Cervical Cancer: Its Symptoms, Causes, And Treatment
Cervical cancer is one of the most commonly seen gynaecological cancers in women in India. The report released by the Indian Council Of Medical Research (ICMR) 2021 reported that Cervical cancer accounted for 15.2% of all cancers occurring in women. The cervix is situated at the lowermost portion of the uterus and is a cylindrical passage connecting the vagina and the uterus. Early diagnosis is crucial in preventing cervical cancer from progressing, yet many women remain unaware of the symptoms until the disease has advanced. How can you know if you're at risk? What signs should you be aware of? In this article, we’ll break down the symptoms, causes, and treatment options for cervical cancer to help you stay informed and proactive about your health.
The primary functions of the cervix include:
- Production of cervical mucus during menstruation.
- Helping the sperm travel into the uterus from the vagina.
- Permitting the passage of the baby during birth by opening up the birth canal.
- Protecting the uterus from bacteria and other foreign material.
What Is Cervical Cancer?
Cervical cancer is a type of gynaecological cancer that begins on the surface of the cervix cells. Cervical cancer occurs when the cervix cells start to change into precancerous cells. However, not all precancerous cells will convert into cancer.
In most cases, cervical cancers occur due to sexually transmitted infection of the Human Papillomavirus (HPV). When screened early, cervical cancers are one of the most treatable cancers. Even in their later stages, cervical cancers can be controlled with appropriate treatment and palliative care.
There are two types of cervical cancers. They are:
- Squamous cell carcinomas: It is a type of cervical cancer that occurs in the thin and flat squamous cells that line the outer area of the cervix.
- Adenocarcinomas: It is a type of cervical cancer that begins in the mucus-producing column-shaped glandular cells lining the cervical canal.
What Are the Stages of Cervical Cancer?
Cervical cancer is categorised into stages depending on how far the cancer has spread. These stages range from Stage 0, where the abnormal cells are confined to the cervix, to Stage IV, where the cancer has spread to distant areas of the body.
1. Stage 0: Precancerous cells are present only on the surface layer of the cervix.
2. Stage I: The cancer is localised to the cervix.
3. Stage II: The cancer has extended beyond the cervix into nearby tissues but has not yet reached the pelvic wall or the lower part of the vagina.
4. Stage III: The cancer has spread to the pelvic wall or the lower section of the vagina.
5. Stage IV: The cancer has progressed to other organs, such as the bladder, rectum, or distant areas of the body.
Cervical Cancer Symptoms
In its earlier stages, cervical cancers won't show prominent symptoms; however, as the cancer advances, the following symptoms are observed:
1. Unusual or abnormal vaginal bleeding: Bleeding post-menopause, bleeding after sex, mensural bleeding that’s longer and heavier than usual, bleeding or spotting while not on period.
2. Unusual or abnormal vaginal discharge: Abnormal discharge with blood, foul odour, watery consistency, change in discharge colour to pink, pale or brown colour.
3. Pelvic pain: Pain in the pelvis may occur.
4. Urine changes: Frequent urge to urinate, pain while urinating, blood in the urine.
5. Unexplained loss of weight and appetite, feeling fatigued.
6. Swelling in the legs and mild backache.
7. Painful bowel movements.
What Causes Cervical Cancer?
Human Papillomavirus (HPV) infection is what causes cervical cancer most commonly. Out of all the strains, there are two types of HPV strains that most commonly cause cancer, and they are HPV-16 and HPV-18. Being infected with HPV doesn’t always mean that you’ll get infected with cervical cancer, as the body’s immune system fights and eliminates most HPV infections within two years.
What Are Major Risk Factors For Getting Cervical Cancer?
The risk factors include:
- Family history
- Smoking
- Excessive use of oral contraceptives
- Having multiple sexual partners
- Weakened immune system
What Is The Most Common Treatment For Cervical Cancer?
Cervical cancer is treatable when detected early. Let's learn about the various treatment options for cervical cancer.
A. Surgery
The primary focus of the surgery is to remove cancer. Surgery can be performed to remove a part of the cervix that consists of the cancer cells or sometimes may also involve removing the cervix and other organs of the pelvis based on its spread. The most common types of surgery performed are:
1. Conization: In this process, the cancerous tissue is removed in the form of a cone-like shape, after which it is then checked under a microscope to determine if the whole tumor was removed. Conization is used for both diagnosis and treatment.
2. LEEP: It involves a loop electrosurgical excision that removes the cancerous tissue with the help of an electrically heated wire.
3. Trachelectomy: This surgical procedure involves the complete removal of the cervix to eliminate cancer completely.
4. Simple Hysterectomy: This procedure involves removing the uterus if cancer has spread to areas other than the cervix.
5. Radical hysterectomy with pelvic lymph node dissection: In this procedure, the cervix, the uterus with its surrounding tissue parametrium, a small portion of the upper vaginal part, and pelvis lymph nodes are removed.
6. Pelvic exenteration: It is similar to a radical hysterectomy. However, this procedure involves the removal of the vagina, the bladder, the rectum, and a portion of the colon, depending upon the spread of cancer.
B. Radiation Therapy
Radiation therapy involves using high-beam radiation directed towards the cancer cells to destroy them. Types of radiation therapy are:
1. External radiation therapy: External Beam Radiation Therapy (EBRT) is performed by targeting x-rays or gamma rays to provide treatment to cancer affected areas. It is done using machines. External radiations are often combined with chemotherapy, otherwise called chemoradiation.
2. Internal radiation or Brachytherapy: In this method, an implant (catheter, rod, sed) is sealed along with a radioactive substance. This implant is then placed inside the uterus to provide radiation therapy.
C. Chemotherapy
Chemotherapy uses medications to kill cancer cells throughout the body. It is often used to treat locally advanced cancer or cancer that has spread to other parts of the body. Medications used for chemotherapy include Cisplatin and topotecan.
D. Immunotherapy
Immunotherapy is given to help the immune system fight cancer. It helps the immune system to recognise cancer cells and destroy them only. Example: Pembrolizumab
E. Targeted drug therapy
It destroys cancer cells by identifying and attacking some types of cancer cells without harming the healthy cells. Example: Bevacizumab.
F. Vaccines
While vaccines don’t treat existing cervical cancer, they play a key role in prevention. The Cervavac Injection and Gardasil injection, for example, is an HPV vaccine designed to protect against high-risk strains of the human papillomavirus that cause most cervical cancer cases. Administered before HPV exposure, usually in preteens, it significantly lowers the risk of developing cervical cancer later in life.
Better Safe Than Sorry
Taking the right precautions at the right time can prevent the chances of getting cervical cancer. Regular screening, such as Pap Smear tests and getting vaccinated for HPV, might seem tedious, but they are essential preventive measures. Other than that, simple measures like limiting or eliminating the habit of smoking, having protected sex, etc., might look small. However, they are essential for protecting overall health; as the saying goes, "An ounce of prevention is worth a pound of cure."
References
- https://www.blkmaxhospital.com/our-specialities/gynaecologic-cancer/conditions-treatments/cervical-cancer
- https://ourbodiesourselves.org/blog/state-support-for-cervical-cancer-vaccine/
- https://www.cancer.org/cancer/types/cervical-cancer/detection-diagnosis-staging/staged.html#:~:text=Cervical%20cancer%20stage%20ranges%20from%20stages%20I%20%281%29,stage%2C%20an%20earlier%20letter%20means%20a%20lower%20stage.https://cancerlibrary.mrmed.in/cancer-types/cervical-cancer
- https://my.clevelandclinic.org/health/diseases/12216-cervical-cancer
