Cervical Cancer - Causes, Symptoms, Diagnosis & Prevention

Cervical Cancer

Dr.Purnima Nadkarni profile Authored by Dr.Purnima Nadkarni on 15 Apr 2014 - 14:10.

Cervical cancer affects the cervix (a part of female genital organ that connects the uterus and the vagina). It begins when sudden genetic changes occur in the normal cells of the cervix making them abnormal. These abnormal cells grow uncontrolled to form tumors that may spread to other parts by invading into it. It is important to detect the cervical cancer in its earliest stages so that it can be successfully controlled and treated. It has been recommended to get screened for cervical cancer, once you turn 21.

Types of cervical cancer

Based on the cell involved in the early genetic mutation (a sudden change in normal cells) cervical cancer is categorized into two main types:

  • Cancer of squamous cells: This type contributes to the majority of cervical cancer cases. It affects the squamous cells, that lines the outer part of lower uterus.
  • Adenocarcinomas: This kind of cervical cancer is rarely observed. It mainly affects the glandular cells that are present as a lining of the cervical canal.

Although the squamous cell carcinoma is majorly spotted and adenocarcinomas are rare, sometimes both types of cells contribute to cervical cancer. But the cancer of other cells of the cervix is very unusual.

The exact causes of cervical cancer are not clear, but it implies that many factors contribute to it. Most of the cases of cervical cancer are found to be caused by diverse range of strains of the Human Papilloma Virus (HPV), which is often transmitted through sexual activity.  Other factors which may contribute to the development or increase the risk of cervical cancer are:

  • Smoking: HPV infection and smoking habit can make you very prone to cervical cancer.
  • Multiple sex partners.
  • Initiating sexual activityat a young age.
  • Having any sexually transmitted disease like Chlamydia, AIDS (HIV-infection), gonorrhea, syphilis etc.
  • Weak immunity body may have less capability to fight against any infection.
  • Genetic environment and lifestyle choices.

The disease progresses very slowly and hence may not develop symptoms early; it frequently goes undiagnosed unless the Pap test is done [Pap test involves the scraping the suspected cells from the cervix (a lower region of the womb) and measuring it for the presence of cancerous cells]. With time, cervical cancer progresses to display its symptoms. In advanced stages of cervical cancer, following symptoms can be seen:

  • Abnormal bleeding after intercourse (although you are not in your periods).
  • Heavy vaginal discharge with foul and an unusual odor (discharge can be watery transparent or with blood).
  • Painful intercourse.
  • Heavy and longer menstrual periods.
  • Abnormal bleeding even after menopause.

Diagnosis of cervical cancer involves following tests and procedures:

  • Pap test:  To detect the presence of cancerouscells or abnormal cells in the cervix area.
     
  • Human Papilloma Virus (HPV) - DNA test: It is usually performed to detect infection with HPV, if you are 30 or older.

To confirm the diagnosis, your doctor may perform the following tests:

  • Colposcopy (cervix assessment): To detect abnormal cells in the cervix usingan instrument called colposcope.
     
  • Biopsy : To support the suspected cervical cancer, your physician may do a biopsy (scraping the cells from the affected area of the cervix and then assessing it under the microscope).
     
  • Cone biopsy : To obtain cells from deeper layers of thecervix using laser or electronic equipment for better analysis of the condition.

Once cervical cancer is determined, the doctor may advise several tests to determine the stage of your cervical cancer. Following tests may be performed to determine the stage of your cancer:

  • Imaging tests (X-rays, CTscans, MRI and positron emission tomography): To determine whether other parts of the body are affected.
     
  • Cystoscopy (bladder exam) and Proctoscopy (rectum exam): Visual examination of bladder and rectum using scopes.

Cervical cancer often progresses in various stages such as:

Stage I-During this stage, cancer is often restricted to the cervical area.

Stage II-Cancer has affected cervix and vagina, but not the lower vagina part.

Stage III-Cancer has spread to the lower part of the vagina.

Stage IV- Cancer has spread to the other organs including bladder,rectum, lungs or liver.

The idealistic approach towards the management of cervical cancer is frequently based on the rigor of the disease (stage), pregnancy and other underlying health conditions.Common treatment measures include surgical procedures, chemotherapy and radiation therapy. If needed, your doctor may choose a combination of treatments for best results.

Surgical procedures :

Hysterectomy:
 To remove the affected uterus in the very early stages of cervical cancer (when the invasion is < 3 millimeters (mm) into the cervix).

A radical hysterectomy: To remove the cervix along with nearby organs, includingthe uterus, affected part of the vagina and lymph nodes preferably in the advanced stage of cancer when the invasion is > 3 mm into the cervix.

Radiation Therapy:  To kill cancerous cells using radiation produced byplacing radioactive material in the cervix area.

Chemotherapy:  To kill cancer cells with the aid of drugs injected into a vein, which wipes out cancer cells.The dose of drugsdepends on the severity level of the cancer. Unfortunately, few drugs used to treat cervical cancer,may lead to infertility and unexpectedly early menopause.

Combination Therapy: If needed, radiation therapy and low doses of chemotherapy can be given as a combination, most often to shrink a tumor before surgery or to kill the remaining cancer cells, after a surgical procedure.

 

 

Preventive measures for cervical cancer are:

  • Early screening
  • Protective sex
  • Avoiding sexual activity in early years of life and with multiple sex partners
  • Quit smoking
  • Vaccination from the age of 13 to 45 HPV vaccine for prevention, 3 doses at 0, 1 and 6 months.
*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.