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| Women's Health >>
cervical cancer |
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What is cervical cancer?
What are the causes?
What are the symptoms?
How is the diagnosis made?
What is the treatment?
What is the prevention? |
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What is
cervical cancer?
Cervical cancer is a disease caused by the abnormal
growth and division of cells that make up the cervix
(the portion of the uterus attached to the top of
the vagina). Ninety percent of the cervical cancers
arise from the flattened or squamous cells covering
the cervix. Most of the remaining 10% arise from the
glandular, mucous-secreting cells of the cervical
canal leading into the uterus. |
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What are the causes?
The development of cervical
cancer is gradual and begins as a pre-cancerous
condition called dysplasia. In this form it is 100%
treatable, usually without the need for a
hysterectomy (surgical removal of the uterus).
Dysplasia, depending on its severity, can resolve
without treatment, particularly in young women.
However, it often progresses to actual cancer called
‘carcinoma in situ’ (CIS) if it has not spread, or
‘microinvasive’ if it has spread only a few
millimeters into the surrounding tissue but not into
the lymph channels or blood vessels.
The risk factors for cervical cancer are:
* Infection with the virus that causes genital warts
(human
papilloma virus or HPV) may increase the risk of
developing dysplasia and subsequent cancer.
Fortunately, not all women who have had HPV
infection or genital warts develop cervical cancer.
Other factors, such as smoking, may increase the
risk of developing cervical cancer in those who have
had HPV
* Early age at first sexual intercourse
* Multiple sexual partners or partners who have
multiple partners
* There is a small increased risk of abnormal Pap
smears among women who take birth control pills. It
is because such women are more sexually active, are
less likely to use condoms, and have more frequent
Pap smears in order to be prescribed the birth
control pill
* Women whose immune systems are weakened - such as
those with HIV infection or women who have received
organ transplants and are taking drugs to suppress
the immune system - may be at a higher risk
* Infections with genital herpes or chronic
chlamydia infections, both sexually transmitted
diseases, may increase risk |
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What are the
symptoms?
Most often, cervical cancer in its earliest and most
treatable stages does not cause any symptoms. When
there are symptoms, the most common are:
* Persistent vaginal discharge, which may be pale,
watery, pink, brown, blood streaked, or dark and
foul-smelling
* Abnormal vaginal bleeding, especially between
menstrual periods, after intercourse or douching,
and after menopause, which gradually becomes heavier
and longer
Symptoms of advanced cervical cancer may include:
* Loss of appetite, weight loss, fatigue
* Pelvic, back, or leg pain
* Leaking of urine or faeces from the vagina
* Bone fracture |
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How is the diagnosis made?
Invasive cervical cancer often appears as an
irregular fleshy growth, often firm or hard, that
tends to bleed easily. But even on pelvic
examination by a doctor, pre-cancers and even early
cancers of the cervix are often not visible to the
naked eye. Special tests are necessary to diagnose
cervical pre-cancers and cancers:
* Pap smears screen for cervical pre-cancers and
cancers. The Pap smear test consists of cells wiped
or brushed off the cervix and placed on a microscope
slide. This is usually done at the time of a pelvic
examination, though not every pelvic exam includes a
Pap smear.
* Colposcopy is an examination of the cervix under
magnification in order to locate an abnormality of
the cervix
* Biopsy, colposcopy, or sometimes the use of LASER
(a loop electrode) or other instrument allows a
diagnosis to be made
* When cervical cancer is found, additional tests -
such as X-rays, using an instrument to look into the
bladder (cystoscopy), and rectum and colon
(colonoscopy) - are used to determine how far the
cancer has spread and what stage the disease is in |
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What is the
treatment?
Treatment of cervical cancer depends on the type of
cancer, the stage, the size and shape of the tumour,
the age and general health of the woman, and her
desire for future childbearing.
In its earliest stages, the disease is curable by
removing or destroying the pre-cancerous or
cancerous tissue. This can often be done in various
ways without removing the uterus or damaging the
cervix so that a woman is still capable of having
children.
In other cases, a removal of the uterus
(hysterectomy) is performed, with or without removal
of the ovaries. In more advanced disease, a radical
hysterectomy may be performed which removes the
uterus and much of the surrounding tissues,
including internal lymph nodes. In the most extreme
surgery, called a pelvic exenteration, all of the
organs of the pelvis, including the urinary bladder
and rectum, are removed.
Radiation or chemotherapy may be used to treat
cancer that has spread beyond the pelvis, or has
recurred. A variety of chemotherapeutic drugs, or
combinations of them, are used. Sometimes radiation
and chemotherapy are used before or after surgery. |
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What is the prevention?
There are two ways to prevent cervical cancer - the
first is to
prevent infections with HPV, the second is to get
regular Pap smears that will detect pre-cancerous
conditions and HPV. Both of these can be treated and
the progression to cervical cancer be arrested.
Precancers are completely curable when followed up
properly. To reduce the chances of cervical cancer,
girls less than 18 years of age should avoid sexual
activity or always use condoms. HPV infection causes
genital warts. These may be barely visible or
several inches across. If a woman sees warts on her
partner's genitals, she should avoid intercourse. To
further reduce the risk of cervical cancer, women
should limit the number of their sexual partners,
avoid sexually promiscuous partners, and discontinue
any tobacco use. Condoms may help prevent the
transmission of HPV.
Annual pelvic examinations, including a pap smear,
should begin when a woman becomes sexually active,
or by the age of 20 in a non-sexually active woman.
All abnormal findings should be followed up with
colposcopy and biopsy. |
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Disclaimer - The
contents of this site are for informational purposes
only. Always seek the advice of a qualified
physician for any doubts. |
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