Cervical cancer is a type of cancer that occurs in the cells of the cervix. The cervix is the lower part of the uterus that connects to the vagina. Various strains of the human papillomavirus (HPV) are responsible for causing most cervical cancer.
For women with strong immune system who have been exposed to HPV, the virus is prevented from doing harm. In some cases, the virus survives for years, contributing to the process that causes some cells on the surface of the cervix to become cancer cells.
Women can get vaccinated against HPV infection and undergo Pap smear, to reduce their risk of developing cervical cancer.
Symptoms of Cervical Cancer
At the early stage, cervical cancer generally produces no signs or symptoms. However, as the cancer progresses, symptoms may include:
- Watery, bloody vaginal discharge with heavy and foul odor
- Pelvic pain
- Vaginal bleeding after intercourse
- Pain during intercourse
- between periods or after menopause
Causes of Cervical Cancer
Cervical cancer starts when healthy cells undergo genetic mutation that causes them to turn into abnormal cells. Normally, healthy cells grow and multiply at a set rate, eventually dying at a set time. However, cancer cells grow and multiply uncontrollably, and refuse to die. The accumulating abnormal cells form a mass or tumor. As cancer progresses, it attacks nearby tissues and can break off from a tumor to metastasize or spread to other body parts.
It isn’t totally clear as to what causes cervical cancer, however, doctors suspect HPV plays a role. HPV is very common, and most women with the virus never develop cervical cancer. So, environment factors or poor lifestyle choices, also contribute to cervical cancer.
Types of Cervical Cancer
The type of cervical cancer that you have helps determine your prognosis and treatment. The main types of cervical cancer are:
- Squamous cell carcinoma:This begins in the thin, flat cells (squamous cells) lining the outer part of the cervix, which projects into the vagina. Most cervical cancers are squamous cell carcinomas.
- This type of cervical cancer begins in the column-shaped glandular cells that line the cervical canal.
Risk factors for Developing Cervical Cancer
Risk factors for cervical cancer include:
- Weak immune system: You may have cervical cancer if your immune system is weakened by another health condition and you have HPV.
- Having many sexual partners: Keeping many sexual partners or your partner having many sexual partners increases your chances of getting exposed to HPV.
- Early sexual activity.Having sex at an early age increases your risk of HPV.
- Sexually transmitted infections (STIs): Having other STIs like gonorrhea, syphilis, HIV/AIDS, and chlamydia— increases your threat of getting exposed to HPV.
- Smoking: Smoking is associated with squamous cell cervical cancer.
Preventing Cervical Cancer
To reduce your risk of cervical cancer:
- Undergo routine Pap tests.This can help detect precancerous conditions of the cervix, so they can be monitored or treated in order to prevent cervical cancer.
- Get vaccinated against HPV.Vaccination is available for girls and women ages 9 to 26. The vaccine is most effective if given to girls before they become sexually active.
- Practice safe sex.Engaging in safe sex by using a condom, keeping one sexual partner who is equally faithful, and delaying intercourse may reduce your risk of cervical cancer.
- Don’t smoke.
Diagnosing Cervical Cancer
Like most cancers, the key to surviving cervical cancer is early detection and treatment. It is recommended that women begin screening for cervical cancer and precancerous changes at age 21.
Screening tests include:
- Pap test: This involves your doctor scraping and brushing cells from your cervix, which are then inspected in a lab for irregularities. A Pap test can detect abnormal cells in the cervix, including cancer cells and cells that show changes that increase the risk of cervical cancer.
- HPV DNA test: This test involves testing cells collected from the cervix for infection with any of the types of HPV that are most likely to lead to cervical cancer.
If cervical cancer is suspected, your doctor is likely to start with a full examination of your cervix using colposcope (Special magnifying instrument used to check for abnormal cells). During this examination, your doctor may take a sample of cervical cells (biopsy) for laboratory testing using punch biopsy or endocervical curettage.
If the punch biopsy or endocervical curettage is disturbing, your doctor may perform one of the following tests:
- Electrical wire loop. This is performed under local anesthesia in the office, using a thin, low-voltage electrical wire to obtain a small tissue sample.
- Cone biopsy. This procedure allows your doctor to obtain deeper layers of cervical cells for laboratory testing. A cone biopsy may be done in a hospital under general anesthesia.
Staging Cervical Cancer
The stage of your cancer is the key to deciding what treatment option will be most suitable for you. If your doctor suspects that you have cervical cancer, you’ll have further tests to determine the extent (stage) of your cancer.
Staging exams include:
- Imaging tests.These includes X-rays, CT scans, magnetic resonance imaging (MRI) and positron emission tomography (PET). These tests help your doctor determine whether your cancer has spread beyond your cervix.
- Visual examination of your bladder and rectum.Your doctor may use special scopes to examine inside your bladder and rectum.
Stages of cervical cancer include:
- Stage I.Cancer is confined to the cervix.
- Stage II.Cancer is present in the cervix and upper portion of the vagina.
- Stage III.Cancer has moved to the lower portion of the vagina or internally to the pelvic side wall.
- Stage IV.Cancer has spread to nearby organs, such as the bladder or rectum, or it has spread to other areas of the body, such as the lungs, liver or bones.
Treatment for cervical cancer may include surgery, radiation, chemotherapy, or a combination of the three may be used.
Surgery is best for early-stage cervical cancer. The procedure removes the uterus (hysterectomy). A hysterectomy can cure early-stage cervical cancer and prevent recurrence. Note that removing the uterus makes it impossible to become pregnant.
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Your doctor may recommend:
- Simple hysterectomy.The cervix and uterus are removed along with the cancer. Simple hysterectomy is usually an option only in very early-stage cervical cancer.
- Radical hysterectomy.The cervix, uterus, part of the vagina and lymph nodes in the area are removed with the cancer.
Minimally invasive surgery may be an option for early-stage cervical cancer.
Radiation therapy involves using high-powered energy beams, such as X-rays or protons, to destroy cancer cells. Radiation therapy may be used alone or with chemotherapy before surgery to shrink a tumor or after surgery to kill any remaining cancer cells. Radiation treatment can be given:
- Externally, by directing a radiation beam at the affected area of the body
- Internally, by placing a device filled with radioactive material inside your vagina
- Both externally and internally
Radiation therapy may cause premenopausal women to stop menstruating and begin menopause. So, for women who want to get pregnant after radiation treatment, discuss with your doctor about ways to preserve your eggs before treatment commences.
This treatment uses medications, usually injected intravenously to destroy cancer cells. Low doses of chemotherapy are often combined with radiation therapy, since chemotherapy may enhance the effects of the radiation. Higher doses of chemotherapy are used to control advanced cervical cancer that are incurable.
At the end of your treatment, your doctor will recommend regular checkups.
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