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Cervical Cancer

Cervical cancer is cancer that starts in the cells of the cervix. It is primarily caused by persistent infection with certain types of human papillomavirus (HPV), a common sexually transmitted infection. While most HPV infections resolve on their own, some can lead to cellular changes that, over time, may develop into cancer. Screening tests and the HPV vaccine can help prevent cervical cancer. Receiving the HPV vaccine for girls between 9 and 45 years old can also be helpful. Cervical cancer usually develops slowly over time. When cervical cancer is found early, it is highly treatable and associated with long survival and good quality of life.

Symptoms

Types

Causes & Risks

Prevention

Treatments

Signs & Symptoms

Women with pre-cancers and early cervical cancers usually have no signs and symptoms. Signs & symptoms of Cervical cancer appear only after the cancer has reached an advanced stage. However, during the advanced stage of cervical cancer, there are some signs and symptoms including:

1. Abnormal Vaginal Bleeding:

  • Bleeding between menstrual periods.
  • Bleeding after sexual intercourse.
  • Heavier and longer menstrual periods than usual.
  • Bleeding after menopause

2. Unusual Vaginal Discharge:

  • Watery, pink, or foul-smelling discharge

3. Pelvic Pain:

  • Pain in the pelvic region, which may occur independently of the menstrual cycle.
  • Pain during sexual intercourse (dyspareunia)

4. Other Possible Symptoms:

  • Pain during urination.
  • Frequent urination
  • Unexplained weight loss
  • Fatigue
  • Swelling in the legs

Types of Cervical Cancer

Cervical cancer primarily occurs in two main types, each arising from different cells in the cervix:

1. Squamous Cell Carcinoma

  • Origin: This type of cervical cancer originates in the squamous cells, which are the flat, thin cells lining the outer part of the cervix (the ectocervix).
  • Prevalence: It is the most common type of cervical cancer, accounting for about 70-90% of all cases.
  • Characteristics: Squamous cell carcinoma typically develops in the area where the outer part of the cervix meets the inner cervical canal, known as the transformation zone.

 

2. Adenocarcinoma

  • Origin: Adenocarcinoma arises from the glandular cells that line the cervical canal (the endocervix).
  • Prevalence: This type of cervical cancer is less common, making up about 10-20% of cases.
  • Characteristics: Adenocarcinoma tends to occur higher up in the cervical canal, making it more challenging to detect through routine Pap smears compared to squamous cell carcinoma.

Causes & Risks of Cervical Cancer

Cervical cancer is primarily caused by persistent infection with high-risk types of human papillomavirus (HPV). However, several factors can increase the risk of developing this cancer. Here’s a detailed look at the causes and risk factors:

Causes

Human Papillomavirus (HPV) Infection:

  • HPV: The most significant cause of cervical cancer is infection with HPV, a group of more than 200 related viruses. About 14 types of HPV are considered high-risk because they can lead to cervical cancer. The two most common high-risk types are HPV 16 and HPV 18.
  • Transmission: HPV is transmitted through intimate skin-to-skin contact, most commonly through sexual intercourse.
  •  

Risk Factors

  1. Multiple Sexual Partners:

    • Having multiple sexual partners increases the likelihood of HPV infection, which raises the risk of cervical cancer.

  2. Early Sexual Activity:

    • Becoming sexually active at a young age increases the risk of HPV infection.

  3. Other Sexually Transmitted Infections (STIs):

    • Having other STIs, such as chlamydia, gonorrhea, syphilis, or HIV/AIDS, can increase susceptibility to HPV infection.

  4. Weakened Immune System:

    • Individuals with weakened immune systems, such as those with HIV/AIDS or those taking immunosuppressive medications, are at higher risk because their bodies are less able to fight off infections, including HPV.

  5. Smoking:

    • Tobacco use is linked to squamous cell cervical cancer. Smoking exposes the body to cancer-causing chemicals that can affect the cervix and weaken the immune system’s ability to fight HPV infections.

  6. Long-term Use of Oral Contraceptives:

    • Prolonged use of birth control pills (five or more years) has been associated with a slightly increased risk of cervical cancer.

  7. Multiple Full-Term Pregnancies:

    • Women who have had three or more full-term pregnancies have a higher risk of developing cervical cancer.

 

Preventions of Cervical Cancer

  1. HPV Vaccination: Vaccines like Gardasil and Cervarix protect against the most common cancer-causing types of HPV. Vaccination is recommended for preteens (boys and girls) and can be given up to age 45.

  2. Regular Screening: Pap smears and HPV testing can detect precancerous changes in the cervix early, allowing for treatment before cancer develops.

  3. Safe Sexual Practices: Using condoms and limiting the number of sexual partners can reduce the risk of HPV infection.

  4. Avoiding Smoking: Not smoking reduces the risk of cervical and other cancers.

Understanding these causes and risk factors can help in taking preventive measures to reduce the likelihood of developing cervical cancer.

Treatments for Cervical Cancer

Treatment for cervical cancer depends on several factors, including the stage of the cancer, the size and shape of the tumor, the patient’s age and overall health, and whether the patient wishes to have children in the future. Here are the main treatment options:

1. Surgery: Surgical treatment is often used for early-stage cervical cancer and can include several types:

  • Conization: Removes a cone-shaped piece of tissue from the cervix.

  • Hysterectomy: Removal of the cervix and uterus.

  • Trachelectomy: Removal of the cervix and upper part of the vagina while preserving the uterus during the early-stage cancer who wish to maintain fertility.

  • Pelvic Exenteration: Extensive surgery that removes the cervix, uterus, vagina, and surrounding organs like the bladder or rectum.

2. Radiation Therapy: Radiation therapy uses high-energy rays to kill cancer cells. It can be used alone or in combination with surgery and/or chemotherapy.

3. Chemotherapy

Chemotherapy uses drugs to kill cancer cells or stop them from growing. It is typically used for advanced cervical cancer.

4. Targeted Therapy

Targeted therapy uses drugs or other substances to precisely identify and attack cancer cells, usually while doing little damage to normal cells.

5. Clinical Trials

Participation in clinical trials can provide access to new and innovative treatments that are not yet widely available.

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