Cervical Cancer: Types, Causes, Risk Factors, Sign, Symptoms, Stages, Screening, Diagnosis, Prevention

Is Cervical Cancer Treatable?

The lower part of the uterus in the female reproductive system connecting the uterine cavity and the lumen of the vagina is called the cervix or cervix uteri, a 2-3 cm long tube, cylindrical in shape. This cervical canal (cervix) acts as a passage through which sperms travel to fertilize the eggs after sexual intercourse.

The continuous division of the atypical or malformed cells of the cervix either on the cervix camera or any remote organ creates a tumor, also called cervical cancer (cancer of the cervix). The cervical cancer not only affects the cervix but can also spread to other organs such as the bladder, vagina, rectum, etc. In India, the cases of cervical cancer have come down in recent years, due to early and easy access to screening and vaccines.

Types of cervical cancer

There are 2 main types of cervical cancers known to affect women:

• Squamous cell carcinoma: It is a type of cervical cancer which begins in the thin, flat squamous cells, lining the outer part of the cervix. It constitutes up to 90% of the total cervical cancer cases.
• Adenocarcinoma: It is a type of cervical cancer which begins in the glandular cells that produce mucus.
• Adenosquamous carcinoma or mixed carcinoma: It occurs when the cervical cancer shows the features of both squamous cell carcinoma and adenocarcinoma.

Causes of cervical cancer

When women come in sexual contact or skin to skin contact with a person suffering from sexually transmitted diseases caused by Human Papilloma Virus (HPV), it may lead to cervical cancer. This disease is commonly seen in women who have multiple sexual partners. Among the 100 different types of virulent HPV strains, HPV-16 and HPV-18 are the two most common types of strains known to affect women, causing cervical cancer. Apart from cervical cancer, HPV also causes some other types of cancers such as vulvar cancer, vaginal cancer, anal cancer, rectal cancer, etc.

It is also observed that mutations change the DNA of the cervical cells causing them to grow abnormally. When these odd cells grow uncontrollably, it forms a tumor (a mass of cells). Other factors such as environment and the lifestyle that a person follows will also determine whether you will develop cervical cancer or not.

Risk factors of cervical cancer

Some of the risk factors associated with cervical cancer are as follows:

• Having multiple sexual partners
• Smoking cigarettes
• Being overweight
• HIV infection
• Suppressed immune system
• Long term use of oral contraceptives (birth control pills)
• Getting pregnant before the age of 16
• Some other sexually transmitted diseases like chlamydia etc.
• Family history of cervical cancer
• Not maintaining a good personal hygiene

Sign and symptoms of cervical cancer

Early stages of cervical cancer do not show any sign and symptoms. Most of these signs and symptoms are observed only in the advanced stages. These are as follows:

• Vaginal bleeding after sexual intercourse
• Vaginal bleeding in between periods or post menopause
• Prolonged menstrual cycles than usual
• Pain while having sex
• Persistent pain in the pelvic region
• Abnormal discharge of fluids from the vagina
• Pain while urinating

Stages of cervical cancer

Stage 0: In this stage, odd cancerous cells are present on the surface of the cervix. Stage 1: This stage shows the presence of a small number of tumors which have not spread to any other tissue or organ.

Stage 2: This stage indicates that the infection has begun to spread beyond the cervix and the uterus.

Stage 3: This stage shows that the cancer has begun to grow into the pelvic walls and in the lower part of vagina.

Stage 4: It is the most advanced stage of cancer in which infection begins to spread to nearby organs like rectum, bladder and other body parts.

Screening and diagnosis for cervical cancer

If cervical cancer is suspected, your doctor will ask you to undergo various tests and screening procedures to diagnose the cause of the disease:

• Pap smear test: In this test, cells from the cervix are scrapped out to test them in the lab for finding abnormalities.
• HPV DNA test: It involves testing of the cervical cells for infection of any of the HPVs that lead to the development of cervical cancer.
• Colposcopy: This procedure uses a special magnifying instrument called colposcope for observing the abnormal cell growth in the area.
• Punch biopsy: It is done by pinching off the sample cells from the cervical tissue using a sharp tool.
• Endocervical curettage: Tissue from the cervix is scrapped off using a small, spoon shaped instrument called curet for laboratory testing.

If punch biopsy and endocervical curettage appear to be worrisome, then the following tests are performed by doctors under general or local anesthesia:

• Electric wire loop: It uses a low-voltage, thin electrified wire to obtain tissue from the cervix.
• Cone biopsy: It is the procedure used by doctors to obtain tissues from the deeper layers of the cervix for laboratory testing.
• Imaging tests such as CT scan, X-ray and MRI can also be performed.

Prevention from cervical cancer

Here are some ways which can help the woman from getting an infection:

• Avoid having multiple sex partners.
• Always use a barrier method like a condom while having sex.
• Vaccinating against HPV can also prevent getting the disease.
• For sexually active persons, regular screening with a Pap smear test or HPV test can prevent the disease.

Available treatment for cervical cancer

Cervical cancer is curable if detected in the early stages. Some common treatments used by doctors to cure the disease are as follows:

• Surgery: Doctors may remove the affected parts of the cervix or tumors surgically to cure the disease.
• Radiation therapy: It uses high frequency radiation beams to kill cancer cells.
• Chemotherapy: This therapy uses various chemotherapeutic drugs to destroy cancer causing cells.
• Targeted therapy: This therapy uses drugs which block the growth of blood vessels that help cancer cells to grow and survive.

Dr. (Maj. Gen.) B.N. Kapur, the director of Medical Oncology, has speciality in medical oncology and in treating blood related disorders like leukemia, myelodysplastic syndrome, lymphomas, multiple myeloma, etc. He has served in the army for more than 36 years as a medical oncologist at the Armed Force Medical College and Command Hospital, Pune. Dr.

Kapur is known for treating solid organ cancers using latest evidence-based therapies.

Dr. (Brig.) Arvind K. Tyagi, the director of Surgical Oncology, is the best surgical oncologist in Delhi NCR and one of the best surgical oncologists across the country. With a medical experience of more than 30 years and having served in the army for almost 3 decades, he is the best surgical oncologist you are looking for.

Yashoda Superspeciality Hospital And Cancer Institute, Sanjay Nagar, Ghaziabad provides the best cervical cancer treatments as it is one of the leading hospitals in Delhi NCR. Women suffering from any type of cancers including cervical cancer can contact our gynecologic-oncologist, radiation oncologist, medical oncologist etc. at Yashoda as they use modern equipments and scientifically proven ways to treat cancer patients. Our doctors use a multi-disciplinary approach to diagnose and treat cancer. Remember- early diagnosis of cancer with timely treatment such as chemotherapy, surgery, radiation therapy, etc. can save life and increase the chances of survival.