Cervical cancer starts in the cells that line the cervix when the normal cells gradually become cancerous. Women over 30 years are generally at risk of developing cervical cancer. Nearly all cervical cancers (99%) are linked to a high-risk human papillomaviruses infection(HPV), which is commonly transmitted through sexual contact. Regular screening and HPV vaccines are thus known to help prevent Cervical Cancer.
Types of Cervical Cancer are:
Early-stage cancer generally produces no symptoms. This is why women are advised to undergo regular Pap smear tests or cervical smear tests, for early diagnosis. As the cancer advances, women may experience:
Nearly all cervical cancers are caused by HPV infections. High-risk HPVs are known to cause cervical cancer while low-risk HPV types cause genital warts. Cervical cancer may develop if there is a persistent infection of high-risk HPV in an individual. HPV can be transmitted through:
Other risk factors that contribute to cervical cancer are:
The main diagnostic test for cervical cancer is Colposcopy wherein a tube-shaped tube is inserted into the vagina. A microscope lightly placed outside the body is used to look at the cervix. A sample of cells may be collected for biopsy.
The two major cervical screening tests include:
Both the tests are generally recommended for females over 30 years of age. When done alone, the PAP test can be done once every three years. A co-testing of HPV and PAP tests can be done once every 5 years.
The staging of cancer helps identify the extent of growth and spread of the cancerous cells. There are 4 stages of cervical cancer identified:
|0||The presence of precancerous cells only|
|1||Cancerous cells found in deeper tissues of the cervix and possibly into the uterus and nearby lymph nodes|
|2||Cancer has grown into the cervix and uterus but not as far as the pelvic wall or lower part of the vagina. It may or may not affect nearby lymph nodes.|
|3||Cancer cells are found in the lower part of the vagina and pelvic walls and may be blocking the uterus or the tubes that carry urine from the bladder. It may or may not affect nearby lymph nodes|
|4||Cancer that grows out of the pelvis will affect the bladder or rectum. Later in this stage, it spreads into distant organs like lungs, liver, bones and lymph nodes|
Treatment options purely depend on the stage and extent of cancer growth. If the cancerous cells are found only on the surface of the uterus, they can be destroyed with cold-knife conization or LEEP (Loop Electrical Excision Procedure). However, if they have passed deeper into the tissues, surgical removal is recommended. For the invasion of cancer into the entire uterus, a Hysterectomy(removal of the uterus) would be advised. Surgery, radiotherapy and chemotherapy are the widely used treatments across the globe.
Early-stage cancers are treated generally with excision/ surgical removal of the cancerous part. It could be either removal of a piece of cancerous tissue or the entire cervix and some surrounding affected area (trachelectomy) or removing the entire affected cervix and the uterus (hysterectomy). Minimally invasive hysterectomy is an option that allows the removal of the uterus through small incisions.
This uses high-energy radiation waves, such as X-rays or protons, to kill the cancerous cells. It is used either as the main treatment when the cancer is widely spread or along with surgical removal of the cancerous tissue especially when there is a risk of recurrence of cancer. It is generally combined with chemotherapy as the primary treatment of locally advanced cancer cells. It can be done both externally by radiating the beam on the affected part of the body or internally by placing a capsule containing radioactive materials through the vagina into the cervix or a combined approach.
This method uses drugs to kill the cancerous cells administered either through veins (Intravenously) or through oral pills. Drugs can be also used to shrink the cancer cells before the surgery or after surgery to avoid recurrence. Mostly used along with radiotherapy in low doses for locally advanced cells. Higher doses are given in very advanced cancer to help control symptoms.
4. Targeted therapy:
In the case of advanced or recurrent cancer, targeted medicine Avastin is used to either make cancer smaller or prevent it from becoming bigger.
It is a drug treatment to help increase immunity to fight cancer. It is considered along with other treatments for advanced cancer.
6. Palliative care:
It is a form of medical care to help patients feel relief from pain. Along with doctors, the palliative care specialists help patients with the journey of cancer to make them feel better by aiming to improve the quality of life of patients and their families.
There are several ways to prevent cervical cancer:
It is mostly diagnosed in women who are sexually active between the age of 35 and 44.
Yes. Symptoms could include a strong, smelly vaginal odour.
Though very uncommon, it could be a symptom when the cancer is advanced.