Cervical cancer is the fourth most common cancer among women. It is a slow-growing cancer of the cells in the cervix (neck of the womb).
Cervical cancer is caused by Human Papillomavirus (HPV) and it is preventable by vaccination. This article provides complete information on cervical cancer with an emphasis on prevention and treatment.
Cervical cancer begins in the cells of the cervix, the lower and narrow end of the uterus. The cervix cells undergo changes called dysplasia before cancer appears. These abnormal cells if not destroyed become cancerous and spread rapidly deeply into the cervix and surrounding areas.
The outer part of the cervix called the ectocervix is covered with squamous cells. During the gynecologic examination, this part is seen.
The inner part is called the endocervix comprising columnar glandular cells which produce mucus.
The border where both the ectocervix and endocervix meet is called the transformation zone where most cervical cancer begins in squamous cells in this zone.
There are two types of cervical cancer, namely,
Squamous cell carcinoma constitutes 90% of cervical cancer developing from ectocervix cells.
Adenocarcinoma develops in the glandular cells of the endocervix.
Mixed carcinoma, when cervical cancer has features of both squamous cell carcinoma and adenocarcinoma.
Cervical cancer symptoms can be studied as early-stage and advanced-stage cervical cancer symptoms.
Early-stage cervical cancer symptom includes:
Bleeding after sex
Bleeding after menopause
Bleeding between menstrual cycles.
Heavy menstrual cycle longer than usual.
Watery vaginal discharge with blood and a strong odor
Advanced-stage cervical cancer symptoms include:
Swelling in the legs
Painful bowel movements,
Rectal bleeding during bowel movement.
Back pain (dull)
Human Papillomavirus or HPV causes cervical cancer, mostly caused by HPV16 and HPV18.
The other risk factors of cervical cancer are:
Weak immune system: In immunocompromised individuals, the body loses the ability to fight HPV infection. The causes of immunosuppression include HIV, medications suppressing immunity, cancer, etc.
Smoking: Those women who smoke have a higher risk of cervical cancer than women who are non-smokers.
Sex at an early age: The risk of cervical cancer is more among those who are sexually active before 18 and have multiple sexual partners.
Using oral contraceptives.
Multiple pregnancies or birth to many children.
The cervical cancer diagnosis is made by the following considerations:
History and examination: The patient's history and family history is taken by the gynecologist followed by a pelvic examination.
Colposcopy: A colposcopy is a test to closely look at the cervix for screening. A smooth, tube-shaped tool called a speculum is placed into the vagina to open it. A microscope (outside the body) then looks at your cervix in greater detail.
Biopsy: It is used to reveal the signs of cancer. Punch biopsy, endocervical curettage, Loop electrosurgical excision procedure (LEEP), and Cone biopsy are the different types of biopsy to aid diagnosis of cervical cancer
After a diagnosis of cervical cancer, the patient is referred to a gynecologic oncologist.
A gynecologic oncologist is specialized in staging and treatment of cervical cancer. The treatment of cervical cancer is planned based on the stage of cancer.
Various Imaging tests are used to determine the stage of cervical cancer.
PET-CT scan: This refers to positron emission tomography scan and computed tomography scan. After injecting radioactive glucose into the vein, the picture is obtained in which malignant cells appear brighter due to the increased uptake of glucose compared to normal cells.
Magnetic resonance imaging (MRI) provides detailed pictures of areas inside the body.
Complete blood count (CBC)
Blood chemistry study including electrolytes, lactate dehydrogenase, uric acid, blood urea nitrogen, creatinine, and liver function test.
The prognosis of cervical cancer depends on:
Type of cervical cancer
General health status of the patient
The survival rate is high when cervical cancer is diagnosed and treated early.
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It is important to note that the treatment of cervical cancer depends on the stage. The success of cervical cancer treatment is higher when treated in the early stages.
If you have symptoms of cervical cancer, then without delay get all the investigations done, and consult an experienced gynecologic oncologist to initiate the treatment as early as possible to increase your chances of a better life and a good future.
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