(Cancer of the Cervix)
Cervical cancer – Definition
Cervical cancer is a disease in which cancer cells grow in the cervix. The cervix is the lower, narrow part of the uterus (womb) that connects the uterus with the vagina.
Cancer occurs when cells in the body (in this case, epithelial cervix cells lining the cervical canal) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissue and spread to other parts of the body. A benign tumor does not invade or spread.
Cervical cancer – Causes
Research suggests that some sexually transmitted viruses (eg, human papilloma virus) can cause the nuclei in cervical cells to begin the changes that can lead to cancer.
Cervical cancer – Risk Factors
Scientists believe several risk factors act together. These include:
- Infection of the cervix with the human papillomavirus (HPV) — the primary risk factor for cervical cancer
- History of cervical dysplasia (a precancerous condition)
- Being a woman whose mother took the drug diethylstilbestrol (DES) during pregnancy
- Age: over 25 years old
- Multiple sexual partners
- Sexual activity prior to age 18
- First pregnancy prior to age 20
Cervical cancer – Symptoms
Symptoms usually do not appear until the abnormal cells become cancerous. They invade nearby tissue. When this happens, the most common symptom is abnormal bleeding, which may include:
- Bleeding between regular menstrual periods
- Bleeding after sexual intercourse, douching, or a pelvic exam (most common)
- Menstrual bleeding that lasts longer and is heavier than usual
- Vaginal bleeding after menopause
- Increased vaginal discharge that is not blood
These symptoms may also be caused by other, less serious health conditions. If you experience these symptoms, see you doctor.
Cervical cancer – Screening
The Pap test is used to screen for cervical cancer. It is also used to detect cervical dysplasia. The doctor collects a sample of cells from the cervix to be tested. The doctor can also screen you for HPV by testing the sample of cells.
If you are a healthy woman, many professional health organizations offer these recommendations for screening:
- If you are aged 21-29 years — It is recommended that you have the Pap test every three years.
- If you are aged 30-65 — It is recommended that you have the Pap test and the HPV test every five years. (Or, you can continue to have just the Pap test every three years.)
- If you are aged 65 or older — You may be able to stop having Pap and HPV tests if you have had normal results (eg, three normal results in a row and no abnormal results in the past 10 years).
Note: You will need to have Pap tests done more often if you have abnormal results or certain conditions, like a suppressed immune system or a history of cervical dysplasia or cervical cancer. Talk to your doctor about the right screening schedule for you.
Cervical cancer – Diagnosis
Tests to diagnose cervical cancer include:
- Colposcopy — This is an exam of the vagina and cervix. The procedure uses a lighted magnifying instrument. It is needed if the Pap test suggests the presence of cervical dysplasia (precancer) or cancer.
- Biopsy — This is done on any suspicious areas observed during the colposcopy. The removed tissue is tested for the presence of cancer cells.
Cervical cancer – Treatment
Once cervical cancer is found, further tests are performed to find out if the cancer has spread beyond the cervix, and, if so, to what extent. This process is called staging. Treatment depends on the stage of the cancer.
Cervical cancer – Surgery
The cancerous tumor, nearby tissue, and possibly nearby lymph nodes may be removed. The doctor may remove only the tumor and surrounding normal tissue if the tumor is very localized within the cervix. In some cases, a hysterectomy is necessary.
If the cancer is at a high stage, more tissue must be removed. Sometimes the ovaries and fallopian tubes also are removed.
Cervical cancer – Radiation Therapy (Radiotherapy)
Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. Radiation may be given in two ways:
- External radiation therapy — radiation directed at the tumor from a source outside the body
- Internal radiation therapy — radioactive materials placed in or near the cancer cells
Cervical cancer – Chemotherapy
Chemotherapy is the use of toxic drugs to kill cancer cells. It may be given in many forms including: pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body. It kills mostly cancer cells, but also some healthy cells. Chemotherapy alone rarely cures cervical cancer. It may be used in addition to surgery and/or radiation.
This therapy may also be used to help control pain and bleeding when a cure is no longer possible.
Chemotherapy is usually combined with radiation therapy.
If you are diagnosed with cervical cancer, follow your doctor’s instructions.
Cervical cancer – Prevention
Finding and treating precancerous tissue in the cervix is the most effective way to prevent cervical cancer. Talk to your doctor about when you should have pelvic exams and Pap tests done. Another effective approach is to reduce your risk of exposure to the HPV virus. There are currently two methods to accomplish this:
- Safe sexual practice — Limit the number of sexual partners and use latex condoms.
- HPV vaccines — The vaccines protect you against some types of HPV. One vaccine, called Gardasil, is used to prevent cervical cancer by protecting against four types of HPV. Another vaccine, called Cervarix, is also approved for prevention by protecting against two HPV types. The vaccines are routinely given to girls aged 11-12 years old, and a “catch-up” vaccine is given to young women who haven’t been vaccinated.