Cervical Cancer

What is Cervical Cancer?

Cervical cancer is cancer arising from the cervix. It is due to changes in the cells of the cervix which allow them to invade and spread to other parts of the body. 
The main types of cervical cancer are squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma begins in the thin, flat cells that line the cervix. Adenocarcinoma begins in cervical cells that make mucus and other fluids.

What is the Cervix?

The cervix is the lower, narrow end of the uterus also known as the 'neck of the womb'. The cervix leads from the uterus to the vagina. 

What causes Cervical Cancer?

Almost all cases of cervical cancer can be linked to long-term infection with certain types of human papillomavirus (HPV). Vaccines that protect against infection with these types of HPV can greatly reduce the risk of cervical cancer. Having a Pap smear to check for abnormal cells in the cervix or a test to check for HPV can find cells that may become cervical cancer. These cells can be treated before cancer forms. Cervical cancer can usually be cured if it is found and treated in the early stages.

Cervical Cancer Screening

Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage

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 cells that are not normal begin to appear in the cervical tissue
These changes occur more often in women who are in their 20s and 30s. Death from cervical cancer is rare in women younger than 30 years and in women of any age who have regular screenings with the Pap smear
The Pap smear is used to detect cancer and changes that may lead to cancer. (See more information on the Pap Smear here)

An HPV test may be done with or without a Pap smear to screen for cervical cancer. Screening women aged 30 and older with both the Pap test and the HPV test every 5 years finds more cervical changes that can lead to cancer than screening with the Pap smear alone. Screening with both the Pap smear and the HPV test lowers the number of cases of cervical cancer.

What are the signs of Cervical Cancer?

The early stage of cervical cancer is often free of symptoms. Some persons may report one or more of the following symptoms:

• Blood spots or light bleeding between or following periods
• Menstrual bleeding that is longer and heavier than usual
• Bleeding after intercourse, douching, or a pelvic examination
• Increased vaginal discharge
• Pain during sexual intercourse
• Bleeding after menopause
• Unexplained, persistent pelvic and/or back pain

How is Cervical Cancer Diagnosed?

Cervical cancer can be diagnosed by the doctor taking a careful history of the patient's risk factors and symptoms, doing a complete physical examination and performing a number of tests. 
Additionally, a pelvic examination will be done.  In this examination, the doctor feels a woman’s uterus, vagina, ovaries, cervix, bladder, and rectum to check for any unusual changes. A Pap test is often done at the same time. 

If the Pap test showed some abnormal cells and the HPV test is positive, then the doctor may suggest 1 or more of the following diagnostic tests:

• Colposcopy. The doctor may do a colposcopy to check the cervix for abnormal areas. Colposcopy can also be used to help guide a biopsy of the cervix. A special instrument called a colposcope is used. The colposcope magnifies the cells of the cervix and vagina, similar to a microscope. It gives the doctor a lighted, magnified view of the tissues of the vagina and the cervix. The colposcope is not inserted into the woman’s body and the examination is not painful. 
• Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. A pathologist then analyzes the sample(s). If the lesion is small, the doctor may remove all of it during the biopsy.

If the biopsy shows that cervical cancer is present, the doctor will refer the woman to a gynecologic oncologist, who specializes in treating this type of cancer. The specialist may suggest additional tests to see if the cancer has spread beyond the cervix

Cervical Cancer Staging

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body.Doctors use diagnostic tests to find out the cancer's stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer. For cervical cancer, the staging system developed by the International Federation of Obstetrics and Gynecology (Federation Internationale de Gynecologie et d'Obstetrique or FIGO) is used. (Click here for more details on the staging of cervical cancer)

How is Cervical Cancer treated?

In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. The treatment of cervical cancer depends on several factors, including the type and stage of cancer, possible side effects, and the woman’s preferences and overall health.

Treatment Options

Surgery -  the removal of the tumor and some surrounding healthy tissue during an operation.

Radiation therapy - the use of high-energy x-rays or other particles to destroy cancer cells.

Chemotherapy - the use of drugs to destroy cancer cells, usually by ending the cancer cells’ ability to grow and divide.

For more information, screening tests and treatment of Cervical Cancer, book your appointment to see a gynecologist today! 

References: Cancer.net/cervicalcancer