Cervical Cancer

Cervical Cancer 

Cervical Cancer is a type of cancer that occurs in the woman’s cervix. It begins from the cervix’s surface area and ultimately spreads to the vagina( birth canal). It is the fourth most common cancer type that occurs in women globally affecting nearly 604000 people and causing 342000 deaths in 2020 based on reports.

Types of Cervical Cancer 

Cervical Cancer is classified into two types including Squamous cell carcinoma and Adenocarcinoma.

• Squamous cell carcinoma – This is the most common type of cancer that begins in the exocervix that joins to the endocervix area.
• Adenocarcinoma – Cancer starts spreading from glandular cells. It is present in the mucus-producing glandular cells of the endocervix.

Signs and Symptoms of Cervical Cancer

The most prominent signs and symptoms of cervical cancer are hard to detect at the early stages of cancer. The first sign usually takes a few years to get noticed. The common signs that can be experienced during those times are –

• Foul odor in Vaginal discharge 
• Water or blood flow in vaginal discharge
• Menstrual periods can be painful and last longer 

Cervical Cancer

The later stages of Cervical cancer have symptoms such as –

• Painful urination or bleeding while urination.
• Fatigue 
• Unexplained Loss of weight
• Backache and fever
• Abdominal pain
• Diarrhea
• Rectum bleeding

If you’ve experienced any of these irregular and uncommon symptoms in your daily life then you must get yourself check with a medical professional or consult a gynecologist for a thorough examination of your health.

Causes of Cervical Cancer

Cervical cancer is primarily caused by persistent infection with certain types of human papillomavirus (HPV). Here are the key factors and causes associated with cervical cancer –

1. Human Papillomavirus (HPV) Infection – HPV is a sexually transmitted infection that is the primary cause of cervical cancer. Certain types of high-risk HPV, particularly HPV types 16 and 18, are responsible for the majority of cervical cancer cases. HPV is very common and usually clears up on its own, but in some cases, it can persist and lead to the development of abnormal cells in the cervix, which can eventually become cancerous.
2. Sexual Activity – Engaging in sexual activity, including vaginal, anal, or oral sex, increases the risk of acquiring HPV infection. Having multiple sexual partners or having sex with a partner who has had multiple sexual partners further increases the risk.
3. Weakened Immune System – A weakened immune system, often associated with conditions like HIV/AIDS or undergoing immunosuppressive therapy, can make individuals more susceptible to HPV infection and less able to clear the infection, leading to a higher risk of developing cervical cancer.
4. Smoking – Smoking tobacco has been linked to an increased risk of cervical cancer. Chemicals found in tobacco smoke can damage the DNA of cervical cells and weaken the immune system’s ability to fight off HPV infections.
5. Long-Term Use of Oral Contraceptives – Some studies have suggested a link between long-term use of certain types of oral contraceptives (birth control pills) and an increased risk of cervical cancer. However, the increased risk appears to decrease after stopping the use of oral contraceptives and returns to normal after several years.
6. Lack of Regular Pap Tests – Regular screening through Pap tests (Pap smears) allows for the early detection of precancerous changes in the cervix, enabling prompt treatment before cancer develops. Not undergoing regular screening increases the risk of undiagnosed precancerous or cancerous cells.

These factors are associated with an increased risk of developing cervical cancer, not all individuals with these risk factors will develop the disease. Regular cervical cancer screenings and HPV vaccinations can help in early detection and prevention.

Diagnosis and Tests 

Cervical cancer is typically diagnosed through a combination of screening tests and further diagnostic procedures. Here are the common methods used for the diagnosis and testing of cervical cancer –

1. Pap test (Pap smear) – This is a screening test used to detect abnormal cells in the cervix. During a Pap test, a healthcare provider collects cells from the cervix and examines them under a microscope. It can identify pre-cancerous or cancerous changes in the cells.
2. HPV DNA test – Human papillomavirus (HPV) is the primary cause of cervical cancer. The HPV DNA test detects the presence of high-risk HPV strains in cervical cells. It may be used in conjunction with a Pap test, especially for women over 30 years of age.
3. Colposcopy – If abnormal cells are found during a Pap test, a colposcopy may be performed. During this procedure, a special magnifying instrument called a colposcope is used to examine the cervix more closely. A small tissue sample (biopsy) may be taken during the colposcopy for further analysis.
4. Biopsy – A biopsy involves the removal of a small sample of tissue from the cervix for examination under a microscope. A biopsy helps to confirm the presence of cancer and determine its type and stage. There are different types of biopsies, including punch biopsy, cone biopsy, or endocervical curettage (ECC), depending on the suspected area of abnormality.
5. Imaging tests – Imaging tests, such as ultrasound, CT scan, or MRI, may be recommended if there is suspicion of advanced cervical cancer or to evaluate the extent of the disease.
6. Lymph node biopsy – If cervical cancer has spread or is suspected to have spread to nearby lymph nodes, a biopsy of the lymph nodes may be performed to determine if they contain cancer cells.
7. Staging – Staging helps determine the extent and spread of cancer. It is usually done through a combination of physical examination, imaging tests, and sometimes additional procedures, such as a cystoscopy or proctoscopy, to assess the involvement of the bladder or rectum.

The specific diagnostic approach may vary depending on individual circumstances and healthcare practices. If you have concerns or suspect cervical cancer, it is best to consult with a healthcare professional who can guide you through the appropriate diagnostic process.

Stages

A general overview of the outlook for cervical cancer based on the stages –

1. Stage 0 (carcinoma in situ) – This is the earliest stage of cervical cancer, where abnormal cells are confined to the surface of the cervix. The five-year survival rate for stage 0 cervical cancer is nearly 100% when treated appropriately.
2. Stage I – At this stage, cancer has spread beyond the surface of the cervix but is still limited to the cervix. The five-year survival rate for stage I cervical cancer is approximately 92-93%.
3. Stage II – Cancer has spread beyond the cervix but is still within the pelvic area. The five-year survival rate for stage II cervical cancer is around 58-63%.
4. Stage III – Cancer has spread to the lower part of the vagina or the pelvic wall. The five-year survival rate for stage III cervical cancer is approximately 32-35%.
5. Stage IV – Cancer has spread to nearby organs or distant parts of the body. The five-year survival rate for stage IV cervical cancer is around 16-17%.

These survival rates are general estimates and can vary depending on individual factors. Advancements in treatment options, such as surgery, radiation therapy, chemotherapy, and targeted therapy, have improved outcomes for many individuals with cervical cancer.

Treatment

The treatment plan for cervical cancer is recommended only after proper evaluation of lots of factors i.e. patient’s stage, age, and general health. The broad spectrum of treatments our cancer care team will suggest for cervical cancer are radiation, surgery, chemotherapy, targeted therapy, and immunotherapy.

• Radiation – It uses beams of high-energy rays to kill cancer cells in the cervix. The two types of radiation therapy used to treat cervical cancers are 
• External beam radiation therapy (EBRT) – High-power radiation is used to kill cancer
• Brachytherapy – Radiation is applied in or around cancer cells.
• Surgery – Various types of surgeries are used to treat cervical cancer including Laser Surgery, Cryosurgery, Cone Biopsy, Trachelectomy, hysterectomy, and pelvic exenteration.
• Chemotherapy – Chemotherapy is a drug that is administered through veins or medicine in the body. It kills cancer cells present anywhere in the body. 
• Targeted therapy – It specifically targets cancer cells without damaging healthy cells in the body. It usually targets specific genes or proteins that help in the growth and spread of cancer cells. 
• Immunotherapy – In this medicine is used for cancer treatment. The patient’s own immune system is recognized to kill cancer cells effectively. Cancer cells stay hidden from the immune system and survive in the body. However, immunotherapy identifies these cancer cells by targeting them directly in the body. 

Outlook

The outlook for cervical cancer depends on several factors, including the stage of cancer at diagnosis, the overall health of the individual, and the effectiveness of the treatment provided. Early detection and treatment of cervical cancer can significantly improve the prognosis.

Regular screenings, such as Pap tests and HPV testing, can help detect cervical cancer at an early stage or even prevent it by identifying pre-cancerous changes. Vaccination against high-risk HPV strains, as recommended for young individuals, can also significantly reduce the risk of developing cervical cancer.

If you or someone you know has been diagnosed with cervical cancer, it is crucial to consult with healthcare professionals who can provide personalized information and guidance based on specific circumstances.