure to Diethylstilbestrol (miscarriage prevention drug) during pregnancy.
What Are the Different Types of Cervical Cancer?
Cervical cancers are classified based on how they appear under the microscope. Some of the types of cervical cancer are:
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Squamous cell carcinoma.
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Adenocarcinomas.
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Mixed carcinomas.
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.
Adenocarcinomas:
Cancers that develop from the glandular cells are the adenocarcinomas. Cervical adenocarcinomas arise from the mucus-producing gland cells of the endocervix.
Mixed Carcinomas:
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.
How Are Cervical Cancers Diagnosed?
Screening Tests:
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:
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Pap test.
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HPV DNA test.
Pap 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:
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Punch biopsy.
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Endocervical curettage.
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Electric wire loop.
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Cone biopsy.
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:
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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.
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Visual examination using special scopes to check inside the bladder and the rectum.
How Are Cervical Cancers Treated?
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:
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Surgery.
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Radiation.
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Chemotherapy.
Surgery:
Based on the extent to which the cancer has spread, surgery can be performed to remove,
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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.
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The Cervix - The surgery in which the cervix and some surrounding tissues are removed called the trachelectomy is done.
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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.
Radiation:
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:
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.
How to Prevent Cervical Cancers?
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.
Conclusion:
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.
