Cervical Cancer

Published: 25 Mar 2024, 23:05 pm IST

What is Cervical Cancer?

Cancer is a disease that happens when the cells in your body grow out of control. It can affect any part of the body, including the cervix. Cancer that happens in the cervix is known as cervical cancer. The cervix is the lower part of the uterus that connects to the vagina, and the uterus is where the baby grows during pregnancy.

Cervical cancer awareness is much-needed. Image courtesy: Freepik

Cervical cancer is primarily caused by infection with high-risk strains of the human papillomavirus (HPV), a sexually transmitted infection. It is the fourth most common cancer among women across the world with 6,60,000 new cases and around 3,50,000 deaths in 2022, as per data by the World Health Organization. It affects middle-income countries where there is a lack of access to HPV vaccination, screening, treatment, and other healthcare services.

Women living with HPV are six times more likely to suffer from cervical cancer as compared to people who do not have the virus. An estimate of 5 percent of these cases are attributed to HIV, finds a study published in The Lancet.

Causes of Cervical Cancer

The main cause of cervical cancer is human papillomavirus (HPV), which is a common sexually transmitted infection that persists over time. Though not all HPV infections cause cervical cancer, certain types can cause changes in the cells of the cervix, which can progress into cancer. However, other factors increase the risk of cervical cancer, including:

  • Early sexual activity: Engaging in sexual activity at a young age increases the likelihood of HPV exposure.
  • Multiple sexual partners: Having multiple sexual partners increases the risk of HPV transmission.
  • Weak immunity: Certain medical conditions like HIV/AIDS or immunosuppressive drugs weaken the immune system, making it harder to fight HPV infection and increasing the risk of cervical cancer.
  • Smoking: The carcinogens in tobacco smoke can damage the cervical cells, making it easier for HPV to cause cancer.
  • Limited access to healthcare: People who don’t have access to cervical cancer screening and HPV vaccination are at a higher risk of getting infected.
  • Family history: Having a close relative with cervical cancer can increase the risk slightly, suggesting a possible genetic predisposition.

While these factors can cause cervical cancer, there is no guarantee that the development of cervical cancer. It is better to get a proper diagnosis to avoid the progression of the disease.

Symptoms of Cervical Cancer

You may not experience any noticeable symptoms in the initial stage of cervical cancer. As it progresses, the following symptoms may occur:

  • Unusual bleeding between periods, after intercourse, or after menopause.
    Watery, bloody, or foul-smelling discharge from the vagina.
  • Pain or discomfort in the pelvic area, including during sexual intercourse, can occur.
  • Advanced cervical cancer may press on the bladder, causing pain or discomfort during urination.
  • Changes in menstrual patterns, such as heavier or longer periods.
  • Pain in the lower back or pelvis in tissues and organs as cervical cancer progresses.

It is important to note that these symptoms can also be caused by other conditions unrelated to cancer. However, if these symptoms persist or worsen over time, you should consult a healthcare provider for evaluation and appropriate testing.

Diagnosis of Cervical Cancer

Cervical cancer diagnosis includes multiple tests that help determine whether you are infected with cancer or which stage of cervical cancer you are at. The stages range from 1 to 4, with 1 meaning that you are at the least risk. As the number increases, the more serious the cancer is. Stage 4 cancer is the last stage, which means that the cancer has spread to different parts of the body.

1. Physical examination and medical history: Your doctor will perform a pelvic exam to determine any abnormalities in the cervix or around it. They will also ask for your medical history and any symptoms you may be experiencing.
2. Pap smear test: For this test, your doctor will collect cells from the cervix and examine them under a microscope to check for any issues.
3. HPV test: In addition to a Pap smear, your doctor may do an HPV test to detect the presence of high-risk strains of the human papillomavirus (HPV), which can cause cervical cancer.
4. Colposcopy: If any abnormal cells are detected during a Pap smear or HPV test, a coloscopy is conducted to examine the cervix cells more closely.
5. Biopsy: If abnormal cells are found during a colposcopy, a biopsy (small samples) may be performed to confirm the presence of cancerous cells. There are different types of biopsies, including punch biopsy, cone biopsy, or endocervical curettage, depending on the location and extent of abnormal tissue.
6. Imaging Tests: These are done to determine the extent of the cancer and whether it has spread to other parts of the body. Imaging tests include ultrasound, CT scan, MRI, or PET scan.

Treatment of Cervical Cancer

If caught early, cervical cancer can be treated. The treatment of cervical cancer includes:

1. Surgery

Your doctor may recommend treatment at the early stage of cervical cancer. Surgery options for cervical cancer include:

  • Cone biopsy: Removal of a cone-shaped piece of tissue from the cervix to remove precancerous or early-stage cancerous cells.
  • Hysterectomy: It involves the removal of the uterus and cervix. In some cases, the ovaries and fallopian tubes may also be removed. This procedure is suitable for women who have completed childbearing or have advanced-stage cervical cancer.
  • Lymphadenectomy: The removal of lymph nodes in the pelvis to control the spread of cancer.

2. Radiation Therapy

This involves high-energy beams to destroy cancer cells. It may be used alone or combined with chemotherapy. There are two main types:

  • External beam radiation: In this procedure, radiation is directed at the affected area from the machine outside the body.
  • Brachytherapy: Radioactive sources placed inside the vagina are directed into or near the tumor.

3. Chemotherapy

Chemotherapy includes the use of strong medicines that help kill cancer cells or stop their growth. It can be given alone or combined with radiation therapy.

4. Targeted therapy

Targeted therapy uses medicines that specifically target the chemicals involved in cancer growth. It blocks these chemicals, causing the cancer cells to die. It can be used in combination with chemotherapy for advanced-stage cervical cancer.

5. Immunotherapy

Immunotherapy drugs help the immune system recognise and attack cancer cells. While still being studied, immunotherapy may be used in certain cases of advanced cervical cancer, particularly those that have not responded to other treatments.

Treatment decisions are made in consultation with the healthcare team, considering the stage and characteristics of the cancer, as well as the patient’s overall health and preferences. Palliative care may also be provided to manage symptoms and improve the quality of life for patients with advanced-stage cervical cancer. Regular follow-up care is important to monitor for recurrence and manage any long-term effects of treatment.

Cervical Cancer Related FAQs

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