Cervical cancer is a type of cancer that occurs in the cells of the cervix —narrow part of the lower uterus, often referred to as the neck of the womb that connects to the vagina.Cervical cancer affects the entrance to the womb. This cancer can affect the deeper tissues of their cervix and may spread to other parts of their body (metastasize), often the lungs, liver, bladder, vagina, and rectum.
Most cases of cervical cancer are caused by infection with human papillomavirus (HPV), which is preventable with a vaccine. Women 35 to 44 years old are most likely to get it.
There’s more than one kind of cervical cancer.
• Squamous cell carcinoma. This forms in the lining of your cervix. It’s found in up to 90% of cases.
• Adenocarcinoma. This forms in the cells that produce mucus.
• Mixed carcinoma. This has features of the two other types.
In the early stages of cervical cancer, a person may experience no symptoms at all.
You might not notice symptoms of cervical cancer until it’s far along. They may include:
• Pain when you have sex
• Unusual vaginal bleeding, such as after sex, between periods, after menopause, or after a pelvic exam
• Unusual vaginal discharge
After it has spread, the cancer can cause:
• Pelvic pain
• Trouble peeing
• Swollen legs
• Kidney failure
• Bone pain
• Weight loss and lack of appetite
A 4-stage system is the most common way to stage cervical cancer.
• Stage 0
Precancerous cells are present.
• Stage 1
Cancer cells have grown from the surface into deeper tissues of the cervix, and possibly into the uterus and to nearby lymph nodes
• Stage 2
The cancer has now moved beyond the cervix and uterus, but not as far as the walls of the pelvis or the lower part of the vagina. It may or may not affect nearby lymph nodes.
• Stage 3
Cancer cells are present in the lower part of the vagina or the walls of the pelvis, and it may be blocking the ureters, the tubes that carry urine from the bladder. It may or may not affect nearby lymph nodes.
• Stage 4
The cancer affects the bladder or rectum and is growing out of the pelvis. It may or may not affect the lymph nodes. Later in stage 4,
it will spread to distant organs, including the liver, bones, lungs, and lymph nodes.
Cervical cancer begins when healthy cells in the cervix develop changes (mutations) in their DNA. Healthy cells grow and multiply at a set rate, eventually dying at a set time. The mutations tell the cells to grow and multiply out of control, and they don’t die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can break off from a tumor to spread (metastasize) elsewhere in the body.
Most cases are linked to infection with Human papillomavirus(HPV). Different types of HPV can cause skin warts, genital warts, and other skin disorders. Others are linked to cancers involving the vulva, vagina, penis, anus, tongue, and tonsils.
Risk Factors –
You might be at higher risk of cervical cancer if you:
• Started having sex before age 16 or within a year of starting your period
• Have multiple sexual partners
• Take birth control pills, especially for longer than 5 years
• Smoke cigarettes
• Have a weakened immune system
• Have a sexually transmitted disease (STD)
Screening tests can help detect cervical cancer and precancerous cells that may one day develop into cervical cancer.
Screening tests include:
• Pap test
• HPV DNA test
During the colposcopic examination, your doctor is likely to take a sample of cervical cells (biopsy) for laboratory testing. To obtain tissue, your doctor may use:
• Punch biopsy
• Endocervical curettage
If your doctor determines that you have cervical cancer, you’ll have further tests to determine the extent (stage) of your cancer. Your cancer’s stage is a key factor in deciding on your treatment.
Staging exams include:
• Imaging tests. Tests such as X-ray, CT, MRI and positron emission tomography (PET) help your doctor determine whether your cancer has spread beyond your cervix.
• Visual examination of your bladder and rectum. Your doctor may use special scopes to see inside your bladder and rectum.
Treatment for cervical cancer depends on several factors, such as the stage of the cancer, other health problems you may have and your preferences. Surgery, radiation, chemotherapy or a combination of the three may be used.
Early-stage cervical cancer is typically treated with surgery. Which operation is best for you will depend on the size of your cancer, its stage and whether you would like to consider becoming pregnant in the future.
Options might include:
• Surgery to cut away the cancer only
• Surgery to remove the cervix (trachelectomy)
• Surgery to remove the cervix and uterus (hysterectomy)
Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer cells. Radiation therapy is often combined with chemotherapy as the primary treatment for locally advanced cervical cancers. It can also be used after surgery if there’s an increased risk that the cancer will come back.
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. It can be given through a vein or taken in pill form. Sometimes both methods are used.
Targeted drug treatments focus on specific weaknesses present within cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die. Targeted drug therapy is usually combined with chemotherapy.
Immunotherapy is a drug treatment that helps your immune system to fight cancer. For cervical cancer, immunotherapy might be considered when the cancer is advanced and other treatments aren’t working.
▪︎ Supportive (palliative) care
Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care.
• Human papillomavirus (HPV) vaccine
The link between the development of cervical cancer and some types of HPV is clear. If every female keeps to the current HPV vaccination programs, they could reduce the frequency of cervical cancer.
• Cervical screening
Regular cervical screening might help a person identify and deal with signs of cancer before the condition can develop or spread too far. Screening does not detect cancer but indicates changes to the cells of the cervix.
• Safe sex
Using a condom during sex helps protect from HPV infection.
• Delaying first sexual intercourse
The younger a woman is when she has sexual intercourse for the first time, the higher the risk of HPV infection becomes. The longer she delays it, the lower her risk.
• Having fewer sexual partners
The more sexual partners a woman has, the higher the risk of transmitting the HPV virus becomes.
• Stopping smoking
Women who smoke and have HPV face a higher risk of developing cervical cancer than people who do not.
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