Cervical cancer originates in the cervix, the lower part of the uterus (womb) and opens into the vagina. It arises from the cells present on the surface of the cervix.
Cervical cancer stands as the third most common type of cancer in women. The main cause is HPV (Human Papilloma Virus), a common virus that spreads through sexual intercourse.
- Having premature sex
- Having more than one sexual partner
- Poor socioeconomic status
- Weakened immune system
- Vaginal bleeding after menopause
- Foul-smelling vaginal discharge
- Bleeding after intercourse
- Heavy menstrual or intermenstrual bleeding
Symptoms of advanced cervical cancer
- Low backache
- Pain in the pelvis
- Excretion of urine or feces through the vagina
- Single swollen leg
- Loss of appetite
- Weight loss
Investigations – Screening tests
- For pre-cancer and cancer, Pap smear screens are effective, though not for final diagnosis.
- Colposcopy is carried out if abnormal changes are discovered. In this procedure, pieces of tissue are surgically removed (biopsy) and sent to a laboratory for examination under magnification.
- Endocervical curettage (ECC) is used to examine the opening of the cervix
- Cone biopsy
- Punch biopsy from cervical growth
- Chest X-ray
- CT scan or MRI
- Intravenous Pyelogram (IVP)
The treatment of cervical cancer depends on:
- Size and shape of the tumour
- The woman’s desire to have children in the future
- The woman’s age and general health
Treatment of early cervical cancers
- To ensure that a woman can bear children in the future, removing the precancerous or cancerous tissue without removing the uterus or harming the cervix, can cure early cervical cancer.
- Pre-cancerous conditions are curable when followed up and administered proper treatment.
- 92 per cent of women with cervical cancer have a five-year survival rate.
Treatment of advanced cervical cancers
- Radical hysterectomy: The uterus and much of the surrounding tissues are removed, including lymph nodes and the upper part of the vagina.
- Radiation therapy: It is used in cases where the cancer has spread beyond the pelvis, or cancer that has returned.
Radiation therapy is of two types:
- External radiation therapy is like an X-ray and delivers radiation from a large machine onto the part of the body where the cancer is located.
- Internal radiation therapy or brachytherapy entails placing a device filled with radioactive material inside the woman’s vagina.
- Intensity Modulated Radiation Therapy (IMRT) and Image Guided Radiotherapy (IGRT) help deliver radiation to the tumour and adjacent tissues sparing nearby normal structures like urinary bladder, rectum and intestines and thus preventing long term complications.
- Chemotherapy uses drugs such as carboplatin, paclitaxel, 5-FU and cisplatin to destroy cervical cancer. It is generally used along with radiation to sensitize the tumour. Radiation and chemotherapy may be used before or after surgery.
- In 2006, the U.S. Food and Drug Administration approved Gardasil as a vaccine to prevent cervical cancer.
- H Regular Pap smears are useful in detecting pre-cancerous changes, which can be cured before they turn into cervical cancer. A woman should undergo annual pelvic examinations, including a Pap smear when she becomes sexually active, 66 or by the age of 20, whichever is earlier.