CERVICAL CANCER
Overview
Cervical cancer is a type of cancer that develops in the cells of the cervix, which connects the uterus to the vaginal canal. Most cervical cancer is caused by different strains of the human papillomavirus (HPV), a sexually transmitted infection. When the body is exposed to HPV, the immune system usually stops the virus from causing harm. However, in a small percentage of people, the virus can live for years, contributing to the transformation of some cervical cells into cancer cells.
Cervical cancer can be prevented by having screening tests and getting a vaccine that protects against HPV infection.
Symptoms :
Cervical precancers and cancers do not cause pain or other symptoms in the early stages. That's why it's critical for women to have regular pelvic exams and Pap tests to catch cancer early on, when it's still treatable. The following are likely to be the first signs of cervical cancer:
● Menstrual periods may be heavier and last longer than usual due to abnormal vaginal bleeding, such as after intercourse, between menstrual periods, or after menopause.
● During intercourse, there is pain.
● Vaginal discharge and odour .
● Pelvic discomfort.
Symptoms of cervical cancer that has spread to nearby tissues include:
-
Having trouble urinating, urinating with pain, or urinating with blood
-
Swelling in the legs or a dull backache
-
Diarrhea, or rectum pain or bleeding during defecation
-
Fatigue, weight loss, loss of appetite, and a general feeling of illness
-
Constipation, nausea, vomiting, and a swollen abdomen
When should you contact your doctor?
a) Bleeding after menopause is never normal, so if you're experiencing it, see your doctor as soon as possible.
b) If you have very heavy periods or bleed a lot between periods, tell your doctor.
c) After sex, some women experience bleeding, especially after vigorous sex. It's most likely nothing to be concerned about. However, if it occurs frequently, you should inform your doctor.
d) If you have vaginal bleeding and weakness, or if you feel faint, light-headed, or pass out, go to the emergency room.
Where do Cervical cancer start and the causes?
Cervical cancer is caused by changes (mutations) in the DNA of healthy cells in the cervix. The DNA of a cell contains the instructions that tell it what to do. Healthy cells grow and multiply at a predetermined rate before dying at a predetermined time. The mutations cause the cells to grow and multiply uncontrollably, and they do not die as a result. The abnormal cells that are accumulating form a mass (tumor). Cancer cells can infiltrate nearby tissues and break away from a tumour to spread (metastasize) to other parts of the body. Although the exact cause of cervical cancer is unknown, HPV is known to play a role. HPV is extremely common, and the majority of people infected with it never develop cancer. This means that other factors, such as your environment and lifestyle choices, play a role in whether or not you develop cervical cancer.
Cervical cancer is linked to the following risk factors:
-
There are a lot of sexual partners. The more sexual partners you have — and the more sexual partners your partner has — the more likely you are to contract HPV.
-
Sexual activity in the adolescent years. HPV infection is more likely if you have sex when you're young.
-
Viruses that are sexually transmitted (STIs). Other sexually transmitted infections (STIs) such as chlamydia, gonorrhoea, syphilis, and HIV/AIDS increase your risk of contracting HPV.
-
A compromised immune system. If your immune system is weakened by another health condition and you have HPV, you may be more likely to develop cervical cancer.
-
Smoking. Squamous cell cervical cancer is linked to smoking.
-
Miscarriage prevention drug exposure. If your mother used the drug diethylstilbestrol (DES) while pregnant in the 1950s, you may have a higher risk of clear cell adenocarcinoma, a type of cervical cancer.
Cancer types:
The type of cervical cancer you have influences your prognosis and treatment options. The following are the most common types of cervical cancer:
-
Squamous cell carcinoma is a type of cancer that affects the skin. Cervical cancer of this type starts in the thin, flat cells (squamous cells) that line the outer part of the cervix, which protrudes into the vaginal canal. Squamous cell carcinomas account for the majority of cervical cancers.
-
Adenocarcinoma. The column-shaped glandular cells that line the cervical canal are where this type of cervical cancer begins. Cervical cancer can involve both types of cells at times. Cancer in the cervix's other cells occurs very rarely.
Prevention:
To lower your chances of cervical cancer, do the following:
-
Inquire about the HPV vaccine with your doctor. Preventing HPV infection with a vaccine may lower your risk of cervical cancer and other HPV-related cancers. Consult your doctor to see if an HPV vaccine is right for you.
-
Pap tests should be done on a regular basis. Precancerous conditions of the cervix can be detected using Pap tests, which can then be monitored or treated to prevent cervical cancer. Routine Pap tests should be started at the age of 21 and repeated every few years, according to most medical organizations.
-
Use caution when having sex. Take steps to prevent sexually transmitted infections, such as using a condom every time you have sex and limiting your sexual partners, to lower your risk of cervical cancer.
-
Don't take up smoking. Don't start smoking if you don't already. If you do smoke, talk to your doctor about quitting strategies.
Diagnosis:
Screening Cervical cancer and precancerous cells that may develop into cervical cancer can both be detected with screening tests. The majority of guidelines recommend starting cervical cancer and precancerous changes screening at the age of 21.
The following are examples of screening tests:
Pap smear. Your doctor scrapes and brushes cells from your cervix during a Pap test, which are then analyzed in a lab for abnormalities.
A Pap test can detect abnormal cells in the cervix, such as cancer cells and cells that have undergone changes that raise the risk of cervical cancer.
HPV DNA test is a test that detects the presence of the human papillom .The HPV DNA test involves looking for infection with any of the HPV types that are most likely to cause cervical cancer in cells taken from the cervix.
Consult your doctor about cervical cancer screening options.
If cervical cancer is suspected, your doctor will most likely begin by examining your cervix thoroughly. To look for abnormal cells, a special magnifying instrument called a colposcope is used. Your doctor will most likely take a sample of cervical cells (biopsy) during the colposcopic examination for laboratory testing. Your doctor may use the following methods to obtain tissue:
-
Punch biopsy - which involves pinching small samples of cervical tissue with a sharp tool.
-
Endocervical curettage involves scraping a tissue sample from the cervix with a small spoon-shaped instrument (curet) or a thin brush.
If your doctor is concerned about the punch biopsy or endocervical curettage, he or she may order one of the following tests:
-
Electrical wire loop, which obtains a small tissue sample using a thin, low-voltage electrified wire. This is usually done in the office under local anesthesia.
-
Cone biopsy (conization) is a procedure that allows your doctor to obtain deeper layers of cervical cells for testing in the laboratory. A cone biopsy can be performed under general anesthesia in a hospital.
Staging:
If your doctor determines that you have cervical cancer, you will undergo additional tests to determine the cancer's extent (stage). The stage of your cancer plays an important role in determining your treatment options.
Exams for staging include:
Imaging examinations. X-rays, CT scans, MRIs, and positron emission tomography (PET) scans can all help your doctor figure out if your cancer has spread beyond your cervix. Visually inspect your bladder and rectum. To examine the inside of your bladder and rectum, your doctor may use special scopes.
Treatment:
Treatment for cervical cancer is determined by a number of factors, including the cancer's stage, any other health issues you may have, and your personal preferences. Surgery, radiation, chemotherapy, or a combination of the three can all be used to treat cancer.
Surgery:
Cervical cancer in its early stages is usually treated with surgery. The best operation for you will be determined by the size and stage of your cancer, as well as whether or not you want to consider becoming pregnant in the future. Among the possibilities are:
1. Only the cancer will be removed during surgery. With a cone biopsy, it may be possible to completely remove a very small cervical cancer. Cutting away a cone shaped piece of cervical tissue while leaving the rest of the cervix intact is the goal of this procedure. This option may allow you to think about becoming pregnant in the future.
2. Surgical removal of the cervix (trachelectomy). A radical trachelectomy procedure, which removes the cervix and some surrounding tissue, may be used to treat early stage cervical cancer. Because the uterus is preserved after this procedure, you may
be able to become pregnant if you so desire.
3. Surgical removal of the cervix and uterus (hysterectomy). The cervix, uterus, part of the vaginal wall, and nearby lymph nodes are all removed during a radical hysterectomy operation for most early-stage cervical cancers. Early-stage cervical cancer can be cured and recurred with a hysterectomy. However, removing the uterus makes it impossible to conceive.
4. For early-stage cervical cancer, a minimally invasive hysterectomy, which involves making several small incisions in the abdomen rather than one large incision, may be an option. People who have minimally invasive surgery recover faster and stay in the hospital for less time. However, some research suggests that minimally invasive hysterectomy is ineffective compared to traditional hysterectomy. If you're thinking about having minimally invasive surgery, talk to your doctor about the advantages and disadvantages.
Radiation:
To kill cancer cells, radiation therapy uses high-powered energy beams such as X-rays or protons. For locally advanced cervical cancers, radiation therapy is frequently combined with chemotherapy as the primary treatment. It can also be used after surgery if there is a
higher risk of the cancer returning. Radiation therapy can be given in the following ways :
Externally, by directing a beam of radiation at the affected body part (external beam radiation therapy)
Internally, by inserting a device containing radioactive material into your vagina for a few minutes (brachytherapy)
Radiation therapy may cause menopause if you haven't started it yet. If you want to try to get pregnant after radiation, talk to your doctor about ways to preserve your eggs before you start treatment.
Chemotherapy:
Chemotherapy is a drug treatment that kills cancer cells by using chemicals. It can be injected into a vein or taken as a pill. Both methods are sometimes used.
Low doses of chemotherapy are frequently combined with radiation therapy for locally advanced cervical cancer, as chemotherapy may enhance the effects of the radiation. To help control the symptoms of very advanced cancer, higher chemotherapy doses may be
recommended.
Therapy that is specific to the patient:
Targeted drug treatments concentrate on specific flaws found in cancer cells. Targeted drug treatments can kill cancer cells by preventing them from exploiting these flaws. Chemotherapy is frequently used in conjunction with targeted drug therapy. It could be a viable option for advanced cervical cancer patients.
Palliative (supportive) care:
Palliative care is a type of medical treatment that focuses on relieving pain and other symptoms associated with a serious illness. Palliative care specialists collaborate with you, your family, and your other doctors to add an extra layer of support to your ongoing treatment.
People with cancer may feel better and live longer when palliative care is used in conjunction with all other appropriate treatments.
A team of doctors, nurses, and other specially trained professionals provide palliative care. Palliative care teams are dedicated to enhancing the quality of life for cancer patients and their families. This type of treatment is provided in addition to any curative or other treatments you may be receiving.
Cervical Cancer Prognosis:
When precancerous or early cancerous changes are detected and treated, the survival rate approaches 100%. The prognosis for invasive cervical cancer is determined by the stage of the disease.
1. More than 90% of women with stage 0 cancer live for at least 5 years after being diagnosed.
2. Patients with stage I cervical cancer have a 5-year survival rate of 80 to 93 percent.
3. The 5-year survival rate for women with stage II cervical cancer is 58 percent to 63 percent.
4. Women with stage III cervical cancer have a survival rate of 32 percent to 35 percent.
5. Women with stage IV cervical cancer have a survival rate of 16% or less after 5 years.
6. When treating cancer, health care providers frequently use the term "remission" rather than "cure." Cervical cancer can be completely cured in many women, but it can also recur.