What is cervical cancer
It is a malignant growth in the cells of the cervix, connecting the uterus to the vagina. Cervical cancer develops dilatory, but without treatment it can metastasize to other parts of the body.
Among other types of cancer in women in the world, cervical cancer (CC) is the 4th most common cancer. However, it is most typical for countries with low standards of living, where women’s access to quality health services is limited. In 2020, 604,000 new cases of cervical cancer were recorded, 342,000 women died. Almost 90% of new cases and deaths worldwide occurred in low- and middle-income countries.
Types of cervical cancer
The cervix consists of the endocervix, the canal that leads into the uterus (covered with glandular cells), and the exocervix, the outer part of the cervix (covered with squamous cells). The place of their intersection is called the transformation zone. Depending on the type of cells that become cancerous, there are different types of cervical cancer:
- Squamous cell carcinoma – 90% of all cases. Most often begins in the transformation zone.
- Adenocarcinoma. The tumor develops from the glandular cells of the endocervix, which produces mucus.
- Mixed carcinoma. It has signs of both types above.
The main cause is the human papillomavirus (HPV) – found in 95-99% of women diagnosed with invasive cervical cancer. The most dangerous for women are HPV strains 16 and 18 – they are responsible for almost 70% of cervical cancer cases. At the same time, the presence of HPV, even of a highly oncogenic type, does not mean that cancer cannot be avoided. Regular medical examinations and Pap smear at least once a year will detect abnormal cells before they lead to cancer.
Anyone with a cervix has a chance of cervical cancer. That is, if you have had a complete hysterectomy (removal of the uterus and cervix), you are not at risk of this type of cancer. However, certain risk factors increase your chances of developing the tumor, especially if you have high-risk HPV types. Without them, the probability of getting cancer is extremely low.
- Smoking – this bad habit increases the chances of many types of cancer, and cervical cancer is no exception;
- Weak immunity, in particular due to HIV;
- Several sexual partners, or if your partner has a lot of them;
- Early sexual start – before the age of 16 – or within a year after your first menstruation;
- You do not treat your sexually transmitted diseases, especially chlamydia. Some studies show that Chlamydia bacteria can promote the growth and life of HPV in the cervix, which can increase the risk of cervical cancer. Moreover, chlamydia, like other STDs, reduces local immunity;
- You have many (more than three) children, or you gave birth for the first time when you were less than 17;
- You are above 50 –cervical cancer affects younger women more;
- You have been taking oral contraceptives for a long time (more than 5 years);
- Your mother took the hormonal medicine diethylstilbestrol (DES) while pregnant with you.
So, a healthy lifestyle, healthy relationships, proper contraception and timely and regular visits to the gynecologist with a Pap test reduce your chances of cervical cancer to almost zero. Additionally, the use of an intrauterine device also decrease the likelihood of cervical cancer.
In the early stages of cancer, there are usually no symptoms. With the development of the disease, you may notice the following signs:
- Unusual vaginal discharge
- Bleeding after sex, between periods or in your postmenopause
- Pain in the lower abdomen after sexual intercourse
In later stages, other symptoms may appear:
- Swelling of the legs
- Blood in the urine
- Problems with urination or defecation
- Pain in the bones
- Pain in the lower abdomen
- Loss of appetite and weight loss
These symptoms may be related to other causes, but be sure to see a doctor as soon as possible if you notice them. And best of all, remember to have regular annual cervical cancer screenings!
How to treat and prevent cervical cancer
Cancer is usually preceded by precancerous conditions, in particular cervical intraepithelial neoplasia, squamous intraepithelial lesions (cervical dysplasia). At the same time, in most cases, these conditions will not develop into oncology. Plus, timely treatment at these stages mainly prevents the development of cancer.
Basically, cervical cancer is much easier to prevent than to treat. The primary prevention here is vaccination against human papillomavirus. Of course, if you are over 26 and already sexually active, you decide individually with your doctor whether to get vaccinated or not. However, if you have a daughter – do not hesitate! The best age for vaccination is 11-14 years, but you can get vaccinated from 9 to 26 years, but pay attention – before the start of sexual activity.
If you regularly, once a year, do a Pap smear, it is also an almost complete guarantee of preventing the development of cervical cancer at an early stage.
That is why the low standard of living in the country affects the number of cervical cancer cases – women simply do not have access to HPV vaccination and regular medical examinations. Pap smear is free of charge in the most countries of the world for women aged 21 to 65 years and is done every two years.
If the Pap smear reveals a precancerous condition of cells, you will be biopsied. The moderate or severe degree of degeneration is treated with the following methods:
- Loop electrosurgical excision procedure (LEEP). Using a thin wire loop with an electric current, a layer of cervical tissue is removed.
- Cryosurgery. The doctor freeze and destroy abnormal tissue. But this method is outdated and is not used in modern hospitals. Plus, the doctor does not receive material for research, which can be sent to a pathologist. A pathologist is a doctor who examines the obtained cells under a microscope and can tell the degree of precancerous condition or the presence of cancer. Therefore, if a biopsy or PAP test shows the presence of precancerous conditions of the cervix, never agree to treatment with liquid nitrogen or “freezing”.
- Surgery. This is the physical removal of tissue with atypical cells.
- Laser surgery. Removal of tissue using intense laser light.
Treatment of cervical cancer
At the initial stage, the doctor may use cervical conization – removal of the affected tissue with an electric or radio wave loop. At more advanced stages, it is about removing the uterus with appendages and lymph nodes.
Also, you will be examined for metastases, that is, the spread of cancer to other organs.
In addition to surgery, the most popular cancer treatments are radiation therapy (X-rays) and chemotherapy (treatment with powerful drugs). Radiation therapy can be external – using a machine that directs the rays to the area in the lower abdomen. Or it might be contact (brachytherapy) – a capsule with radioactive elements is placed in the cervix for a certain period of time.
Depending on the stage of cervical cancer, therapy may include:
- Radiation or surgery followed by radiation;
- Radiation and chemotherapy at the same time – chemotherapy helps radiation work better;
- Radiation therapy alone – to treat cervical cancer that has spread to other organs and tissues;
- Immunotherapy – the effect of drugs on certain cells of the immune system to cause your body’s immune response. This method is used if chemotherapy has not worked or the cancer continues to spread.
Treatment methods and its duration are determined only by a specialist, based on many factors. The earlier you start therapy, the higher the chances of a complete recovery, at the first stage they are 92%.
To contribute your part, you should take care of your diet, get enough sleep and get rid of bad habits. Moderate physical activity that does not exhaust you, such as yoga, walking or swimming, might help.
I wish you to always be healthy – so choose prevention! And quitting smoking is the first step towards your sexual health!
I tell about your health, the stages of development of the female body and modern methods of prevention and treatment in my courses: A girl becomes a woman, All about you. What it’s like to be a Woman, All about you 35+.
I’m eager to file all of these courses in English, just send me a request to firstname.lastname@example.org
You can always choose your doctor at the Lior Medical Center.