What is a Cervical Cancer
Cervical cancer, known as cancer of the cervix, initiates in the surface cells of the cervix. It develops when cervical cells undergo changes, becoming precancerous. Not all precancerous cells progress to cancer, yet detecting and addressing these abnormal cells beforehand is crucial in preventing the onset of cervical cancer.
Types of Cervical Cancer
Cervical cancer primarily exists in two main types: squamous cell carcinomas and adenocarcinomas. Squamous cell carcinomas represent around 80% to 90% of cervical cancers, while adenocarcinomas make up approximately 10% to 20% of cases.
Symptoms and Causes
Detecting early stages of cervical cancer is challenging as they typically don’t present noticeable symptoms. The development of initial signs may take years. Screening tests for abnormal cervical cells serve as the most effective method for cervical cancer prevention.
Symptoms of stage 1 cervical cancer can include:
- Watery or bloody vaginal discharge, potentially heavy and with an unpleasant odor.
- Vaginal bleeding post-intercourse, between menstrual cycles, or after menopause.
- Longer and heavier menstrual periods than usual.
- If the cancer spreads to nearby tissues or organs, additional symptoms might appear:
- Painful or challenging urination, possibly with blood in the urine.
- Diarrhea, rectal pain, or bleeding during bowel movements.
- Fatigue, weight loss, decreased appetite, and a general feeling of being unwell.
- Persistent dull backache or leg swelling.
- Pelvic or abdominal pain.
- If you encounter unusual bleeding, abnormal vaginal discharge, or any unexplained symptoms, a comprehensive gynecological examination, including a Pap test, is recommended.
How Is Cervical Cancer Diagnosed
Cervical cancer progresses gradually over several years, with cervical cells undergoing various changes before potentially transforming into cancerous cells. Initially normal cells in the cervix may appear irregular or abnormal, which can either resolve, remain unchanged, or progress into cancer cells.
Regular gynecological screenings, particularly the Pap test, are effective in detecting most instances of cervical cancer. The Pap test, or Pap smear, collects cervical cells for examination, aiming to identify precancers or abnormalities.
If an abnormal Pap test result is obtained, additional testing becomes necessary. This might involve an HPV test, specifically designed to check for HPV infection within cervical cells, as certain HPV infections are linked to cervical cancer.
In cases where cancer is suspected, a healthcare provider may conduct a cervix examination and obtain tissue samples for a biopsy. Various methods like punch biopsy, endocervical curettage, or wire loop/conization techniques can be utilized to collect cervical tissue for biopsy.
If cancer is confirmed, further tests will be conducted to determine if the disease has spread, a process known as staging. These tests may involve assessing liver and kidney function, blood and urine tests, as well as X-rays of the bladder, rectum, bowels, and abdominal cavity.
Treatment Options for Cervical Cancer
Cervical cancer treatment typically involves a multidisciplinary approach, often led by a gynaecologic oncologist specializing in female reproductive cancers. The treatment course is determined based on various factors such as the cancer’s stage, the patient’s overall health, age, and fertility desires.
There are several primary treatment modalities for cervical cancer:
Radiation Therapy
External beam radiation therapy (EBRT) uses high-energy radiation externally to target cancer cells. Brachytherapy involves placing radiation sources near or inside the cervix to treat the cancer.
Chemotherapy
Drugs administered intravenously or orally are used to kill cancer cells throughout the body. Different drugs or combinations are employed in cycles, the schedule of which varies based on the specific treatment plan.
Surgery
Various surgical approaches are utilized, depending on the cancer’s stage and extent. These may include:
- Laser surgery: Employing a laser to remove cancer cells.
- Cryosurgery: Freezing and eliminating cancer cells.
- Cone biopsy: Removal of a cone-shaped piece of cervical tissue.
- Hysterectomy: Removal of the uterus, with variations like simple or radical hysterectomy.
- Trachelectomy: Removal of the cervix and the upper part of the vagina without eliminating the uterus.
- Pelvic exenteration: An extensive surgery removing the bladder, vagina, rectum, and adjacent areas affected by cancer.
Targeted Therapy
Targeted drugs focus on specific proteins controlling cancer cell growth and spreading, aiming to destroy these cells more selectively.
Immunotherapy
Medications that stimulate the immune system to recognize and destroy cancer cells. This approach can counteract signals emitted by cancer cells to avoid the immune system’s detection.
Clinical trials are also an option for some patients, offering access to new or experimental treatments. Additionally, alternative treatments such as dietary changes, herbal supplements, acupuncture, and other methods are sometimes used alongside conventional treatments. It’s essential to consult healthcare providers about these complementary methods, as while some may offer support, others might be harmful or interfere with standard treatments.