What is cervical cancer?
Cervical cancer denotes the malignancy originating from abnormal cell growth within the cervix. Prioritizing regular gynaecological examinations, undergoing Pap tests, and adhering to safe sexual practices constitute pivotal measures in the prevention of cervical cancer. Surgical intervention, radiation therapy, and chemotherapy represent the primary modalities for treating cervical cancer. Cervical cancer, also known as cancer of the cervix, originates from the surface of the cervix when its cells undergo precancerous changes. While not all precancerous cells progress to cancer, identifying and treating these abnormal cells before they transform is imperative in averting the onset of cervical cancer.
The cervix is the lowest portion of the uterus, resembling a donut shape, and serves as the conduit between the uterus, where a fetus develops during pregnancy and the opening of the vagina. Admitted cell tissues, the cervix houses healthy cells that have the potential to develop into precancerous cells. The two primary types of cervical cancer are squamous cell carcinomas and adenocarcinomas. Squamous cell carcinomas account for approximately 80% to 90% of cervical cancers, while adenocarcinomas make up the remaining 10% to 20%.
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| Cervical Cancer-Recognizing Symptoms, Signs, and Potential Complications |
What are the frequent signs and symptoms of cervical cancer?
Common signs and symptoms of cervical cancer may not manifest in the early stages, making detection challenging. Initial indications often take several years to develop, highlighting the importance of cervical cancer screenings for identifying abnormal cells. In stage 1 cervical cancer, symptoms may include:
- Watery or bloody vaginal discharge, potentially heavy and accompanied by an unpleasant odour.
- Vaginal bleeding post-intercourse, between menstrual cycles, or after menopause.
- One may have Menstrual periods that are unusually heavy and prolonged.
Advanced stages, characterized by the spread of cancer to nearby tissues or organs, may present additional symptoms such as:
- Difficult or painful urination, occasionally with blood in the urine.
- Diarrhea, rectal pain, or bleeding during bowel movements.
- Fatigue, involuntary weight loss, and diminished appetite.
- Overall discomfort or a feeling of being unwell.
- Persistent dull backache or swelling in the legs.
- Pelvic or abdominal pain.
If you encounter abnormal bleeding, vaginal discharge, or any unexplained symptoms, undergoing a comprehensive gynaecological examination inclusive of a Pap test is strongly advised.
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| Cervical Cancer Prevention-Vaccination and Screening |
The human papillomavirus (HPV), a sexually transmitted infection, primarily causes cervical cancer. HPV spreads through various forms of sexual contact, including anal, oral, or vaginal intercourse, and has the potential to progress to cancer. While most individuals will contract HPV at some stage without exhibiting symptoms, their immune systems typically eradicate the infection. However, in cases where the immune response is inadequate, HPV can trigger the transformation of cervical cells into cancerous cells.
How does cervical cancer pain manifest?
In the early stages of cervical cancer, pain may be minimal or absent. As the disease progresses and spreads to nearby tissues and organs, you may experience pelvic discomfort and difficulties with urination. Some individuals may also experience a general sense of malaise, fatigue, or appetite loss.
What is the diagnostic process for cervical cancer?
Diagnosing cervical cancer involves a gradual process due to its slow development over several years. As normal cervical cells change, they may become irregular or abnormal before progressing to cancer.
- Routine gynaecological screenings, particularly Pap tests, are effective in detecting most cervical cancer cases. During a Pap test, cells are collected from the cervix and examined for signs of precancerous changes or abnormalities.
- If abnormal Pap test results occur, further testing becomes necessary. This abnormal Pap test may involve an HPV test, which checks for HPV infection in cervical cells, as certain HPV types are associated with cervical cancer.
- In cases where cancer is suspected, your healthcare provider may conduct a cervical examination and obtain a tissue sample for biopsy. Various techniques, such as punch biopsy or endocervical curettage, are used to extract tissue from the cervix for analysis. Also, wire loop or conization procedures may be employed to gather biopsy specimens.
- Upon confirmation of cancer through biopsy, additional tests are conducted to determine the extent of disease spread, known as staging. These tests may include liver evaluation and kidney function, blood and urine tests, and X-rays of the bladder, rectum, bowels, and abdominal cavity.
What tests are available to detect cervical cancer?
The primary tests for cervical cancer detection are the Pap test and the HPV test. These screenings aim to identify irregular or problematic cells at their earliest stage before they progress to cancer. Early detection of these cells significantly improves the treatability of cervical cancer and reduces its severity.
- During these tests, your Gynecologic oncologists collects cells from your cervix using a brush or swab. You lie on an examination table with your feet in stirrups, similar to a pelvic exam, while a speculum is inserted into your vagina to access the cervix. After collection, the cells are preserved in a liquid and sent to a laboratory for analysis.
- Cervical cancer screening is vital for detecting cell changes on the cervix before they develop into cancer. Regular screenings have contributed to a significant reduction in cervical cancer cases and deaths in the United States.
- The Pap test identifies abnormal or irregular cells in the cervix, while the HPV test detects high-risk types of HPV infection associated with cervical cancer.
In some cases, Gynecologic oncologists may recommend a combination Pap test/HPV test, known as co-testing, particularly for individuals over 30.
What stages does cervical cancer progress through?
The four stages of cervical cancer are as follows:
- Stage I: Cancer is confined to the cervix and is small in size, with no spread to other areas.
- Stage II: Cancer has extended beyond the cervix and uterus but has not reached the pelvic wall or vagina.
- Stage III: Cancer has spread to the lower part of the vagina and may have affected the pelvic wall, ureters, and nearby lymph nodes.
- Stage IV-Cancer has spread to distant organs such as the bladder, rectum, bones, or lungs.
How is cervical cancer managed?
The treatment of cervical cancer involves a multidisciplinary team led by a gynecologic oncologist who specializes in cancers of the female reproductive system. Various factors, such as the stage of the disease, the patient's age and overall health, and their reproductive preferences, determine the treatment choice.
Treatment modalities for cervical cancer include radiation therapy, chemotherapy, surgery, targeted therapy, and immunotherapy.
Radiation Therapy:
- External beam radiation therapy (EBRT) delivers high-energy radiation from an external machine to target cancer cells.
- Brachytherapy involves placing radiation sources directly into or near the cancerous tissue.
Chemotherapy:
- Chemotherapy drugs, administered intravenously or orally, travel through the bloodstream to kill cancer cells throughout the body. Various drugs can be used alone or in combination, typically administered in cycles.
Surgery:
- Laser surgery employs a laser beam to destroy cancer cells.
- Cryosurgery freezes and destroys cancer cells.
- Cone biopsy removes a cone-shaped piece of tissue from the cervix.
A simple hysterectomy removes the uterus without adjacent tissue removal.
- Radical hysterectomy with pelvic lymph node dissection removes the uterus, surrounding tissue, cervix, upper vagina, and pelvic lymph nodes.
- Trachelectomy removes the cervix and upper vagina while preserving the uterus.
- Pelvic exenteration involves removing the uterus, cervix, surrounding tissues, bladder, vagina, rectum, and part of the colon as needed.
In the early stages, the disease can be curable by removing the cancerous tissue. In more advanced cases, a combination of treatments may be necessary, including radiation or chemotherapy before or after the procedure to manage recurrent or metastatic cancer.
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| Cervical Cancer Vaccine |
What does the cervical cancer vaccine entail?
The cervical cancer vaccine, also known as the HPV vaccine, is approved for individuals aged 9 to 45 and is designed to prevent cervical cancer. By stimulating the body's immune system, the vaccine targets specific types of human papillomavirus (HPV) associated with cervical cancer. Ideally, a gynecologic oncologist should administer the vaccine before the onset of sexual activity. Gynecologic oncologists administer the vaccine in a series of shots, with the number of doses varying based on the age at the first dose. Consultation with a gynecologic oncologist confirms eligibility for the vaccine.