Cervical Cancer


Cervical cancer is one of the most common cancers in women worldwide. It is an abnormal excessive uncontrolled growth of the cells of the cervix which usually begins as a precancerous condition called dysplasia. Dysplasia is easily detected in a routine Pap smear and is completely treatable. More commonly seen in the younger women population. The most common cause of cervical cancer is known to be the human papillomavirus. Other viruses like cytomegalovirus and herpes simplex virus are also known to play a role.

Women who have a weakened immune system, a smoking history, women with multiple sexual partners, and who have given birth to a child at a young age are more prone to develop cervical cancer. Cervical cancer progresses slowly over time from being confined to the cervix to spreading into the other organs of the body.

Routine screening in women is required to diagnose the condition at the precancerous or early stage of cancer. Pap smearing is done to screen for human papillomavirus. imaging techniques are required to look for the amount of spread of cancer. Diagnosis should be done early for effective treatment. Cervical cancer is treated mainly by surgical removal, chemotherapy, and radiotherapy.

Cervical Cancer: Causes

Human papillomavirus (HPV), a sexually transmitted virus, is the main cause of cervical cancer.

Some of the other factors that may raise the risk of acquiring cervical cancer include −

  • Compromised immune system

  • Long-term use of oral contraceptives

  • Sexual activity at the young age

  • Having multiple sexual partners

  • Not routinely screening for cervical cancer (Pap test)

  • Smoking

  • History of having sexually transmitted infections (STIs)

  • Having cervical cancer in the family

  • Inadequate access to healthcare and low socioeconomic level.

Cervical Cancer: Symptoms

Patients with cervical cancer mainly come with symptoms of −

  • Abnormal vaginal bleeding, such as during or after menstruation, during or after intercourse, or following menopause

  • Unusual vaginal discharge that could be red, smelly, or watery Pelvic discomfort or agony

  • Urinary symptoms including the need to urinate frequently or pain while doing so

  • Bleeding in the rectal region or discomfort

  • Sexual discomfort, pain during the intercourse

  • In the later phases of the illness, there is weight loss and exhaustion

Cervical Cancer: Risk Factors

The important risk factors for the development of cervical cancer include −

  • Infection with the human papillomavirus (HPV HPV is a sexually transmitted infection that alters cervix cells and possibly causes cancer.

  • Multiple full-term pregnancies  Women who have had multiple full-term pregnancies may be at increased risk of cervical cancer.

  • Age  Cervical cancer is most common in women over the age of 30

  • Immune system weakness  A compromised immune system may make it more difficult for the body to fight off infections like HPV and others that might cause cervical cancer.

  • Smoking  Smoking can harm cervical cells' DNA and raise their risk of developing cancer.

  • History of STIs  A history of STIs, particularly Chlamydia and Gonorrhea, can raise your chance of developing cervical cancer.

  • Family history  Women who have had cervical cancer in their families may be at higher risk.

  • Long-term hormonal birth control use (five years or more) has been linked to an increased risk of cervical cancer.

Cervical Cancer: Diagnosis

Diagnosis of cervical cancer is mainly done by history, clinical examination, and laboratory investigations. Some of the important tests required include −

  • Examination of the Pelvis  The cervix and its surrounding tissues should be examined to look for any anomalies or risk factors causing cancer

  • Pap smear test  In this procedure, a sample of cervix cells is taken and examined under a microscope to look for any abnormal alterations that might point to cancer. Mainly it is done to screen the human papillomavirus

  • HPV test  The test is done to check the presence of the human papillomavirus (HPV), which is the most common cause of cervical cancer.

  • Biopsy  It is a confirmatory test done an abnormality is discovered during the pelvic examination or Pap test.

  • Imaging techniques  To assess the extent of cancer and the amount of its spread, imaging procedures including X-rays, CT scans, and MRI should be done

Cervical Cancer: Treatment

The treatment will be effective when treated in the early stages or precancerous stages. The treatment is given depending on the amount of cancer present and its spread. Various treatments available are −

  • Surgery  Surgery involves removing a portion of tissue in the shape of a cone from the cervix, which can be used to treat early-stage cervical cancer. A radical hysterectomy, which entails the removal of the cervix, uterus, and surrounding tissues, may be required if cancer has spread.

  • Radiotherapy  High-energy X-rays or other forms of radiation are used in radiation treatment to kill cancer cells. This can be used singly or in conjunction with chemotherapy or surgery. While brachytherapy places radioactive sources inside the body near the malignancy, external beam radiation therapy provides radiation from outside the body.

  • Chemotherapy  Chemotherapy uses medications to destroy cancer cells. It can be used singly or in conjunction with other therapies, such as radiation therapy. Chemotherapy can be given orally or intravenously.

  • Combination therapy  To treat cervical cancer, several different therapies, including radiation therapy and chemotherapy, may be required. This can be used to reduce the tumor before surgery or to eliminate any cancer cells that may still be present after surgery.

  • Palliative care  It is a type of medical treatment that aims to give patients with advanced cancer a higher quality of life. The use of painkillers, symptomatic treatment, and emotional and psychological support are all part of it.

Cervical Cancer: Prevention

Some of the measures that can help to reduce the risk of cervical cancer which include −

  • Taking the HPV vaccination reduces the risk as it is the main cause of cervical cancer.

  • Regular screening for the early detection of cervical cancer, should be carried out. women between 30 and to 65yrs of age should be screened

  • Safe sexual practices: Condom use during sexual activity can assist in lowering the risk of HPV and other STDs that can result in cervical cancer.

  • Avoid smoking as smoking also increases the risk

  • A healthy lifestyle with a balanced diet, regular exercise, and maintaining a healthy weight, can help to reduce the risk of developing cervical cancer.

Conclusion

Cervical cancer is one of the most common cancers affecting women. It arises from the cervical cells which follow the precancerous lesion called cervical dysplasia. It mainly affects women of the young age group. Women affected usually present with discharge, pain during sexual intercourse, and abnormal bleeding. Cervical cancer in later stages is difficult to treat and cannot be completely treated, therefore should be diagnosed and treated in the early stages.

Screening is very important to detect cervical cancer in the early stages. Pap smear and HPV test are done to screen for cancer. The biopsy is used to confirm the diagnosis and imaging techniques are required to look for the amount of the spread of the tumor. Cervical cancer in its early stages can be treated by surgical removal, Radiotherapy and chemotherapy can be used as the sole treatment or in conjunction with surgical removal when the cancer is more spread.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha

MBBS MS [ OPHTHALMOLOGY ]

Updated on: 14-Jul-2023

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