What is Cervical Cancer?

Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina. It is most often caused by persistent infection with certain types of human papillomavirus (HPV), a sexually transmitted infection. Cervical cancer develops gradually, starting with precancerous changes that may progress to cancer if untreated. Regular screenings and HPV vaccination play a critical role in prevention and early detection.

Types

Cervical cancer can be classified into different types based on the cells where it starts:

• Squamous Cell Carcinoma: The most common type, originating in the thin, flat cells lining the outer part of the cervix (ectocervix).
• Adenocarcinoma: A less common type that starts in the glandular cells of the cervical canal (endocervix).
• Adenosquamous (Mixed) Carcinoma: A rare type that has features of both squamous cell carcinoma and adenocarcinoma.
• Neuroendocrine Cervical Cancer: A rare and aggressive form of cervical cancer.

Symptoms

In its early stages, cervical cancer may not cause noticeable symptoms. As the disease progresses, common symptoms include:

• Abnormal vaginal bleeding, such as bleeding after intercourse, between periods, or after menopause
• Unusual vaginal discharge, which may be watery, bloody, or foul-smelling
• Pelvic pain or pain during intercourse
• Frequent or painful urination
• Swelling in the legs or lower back pain (in advanced stages)

If you experience these symptoms, it’s important to consult a healthcare provider promptly.

Causes and Risk Factors

Cervical cancer is primarily caused by persistent infection with high-risk types of HPV. Other factors that may increase the risk include:

• HPV Infection: Persistent infection with high-risk HPV strains (e.g., HPV 16, HPV 18) is the most significant risk factor.
• Smoking: Smoking increases the risk of cervical cancer, especially in women with HPV.
• Weak Immune System: Conditions like HIV/AIDS or medications that suppress the immune system may increase susceptibility.
• Early Sexual Activity: Beginning sexual activity at a young age increases exposure to HPV.
• Multiple Sexual Partners: A higher number of sexual partners increases the risk of HPV infection.
• Long-term Use of Birth Control Pills: Extended use of oral contraceptives is associated with a slightly increased risk.
• Having Many Children: Giving birth to multiple children is linked to an increased risk of cervical cancer.

Stages of Cervical Cancer

Cervical cancer stages describe the extent of the disease:

• Stage 0: Precancerous changes, also known as carcinoma in situ (CIN3).
• Stage I: Cancer is confined to the cervix.
• Stage II: Cancer has spread beyond the cervix to nearby tissues but not to the pelvic wall or lower third of the vagina.
• Stage III: Cancer has spread to the pelvic wall, lower third of the vagina, or causes kidney problems.
• Stage IV: Advanced cancer that has spread to nearby organs or distant parts of the body, such as the lungs or liver.

Diagnosis

Cervical cancer is diagnosed through various methods:

1. Pap Smear Test

A Pap test screens for abnormal changes in cervical cells that could develop into cancer.

2. HPV Test

An HPV test detects the presence of high-risk HPV strains linked to cervical cancer.

3. Colposcopy

If abnormal results are found in a Pap test or HPV test, a colposcopy may be performed to closely examine the cervix.

4. Biopsy

A biopsy involves removing a sample of cervical tissue for microscopic examination to confirm cancer.

Treatment

Treatment for cervical cancer depends on the stage and may include:

1. Surgery

Surgical options aim to remove cancerous tissue and may include:

• Conization: Removal of a cone-shaped section of abnormal tissue.
• Hysterectomy: Removal of the uterus and cervix, sometimes including nearby tissues.

2. Radiation Therapy

Radiation therapy uses high-energy rays to destroy cancer cells, often combined with chemotherapy.

3. Chemotherapy

Chemotherapy uses drugs to kill cancer cells, often used for advanced stages or combined with radiation.

4. Targeted Therapy

Targeted therapies focus on specific molecules involved in cancer growth. Bevacizumab (Avastin) is sometimes used for advanced cervical cancer.

5. Immunotherapy

Immunotherapy boosts the immune system’s ability to fight cancer and is being explored for certain cases of cervical cancer.

Prevention

Cervical cancer is highly preventable through:

• HPV Vaccination: Vaccines like Gardasil and Cervarix protect against high-risk HPV strains.
• Regular Screenings: Pap smears and HPV tests help detect abnormalities early.
• Safe Sexual Practices: Using condoms and limiting sexual partners can reduce HPV risk.
• Quitting Smoking: Avoiding tobacco use lowers the risk of cervical cancer.

Conclusion

Cervical cancer is preventable and treatable if detected early. Regular screenings, HPV vaccination, and awareness of risk factors can significantly reduce the burden of this disease. Consult your healthcare provider for more information and personalized advice.