Cervical cancer is a growth of cells that starts in the cervix. The cervix is the lower, narrow end of the uterus (womb). The cervix connects the uterus to the vagina (birth canal). Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes known as dysplasia, in which abnormal cells begin to appear in the cervical tissue. Over time, if not destroyed or removed, the abnormal cells may become cancer cells and start to grow and spread more deeply into the cervix and to surrounding areas.
What causes cervical cancer?
Almost all cervical cancer cases (99%) are linked to infection with high-risk human papillomaviruses (HPV), an extremely common virus transmitted through sexual contact.
About 14,000 people in the United States receive a cervical cancer diagnosis each year. Women between the ages of 35 and 44 are most likely to receive a diagnosis.
Early stages of cervical cancer don’t usually involve symptoms and are hard to detect. The first signs of cervical cancer may take time to develop. Signs and symptoms of Stage I cervical cancer can include:
Watery or bloody vaginal discharge that may be heavy and can have a foul odour.
Vaginal bleeding after sex, between menstrual periods or after menopause.
Pain during sex (dyspareunia).
If cancer has spread to nearby tissues or organs, symptoms may include:
Difficult or painful urination, sometimes with blood in your urine.
Diarrhoea, pain or bleeding from your rectum when passing stools.
Fatigue, loss of weight and appetite.
A general feeling of illness.
Dull backache or swelling in your legs.
Pelvic/abdominal pain.
If you experience abnormal bleeding, unusual vaginal discharge or any other unexplainable symptoms, you should contact a healthcare provider.
Who is at risk of getting cervical cancer?
In some there may be no identifiable risk, whereas in others the following may predispose a person to get cervical cancer:
People who haven’t had Pap tests at regular intervals are more likely to get cervical cancer (because Pap tests can detect precancerous cells).
Certain types of HPV cause cervical cancer. Lowering your risk for HPV (by vaccination) can also lower your risk for cervical cancer.
Having sexual intercourse before the age of 18 and having many sexual partners may put you at higher risk of HPV infection.
Smoking cigarettes increases your risk of cervical cancer.
People with HIV have a higher-than-average risk of developing cervical cancer.
Having a weak immune system makes your body unable to fight infections.
There are some risk factors you can’t change or control. These are:
DES is a medication that was given to people between 1938 and 1971 to prevent miscarriage. If your mother took DES, you may be more likely to get cervical cancer.
Cervical cancer may have a genetic component.
What are the complications of cervical cancer?
Pain, when it spreads
Cervical cancer can cause urinary problems like difficulty peeing. It can also cause constipation.
Kidney failure is a complication of advanced cervical cancer.
You may experience bleeding from your vagina, rectum or bladder if cancer spreads to those organs.
Depending on the treatment you have, you could lose the ability to get pregnant. Surgery on your cervix to remove cancer cells could also increase your chance of miscarriage with future pregnancies.
Mayo clinic lists Pap smear and HPV DNA tests involve scraping cells from the cervix to detect cancerous growth. In some cases, a tissue sample might be needed to be pinched to send for lab testing. This test maybe in the form of “pinch or cone biopsy”, or “curettage”, or “loop electrosurgical excision procedure”. Tests might include X-ray, MRI, CT and positron emission tomography (PET) scan to determine the location and size. (https://www.mayoclinic.org/diseases-conditions/cervical-cancer/diagnosis-treatment/drc-20352506)
What are the stages of cervical cancer?
Cleveland clinic lists 4 main stages of cervical cancer:
Cancer is found only in the neck of your cervix. It hasn’t spread to the deeper parts of your cervical tissue.
Cancer has spread beyond your cervix and uterus but hasn’t yet spread to your pelvic wall (the tissues that line your pelvis) or your lower vagina.
Cancer has spread to the lower part of your vagina and may have spread to your pelvic wall, ureters (tubes that carry pee from your kidneys to your bladder) and nearby lymph nodes.
SURGERY: Localised cancers are typically excised surgically leaving a scope for future pregnancy unlike radical trachelectomy, in which the entire cervix and some surrounding tissues are removed. For a more widespread cancer, a radical hysterectomy which involves removing the cervix, uterus, part of the vagina and nearby lymph nodes.
RADIATION THERAPY: Radiation therapy uses powerful energy beams to kill cancer cells. The energy can come from X-rays, protons or other sources. Radiation therapy is often combined with chemotherapy as the primary treatment for cervical cancers that have grown beyond the cervix. It also can be used after surgery if there's an increased risk that the cancer will come back. Radiation therapy can be given externally, internally or both ways.
CHEMOTHERAPY: Chemotherapy uses strong medicines to kill cancer cells. For cervical cancer that has spread beyond the cervix, low doses of chemotherapy are often combined with radiation therapy to enhance the effect of radiation.
TARGETED THERAPY: Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Targeted therapy is usually combined with chemotherapy. It might be an option for advanced cervical cancer.
IMMUNOTHERAPY: Immunotherapy is a treatment with medicine that helps the immune system cells find and kill the cancer cells.
