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CERVICAL CANCER

Cervical cancer is a type of cancer that occurs in the cells of the cervix (the entrance to the womb from the vagina). It usually affects sexually active women aged between 30 and 45.

Most cases of cervical cancer are caused by different strains of the HPV (human papillomavirus). HPV is a sexually transmitted infection  that can be passed on through any type of sexual contact with a man or a woman.

There are more than 100 types of HPV, many of which are harmless. When someone’s body is exposed to HPV, the body’s immune system typically prevents the virus from doing harm and may lay dormant and even disappear after a while. But some types can survive for years causing abnormal changes to the cells of the cervix, which can eventually lead to cervical cancer.

Two strains, HPV 16 and HPV 18, are known to be responsible for most cases of cervical cancer.

You can reduce your risk of developing cervical cancer by having a smear test and receiving the HPV  vaccine.

The transformation zone is the area where cells are most likely to turn cancerous and this is the area that is tested during a  pap smear.

Types of Cervical cancer

Knowing the type of cervical cancer one has will determine the treatment to use.

Squamous cell carcinoma

This type starts from the squamous cells (flat, skin cells ) that line the ectocervix. The Ectocervix is the outer part of the cervix leading down into the vagina. The majority of cervical cancers fall into this category.

Adenocarcinoma

This type starts from the glandular cells (column shaped cells ) that line the endocervix, which leads up to the womb. This is the second most common type of cervical cancer.

Adenosquamous carcinoma

This type of cancer have both squamous and glandular cancer cells.

Symptoms of cervical cancer:

Cervical cancer may not present cancer in the early stages. However, more advanced forms may present the following symptoms:

  • Watery, bloody vaginal discharge that may be heavy and have a foul odor
  • abnormal vaginal bleeding, ( can occur during or after sex, in between periods, or new bleeding after menopause)- This is the most common symptom of cervical cancer and is mostly a red flag when you are bleeding other than during your period,
  • Pelvic pain 

Risk factors/causes of Cervical cancer

 

  • HPV:

This is the leading cause of most cervical cancers. HPV is  a sexual transmitted infection which is quite common and clears off the immune system on its own within 2 years for some people. However, some people’s immune system are unable to fight off the infection and some strains may lead to cervical cancer. The two types of HPV strains most known to cause cervical cancer are HPV 16 and 18.

  • Sex

Having sex at an early age and having  more sexual partners will increase your risk of having HPV which can lead to cervical cancer.

  • Smoking

Smoking can increase your risk of cervical cancer and is linked to squamous cells cervical cancer.

  • Weakened immune system

 If your immune system is weakened as a result of another health condition and you have HPV, then you are at greater risk of developing Cervical cancer

Diagnosis

Cervical cancer screening

This procedure helps detect precancerous changes to the cervix before they develop into cancer. They include:

Smear/Pap test:

During a smear test, the physician scrapes cells from the cervix which is then examined under a microscope in a lab to check abnormal cell changes.

HPV DNA test:

This involves testing cervical cells for any type of HPV infection that is likely to lead to cervical cancer.

If cervical cancer is  suspected, the doctor will use a colposcope to check for abnormal looking cells. During this procedure , the doctor can take a sample of cervical cells using a punch biopsy, which involves using a tool to pinch off some cells for testing or Endocervical curettage, which involves using a curet to scrape a sample from the cervix.

Another diagnostic tool is using the Electrical wire loop which uses low voltage electricity to get a small tissue sample.

Cone biopsy is another one done under general anesthesia , which allows your doctor to get deeper layers of cells from your cervix.

Imaging tests is then used to check if the cancer has spread into surrounding tissues and organs. They include CT, MRI and PET scans.

Staging

Stage 1

The cancer cells are still contained to the neck of the womb. It can be divided into 2 stages. Stage 1A (which means the growth is between less than 3mm and 5mm). Stage 1B means its still confined to the cervix but is between 5mm and  just over 4 cm.

Stage 2

The cancer cells have now spread into the upper part of the vagina or nearby tissues.

It can also be divided into stage 2A  which means the cancer which has now spread into the vagina is smaller than 4cm (stage 2A1) or larger than 4cm (stage 2A2) . Stage 2B means the cancer has spread into surrounding tissues.

Stage 3

The cancer has spread into the lymph nodes, pelvis or nearby organs like the abdomen. Stage 3A  means it has spread into the lower part of the vagina only. Stage 3B means it has spread into the pelvic wall and ureters. Stage 3C means the cancer has spread into the pelvis and the nodes in the abdomen.

Stage 4

This is when the cancer has spread into nearby organs like the bladder or colon (Stage 4A) and then moved further into the lungs, liver or bone(Stage 4B) which is then called metastatic cancer.

Treatment

Surgery

This is mostly used for cervical cancer caught in the early stages. It involves removing most of the cervix or the entire cervix and the womb depending on the extent of the tumor. Surgery may also involve removing most of the pelvic lymph nodes.

Chemotherapy

This procedure involves using cytotoxic drugs to destroy the cancer cells. It is normally used when the cancer has spread to other parts of the body. It can be used in combination with radiotherapy to target early stage or advanced cancer

Radiotherapy

This involves using high-energy rays such as x-rays or proton to destroy early stage cancer or advanced cancer.

Immunotherapy

This is a drug that helps the immune system to fight cancer when your immune system is unable to fight off the cancer cells on its own.

REFERENCES

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