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The cervix is the area between the vagina and the uterus. Cervical cancer begins when the healthy cells on the surface of the cervix change and grow out of control, forming a tumour. The changes in the cells at the initial stage are not cancerous, but upon progress, they may become cancerous. It can be life-threatening if it goes undetected or untreated.
Risk Factors of Cervical Cancer
Often risk factors influence the development of cancer, but most of them do not directly cause cancer. The following factors may develop the risk of cervical cancer:
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Human papillomavirus (HPV) infection
HPV infection is the most common risk factor for cervical cancer. Sexual activity with a person who has HPV is the most common route for the transfer of HPV infection.
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Pregnancy
Women who have had a first full-term pregnancy at the age of 17 or who have had three full-term pregnancies are at risk for cervical cancer.
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Family history
Women with a sister or a mother who have had cervical cancer are two or three times more likely to develop cervical cancer.
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Sexual history
People who had sex before the age of 18, sex with multiple partners, and with someone who has had multiple partners may be at risk of getting cervical cancer.
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Weakened immune system
Women with a weak immune system have a higher risk of developing cervical cancer. People with HIV or who take medications that limit the body’s ability to fight off the infection are also at a higher risk of developing cervical cancer.
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Diethylstilbestrol (DES)
If this drug is given to the woman to prevent miscarriage then she is at risk of developing cervical cancer
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Smoking
Women who smoke are at increased risk of developing cervical cancer.
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Age
Girls younger than 15 years are less prone to cervical cancer. The risk is higher among teens and women who are in their mid-30s. Women over 40 are at highest risk and need to go for regular screenings.
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Race/Ethnicity
Cervical cancer is common among black and Hispanic women.
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Oral contraceptives
Women who have taken contraceptives for five years or more have an increased chance of getting cervical cancer.
Consult with our team of oncologists to get the finest treatment.
Signs and symptoms of Cervical Cancer
There are no specific symptoms during the early stages of cervical cancer. In the advanced stage of the disease, the symptoms may be as follows:
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Pelvic pain
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Painful urination
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Longer or heavier menstrual periods than usual.
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Pain during sexual (vaginal) intercourse.
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Abnormal vaginal bleeding
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Vaginal bleeding after sex
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Vaginal bleeding after menopause.
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Bleeding or spotting between periods.
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Other abnormal discharge
You may also experience weight loss and fatigue. As the disease progresses, there is also a risk of bone fractures. These symptoms may not be specific to cervical cancer, and they can be caused by a variety of conditions related to the disease.
Diagnosis of Cancer
There are several tests to diagnose cancer, but biopsy is the more reliable test to confirm the diagnosis. The following tests may be used to diagnose cervical cancer.
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Pap test
It is used to identify the early stages of cancer.
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Pelvic examination
It is used to identify unusual changes in the woman’s uterus, vagina, ovaries, fallopian tubes, cervix, bladder, and the rectum.
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HPV typing
It is similar to the Pap test. It identifies the HPV -16 and HPV-18 strains in the cervix.
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Colposcopy
This test is used to check the cervix for abnormal areas. The test is not painful and does not have any side effects. It can also be done for pregnant women.
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Biopsy
It can make a definite diagnosis. There are several types of biopsies.
Loop electrosurgical excision procedure (LEEP) is used to identify and remove the precancers at an early stage of cancer.
Conization may be done as a treatment to remove precancers or early-stage cancer.
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X-ray
It is a method to create a picture of the structures inside of the body using a small amount of radiation. An intravenous urography is a type of X-ray used to view the bladder and kidneys.
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Computed Tomography (CT) scan
CT scan is used for identifying tumours. It also measures the size of the tumours.
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Magnetic resonance imaging (MRI) scan
This test is used to measure the size of the tumour.
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Positron emission tomography (PET) scan
A PET scan combined with a CT scan is used to identify primary cancer. It is also used to identify the spread of cancer to other tissues or metastasis in the body.
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Cystoscopy
It is used to determine whether cancer has spread to the bladder.
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Proctoscopy
It is used to see if cancer has spread to the rectum.
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Laparoscopy
It is used to identify whether cancer has spread to the abdominal area.
Stages of Cancer
The stage of cancer refers to the extent to which cancer has spread. It is staged using the TNM system.
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Tumour (T) describes the original size of the tumour.
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Lymph Node (N) indicates whether the cancer is present in the lymph nodes.
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Metastasis (M) refers to whether cancer has spread to the other parts of the body mainly the liver, bones or brain.
Once the T, N, and M scores are determined then, the overall cervical cancer stage is assigned.
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Stage 0
In stage 0, cancer is confined to the surface of the cervix. This stage is also called carcinoma in situ (CIS) or cervical intraepithelial neoplasia (CIN) grade III (CIN III).
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Stage I
In stage I, cancer has grown deeper in the cervix. This stage is further subcategorized into two:
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Stage IA
Cancer has spread less than 5mm deep and 7mm wide in the cervix which can be measured only under a microscope.
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Stage IB
Cancer measures about 4cm or less across, more than 5mm deep and 7mm wide.
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Stage II
In this stage, cancer has grown beyond the cervix and uterus, but not to the walls of the pelvis or vagina. This stage is subcategorized into two:
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Stage IIA
Cancer has not spread to the tissues next to the cervix, but has grown to the upper part of the vagina.
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Stage IIB
Cancer has spread into the tissue next to the cervix and the parametria.
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Stage III
In this stage, cancer has spread to the vagina (lower part) or the walls of the pelvis, but not to the nearby lymph nodes or the other parts of the body. It is divided into two categories:
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Stage IIIA
Cancer has spread to the vagina (lower third), but not to the pelvic walls.
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Stage IIIB
Cancer has grown into the walls of the pelvis and/or has blocked both the ureters, but has not spread to the lymph nodes or distant sites.
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Stage IV
In this stage, the disease has spread to the nearby organs or the other parts of the body. It is separated into two categories:
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Stage IVA
Cancer has spread to the bladder or rectum, but not to the lymph nodes.
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Stage IVB
Cancer has spread to the organs beyond the pelvis, such as the lungs or liver.
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Recurrent cervical cancer
This is cancer that has come back after treatment. If there is no occurrence of cancer, then there will be another round of tests to learn about the extent of the recurrence.
Treatment Procedure
The treatment for cervical cancer depends on many factors including the stage of cancer when it is diagnosed. The common methods of treatment for cervical cancer are surgery, radiation therapy, chemotherapy, and targeted therapy.
Surgery of Cancer
Surgery is often performed to remove cancer, especially in the early stages of cancer. A hysterectomy may be performed. Cone biopsy and a trachelectomy are the options that can be used for small tumours in younger women to preserve fertility. The pelvic exenteration removes the uterus, surrounding the lymph nodes, and the parts of the other organs surrounding cancer.
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Radiation Therapy
It is another treatment for cervical cancer. In this, both the external beam radiation therapy and brachytherapy can be used. It is given as the main treatment for cancer and is often combined with chemotherapy.
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Chemotherapy
It may be recommended together with radiation therapy for some stages of cancer. The commonly used chemotherapy drugs are cisplatin and 5-fluorouracil. Chemotherapy is the treatment of choice for recurrent cancer.
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Targeted therapy
It refers to drugs that have been specifically developed or targeted to interrupt the processes that promote the growth of the cells. Bevacizumab (Avastin) is used in targeted therapy.
Preventive Measures
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Vaccination for girls aged between 9 and 26.
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Maintaining one sexual partner
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Quitting smoking
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Practising safe sex
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Undergoing Pap test at least once a year.
Cervical cancer is one of the most successfully treatable cancer types, so early detection and early treatment would save lives. Therefore, it’s important to learn more about cervical cancer as it would help lower your risk of developing it. Book an appointment now to get the best treatment at the top cancer care hospital in Bangalore.
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