Cervical cancer

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 29, 2016
StartDiseasesCervical cancer

Cancer is caused by uncontrolled or abnormal cell growth. When this occurs in the cervix it is called cervical cancer. Though usually treatable upon early diagnosis, the American Cancer Society estimates that about 4,100 women have died from cervical cancer in 2015 in America.

Contents

Definition & Facts

Cervical cancers results from abnormal rapid replication of the cervical cells. This results in formation of a tumor within the cervix. Cervical cancer is one of the most common of all cancers in women. It also has the highest survival rates of patients diagnosed, and is the most treatable of all cancers depending on the stage of cancer at which it was diagnosed. Early diagnosis enables effective treatment.

Cervical cancer is more prevalent in developing countries where cervical cancer screening is not a common medical practice. This cancer is common among women between the ages of 30 to 65 years.

Symptoms & Complaints

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SecurePHP: Permission error <html></div></html> During the early stages of cervical cancer, notable symptoms include heavy vaginal bleeding after sex, bleeding in between periods, or postmenopausal bleeding, pelvic pain, painful intercourse, and abnormal heavy vaginal discharges. Frequent urination is another symptom as is painful urination.

During the advanced stages of cancer, drastic changes in the body cause a combination of symptoms. These include aching back, fatigue, swelling on the lower section of the legs, loss of appetite and unintentional weight loss. Additionally, bleeding after a uterine exam is a common symptom.

Causes

Cervical cancer is caused by the human papilloma virus (HPV). The virus occurs in many strains and not all of them cause cancer. Some cause warts while others cause no harm. The strains 16 and 18 of the virus are known to cause irregular cell growth in the uterus and account for about 70% of all cervical cancer cases. The virus is passed during sexual contact.

Another risk factor is using oral contraceptives. Other risk factors include smoking, having multiple sex partners and early sex. People with HIV have a higher risk of contracting cervical cancer than healthy individuals.

Diagnosis & Tests

The diagnosis of cervical cancer depends on its stage of development. The first step is to check the condition of the cervical cells by a procedure called the Pap test or Pap smear. During this exam, the doctor inserts a speculum into the vagina and scrapes a sample of the cervical tissue, which is then checked for abnormalities. Upon confirmation of cancerous growth, further screening will be done to predict the stage of the cancer. This is done by imaging using either CT scan, MRI or ultrasound. Detailed screening can also include performing a biopsy on the cervix.

There are various types of cervical cancer that can be found, depending on the section of the cervix the cancer has attacked. The most common type is squamous-cell carcinoma. Other types of cervical cancer include adenocarcinoma and adenosquamous carcinoma. Upon complete examination the doctor can stage the cancer based on the chart by International Federation of Gynecologists and Obstetrics. This chart gives eight stages of the development of cervical cancer based on visual examination.

Treatment & Therapy

Cervical cancer is treated with chemotherapy, radiotherapy, and surgery which are used depending on the stage of the cancer and the woman's desire to have children. For stage 0 or 'pre-cancer,' cryotherapy and laser therapy can be employed. For stage 1 cancers, trachelectomy may be recommended which removes the cervix and upper section of the vagina but may not cause infertility. Cone biopsy is also curative for the two first stages of cancer development and may preserve fertility.

For stage 1 cancers in which the woman may not want to have children or in which the cancer has spread to the lymph nodes, hysterectomy may be performed, which removes the uterus. The lymph nodes may also need to be removed. For the advanced stages a combination of chemotherapy and radiotherapy are employed to try and mitigate the cancerous tissue growth.

Prevention & Prophylaxis

One of the simple methods of helping to control and prevent cervical cancer is to ensure that women get regular Pap tests. This ensures that the cancer does not develop to critical stages and is diagnosed as early as possible. The administration of the HPV vaccines to adolescent girls of ages 12 to 20 years may also help to combat future incidences of the disease as these vaccines have shown a risk reduction by up to 93%. Practicing safe sex such as using condoms helps to prevent transmission of HPV: the major cause of this cancer. Eating healthy and regular exercise are also ways to reduce the risk of cancer.