Cervical Cancer

SYMPTOMS, CAUSES AND TREATMENT OPTIONS

What Is Cervical Cancer ?

Cervix is an organ on the lower part of the uterus that connects to the vagina. Cervical cancer is characterized by uncontrolled growth of the cells lining the cervix. Most of the cervical cancers start in the cells of the transformation zone (the part where glandular and squamous cell meet in the cervix).

SYMPTOMS OF CERVICAL CANCER

Symptoms of cervical cancer include the following symptoms

  • Vaginal bleeding after intercourse, between periods or after menopause

  • Watery, bloody vaginal discharge that may be heavy and have a foul odor

  • Pelvic pain or pain during intercourse

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CAUSES OF CERVICAL CANCER

  • Causes of cervical cancer are related to Human papilloma viral infections. In some women, the HPV infection causes precancerous changes in the cells of the cervix.  HPV Viruses produce two proteins known as E6 and E7 which turn off tumor suppressor genes. These can result in abnormal growth of cells lining the cervix.

  • Certain other factors such as HIV and smoking also increase the risk of cervical cancer in women.

STAGES OF CERVICAL CANCER

The most common system used for staging cervical cancer is the TNM system. 

  • T stands for Tumour. It is used to describe the size of the tumour. It also helps to determine whether tumour has grown into other parts of the organ or tissues around the organ. It is represented by a range of 1 to 4. The higher the number means the larger the tumour.

  • N stands for Lymph Nodes. It helps determine if the cancer has spread to the lymph nodes around the organ. NX means the impact on lymph nodes cannot be determined. N0 means cancer hasn’t spread to nearby lymph nodes while N1, N2 and N3 means cancer has spread to lymph nodes. N1 to N3 also shows the range that how many lymph nodes are affected.

  • M stands for Metastasis. It is used to determine if the cancer has spread to other parts of body through blood or lymphatic system. MX means the metastasis cannot be determined; M0 means cancer has not spread to other body parts while M1 indicates that it has spread to other body parts.

  • Sometimes lowercase letters like a, b and c is used to divide the tumour, lymph nodes and metastasis into sub categories. Also lowercase “is” is used to denote carcinoma in situ. For e.g. Tis

For The Convenience Of Grading The Extent Of Spread Of Cancer, The Cancer Is Classified Into 4 Broad Stages.

 

Stage I

In this stage the cancer is characterized as following

  • The cancer cells are growing from the surface of the cervix into deeper tissues of the cervix. The cancer can also be seen growing into the body of the uterus, but it has not grown outside the uterus (T1).

  • It might or might not have not spread to any nearby lymph nodes (Any N).

  • It has not spread to any distant sites (M0).

Stage II

This stage of cancer is characterized by following findings:

  • The cancer has grown beyond the cervix and uterus, but it hasn’t spread to the walls of the pelvis or the lower part of the vagina (T2).

  • It might or might not have not spread to any nearby lymph nodes (Any N).

  • It might or might not have not spread to any nearby lymph nodes (Any N).

Stage III

This is an advanced stage of cancer, it has the following characteristics:

The cancer can be seen spreading to the lower part of the vagina or the walls of the pelvis. The cancer may be blocking the ureters (tubes which carry urine from the kidneys to the bladder) (T3).

It might or might not have not spread to any nearby lymph nodes (Any N).

It has not spread to any distant sites (M0).

Stage IV

This is the most advanced stage of cancer. It is characterized by following conditions

  • The cancer has spread to the bladder or rectum or it is seen growing out of the pelvis (T4).

  • It might or might not have not spread to any nearby lymph nodes (Any N).

  • It has not spread to any distant sites (M0) or the cancer has spread to distant organs beyond the pelvic area, such as distant lymph nodes, bones, lung or liver. (M1)

Risk Factors

A number of factors contribute to increasing the chances of getting cervical cancer. These are called risk factors. Some of the most crucial risk factors are discussed here:

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Types Of Cervical Cancer

There are two types of cervical cancer

  • Squamous cell carcinoma: Develops from cells in the exocervix and show features of squamous carcinomas. They mostly form in transformation zone where exocervix and endocervix meet. 90% of cervical cancers are squamous cell carcinomas.

  • Adenocarcinomas: These are cancers that develop from glands. In cervical cancer it develops from the mucous producing glands present in endocervix.

Diagnosis Of Cervical Cancer

Screening helps in detecting cervical cancer. Most common guideline is to start the screening from the age of 21. The most popular screening tests are:

  • Pap test: In this test, the doctor collects some cells from the cervix using a spatula or small brush. The cells are then smeared on a glass slide (known as Pap smear). It detects the unusual cells that may change to cancer cells.

  • HPV DNA Test. Human papillomavirus or HPV test can be done along with a Pap smear test. It involves testing cells collected from the cervix for infection with any of the types of HPV that are most likely to lead to cervical cancer

If your doctor suspects cervical cancer, he/she may inspect your cervix to collect samples of cells to perform a biopsy. The biopsy can be of two types:

  • Colposcopic Biopsy: In this test, the cervix is examined for abnormal areas, on detection the abnormal cells are collected and tested

  • Endocervical Cutterage: This involves taking cells from endocervix using an instrument called curette.

Treatment Of Cervical cancer

The treatment for cervical cancer depends upon many factors, which includes the stage of cancer when it is diagnosed.

The most common treatment methodologies used are Surgery, radiation therapy, chemotherapy, and targeted therapy.

Prevention

Cervical cancer often can be prevented with the help of vaccination and modern screening techniques such as Pap test that can detect precancerous changes in the cervix. Also, there are some vaccines such as Gardasil that can prevent HPV infections.

The other ways in which you can prevent cervical cancer are:

  • Limiting the number of sexual partners

  • Using protection while engaging in sexual activity