Cervical cancer

 

 

Cervical cancer is marked by the uncontrolled growth of cells of the cervix (i.e., the opening or the mouth of the uterus).

 

 

Cervical cancer generally affects women of age 40 and above. HPV (human papilloma virus), environmental factors, and lifestyle choices are thought to be the causative factors for the development of cervical cancer.

1. HPV: More than 90% cases are caused due to human papilloma virus. Sexually transmitted infections like syphilis, gonorrhea increase the risk of HPV infection.

2. Smoking: Both active and passive smoking

3. Oral contraceptives: Long-term usage of oral contraceptives

4. History of multiple pregnancies

 

 

No clear symptoms are seen at an early stage. At an advanced stage of cervical cancer symptoms include:

1. Abnormal vaginal bleeding, i.e., vaginal bleeding after intercourse, between periods or after menopause

2. Pelvic pain

3. Pain during sexual intercourse

 

 

Regular screening helps to detect a pre-cancer stage before it turns into invasive cancer. Screening test includes a Pap smear test and HPV DNA test.

1. Laboratory tests include,

(a) Papanicolau (Pap) cytology test: In a Pap smear test, cells from the cervix are scraped off and examined under the microscope to find overt cancer cells and other cells that may develop into cervical cancer (i.e., the pre-cancer cells).

2. HPV DNA test: Same cells that are collected for Pap test can be used for HPV DNA test. This test is done to detect the virus that can increase the risk of cervical cancer.

3. Imaging tests are done to determine whether cancer has spread beyond cervix. These include,

(a) MRI (magnetic resonance imaging)

(b) X-ray

(c) CT scans

(d) PET (positron emission tomography) region. These tests are mostly done after the diagnosis of a cervical cancer has been established.

4. Biopsy: A tissue sample is removed from the membrane of the cervix for detecting cancer cells.

 

 

Age, general health condition, and extent of growth and spread of cancer determine the treatment of cervical cancer. A combination of one or all of the following is used to treat cervical cancer.

1. General measures,

(a) No smoking: Limiting or quitting smoking to reduce risk factor causing cervical cancer is advisable.

(b) Radiation: High-powered energy beams are used to destroy cancer cells.

(c) Chemotherapy: It is done to kill cancer cells. Hycamtin and cisplatin are commonly used chemotherapy drugs.

2. Vaccination: HPV vaccines (available under brand names Gardasil and Cervarix) reduce the risk of cervical cancer. This should be taken before the first sexual exposure.

3. Surgery: Removal of the whole uterus including the upper part of the vagina is termed hysterectomy. Simple or radical hysterectomy may be done depending on the extent and size of the cancer.

4. Activity and diet: Vitamin A, vitamin C, vitamin B12, and vitamin E reduce the risk of cervical cancer.

 

 

If you notice one or more of the following symptoms you should consult your doctor. These symptoms are abnormal vaginal bleeding, pelvic pain, and pain during sexual intercourse.

 

 

Prognosis depends upon the stage of cervical cancer. Regular examination and screening through Pap test is helpful in early detection.

Preventive measures include:

1. Proper and sufficient hygiene of female genitals, avoiding multiple sexual partners, timely and complete treatment of any sexually transmitted disease, and HPV vaccination.

2. The best way to prevent cervical cancer is to have testing/screening to find pre-cancers before they can turn into invasive cancer.