Medical

An Overview about Cervical Cancer

Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.

Author: Dr. Shruti

Cervical cancer is when the cells of the cervix grow abnormally. It is metastatic in nature. Cervix is a part of the female reproductive system. It is present in the lowest part of the womb that connects the uterus (also called the womb) to the vagina. Cervix is made of two parts namely endocervix which is lined by glandular cells and exocervix which is also known as ectocervix that is lined by squamous cells.

Cancer is defined as the abnormal growth of new cells that can even spread to other parts of the body. Metastasis is the spread of cells to other organs only. Cervical cancer can even spread to nearby organs such as the vagina or rectum to even far away organs such as the liver or lungs. 99% of the cases of cervical cancer are more or less linked to infections like Human Papilloma Virus (HPV) or Sexually Transmitted Infections that occur as the reason of multiple sexual partners.

Statistics

It has been ranked as the 4^th most common cancer. As per WHO, it has been estimated in 2018 that it has affected nearly 570000 women in the year 2k18 with mortality of 311000. The age group of 35 to 44 yrs is prone to cervical cancer.

Types of Cervical cancer

Cervical cancer has been classified into three types and is as follow-

Adenocarcinoma – This type of cancer develops from glandular cells which line the endocervix.
Squamous Cell Carcinoma – This develops from squamous cells which line the exocervix or ectocervix. This is the most common type of cervical cancer.
Mixed Carcinoma – This type is also called adenosquamous carcinoma. As the name says, it has features of both the other types of cervical cancers.

There are a few more types such as – Neuroendocrine tumor, Glassy cell carcinoma, and Small cell carcinoma.

Symptoms

Usually, the early stage of cancer doesn’t show any signs or symptoms. But on the other hand, this is the most treatable and curable cancer. The signs or symptoms are as follow-

Lower abdomen pain especially after intercourse.
Pain during any sexual activity.
Vaginal discharge with a foul odour.
Bleeding from the vagina after intercourse.
Abnormal bleeding and pain after menopause or in between menstrual cycles.
Pain or bleeding while urinating.
Weight loss.
Loss of appetite.
Fatigue.

If it got metastasized, it gives symptoms like-

Bone pain.
Kidney failure.
Cough and congestion.

Causes and Risk Factors

HPV – Human Papilloma Virus especially HPV-16 and HPV-18. It causes cervical dysplasia also
STIs due to intercourse with more than one partner or multiple partners.
Smoking
Frequent use of contraceptive pills
Make sexual contact at the early age
Early or multiple pregnancies

Signs to consult a doctor immediately

Bleeding after menopause
Pain while intercourse
Effects like fatigue, weakness in legs, unconscious with abnormal vaginal discharge

Diagnosis

The most common and the first test is done for screening is PAP Smear. In this, cells are collected through a swab and the pathologists work on it using a microscope.

After this, if they found anything unusual, more tests are performed such as-

Biopsy – in which a part of cervical tissue has been taken and sent for testing. The result for this test usually takes a week to come.
Colposcopy – It magnifies the cervix from 8 to 15 times. Colposcope is the instrument that is inserted into the cervix to view the cells there. It is done after staining the cervix with a dye.
LEEP (Loop Electrosurgical Excision Procedure) – In this also, a sample of cervical tissue is taken out by using a loop wire and sent for testing.
Conization – It is the removal of an affected part of the cervix. It is done under anesthesia

Other tests done are as follow-

Blood tests
X-ray
Ultrasound
CT Scan
MRI Scan
PET CT Scan

These tests help in confirming the stage, size, and extent of cancer in the body.

Stages

There are 5 stages of cancer.

Stage 0 – This stage has no visible signs and symptoms. It is a pre-cancerous condition

Stage I – The size is small. This stage doesn’t show any metastasis

Stage II – The size is large. Metastasized to uterus or lymph nodes

Stage III – Metastasized to vagina and pelvis and organs in the pelvis, hindering the normal functions of the organs

Stage IV – Metastasized to other organs like lung, liver, etc

Treatment

The treatment options available for cervical cancer are as follows-

Surgery – There are many types of surgeries done for the treatment of cervical cancer-

Laser surgery
Hysterectomy
Pelvic exenteration
Cryosurgery
Conization

Chemotherapy – It kills cancer cells by high-dose drugs or injections. It is usually given in cycles and daycare at the hospital.
Radiation therapy – It is given using high-energy rays that stop the growth of abnormal cells by damaging them. It can be external, internal, or both. It is given usually 5 days a week.
Biological therapy – It is also called immunotherapy as targets immune cells. It is usually used when chemotherapy is not giving any effects.

Out of the above-mentioned procedures, surgery and radiation therapy are the most common type of treatments.

Prevention

Tips to reduce the risk of cervical cancer are as follows-

Administration of HPV vaccine
PAP Smear in every 3 yrs
Use of contraceptive while intercourse
Don’t smoke and drink
Do regular work out but don’t exert yourself
Limit sexual partners

Advancements in research of cervical cancer-

Research has shown recent advancements such as-

Sentinel lymph node biopsy
Immunotherapy
Targeted therapy

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