Overview of cervical cancer:
Cervical cancer is the cancer that starts in the cervix, the narrow opening of the vagina into the uterus. The portion of the uterus that extends into vagina is covered by thin cells known as squamous cell, and the canal is made up of another kind of flat, thin cells known as columner cells. The point where is both cells meet is known as transformation zone, and most of the cervical cancer occur in these zone.
- Most cervical cancer (80 to 90 percent) are squamous cell cancer, occurring in that transformation zone.
- Adenocarcinoma is another kind of cervical cancer(10 to 20 percent), it is produced in the gland that transfer mucus in the uterus opening to the vagina.
Though adenocarcinoma is rare type of cancer, but it is increasing in these days, and mostly in younger girls.
- And further less commonly,some cancers have features of both adenocarcinoma and squamous cell cancers, known as mixed carcinoma. Cervical cancer is the most common type of cancer in women worldwide, but as it develops over time, it is the most preventable type of cancer. Detection and treatment of cervical cancer in early stage can prevent this disease.
Causes of Cervical cancer:
HPV(Human Papillomavirus virus) is the cause of 99% or cervical cancer.
There are many types of HPV virus, but all forms doesn't cause cervical cancer. Almost 80% of women by age 50 get HPV. But, most of the infection resolve on their own. some of them which does not resolve by 2 years may develop into abnormal condition, which over many years and even decades, can cause abnormal growth of cervical cells, and cause cervical cancer.
Risk factors of cervical cancer:
Risk factors are the factors which increase the chance of increasing cervical cancer. Certain risk factors in cervical cancer are-
- HPV infection-There are, mostly 150 variant of HPV. HPV lead to development or certain warts in mouth, throat, lining of the genital and skin but not in blood or internal organs. Infection by HPV is the most common cause of cervical cancer. Chronic variants of HPV such as HPV 16 and HPV 18 are the cause of most cervical cancer. There is no treatment of HPV infection or warts formed by them.
- Smoking-woman who smoke are about the two third risk of getting cervical cancer than non-smokers. Smoke substance are found in the mucus of cervix. It is believed that the DNA of cervix cells are damaged by this substances.
- Having a weak immune system-Human immunodeficiency virus(HIV) makes the immune system of a person weak and make a risk for that woman to cervical cancer. Or woman who are taking drugs for autoimmune disease, to suppress their immune system are also in the risk of getting cervical cancer.
- Chlamydia infection-Chlamydia is a bacteria which infect women's reproductive tract.Woman whose blood test or mucus show current or past Chlamydia infection, have high risk of getting cervical cancer.
- Being overweight-Women who are being overweight, has a risk factor of getting adenocarcinoma.
- Taking birth control pills-Women who take regular OCDs has a high risk of getting cervical cancer. But the risk comes back to normal in 10 years once they are stopped.
- Intrauterine device(IUD)-The women who took IUD,has a lower risk of getting Cervical cancer. If the device is removed, their protection for cervical cancer remains after that.
- Pregnency-Women who have full term pregnancy by 3 or more than that, has risk of getting cervical cancer. And women who were pregnant before the age of 17 years are 2 times more likely to get cervical cancer.
- Family history-Women whose mother and sister have cervical cancer, are in the risk of getting cervical cancer 2-3 times more than that of no family history.
- Economic status-Women in deprived places have certain high risk of cervical cancer.
Symptoms of cervical cancer:
Early symptoms of cervical cancer may include-
- Bleeding from vagina that is not normal-bleeding between menstrual cycle, after menopause,after sexual intercourse.
- Pain in the the pelvic region which Is not similar to the one during menstural cycle.
- Abnormal vaginal discharge with foul smell, thick and blood.
Diagnosis of early symptoms of cervical cancer:
The most effective method of diagnosing cervical cancer is by Pap test.Women before the age of 30, should undergo Pap test very three years, and women after age 30 should undergo Pap and HPV test in 5 years. Women with high risk of cervical cancer should go through the test more often.
- Pap Test-The Pap (papanicolaua) test is a procedure used to collect cells from the cervix so that they can be looked at under the microscope to find cancer and pre-cancer. This can show squamous or epithelial cell abnormality or any malignancy.
- HPV test-Here, the pieces of DNA of HPV are looked for in the cervix. HPV test with pap test is done to know about the chances of cervical cancer in woman more accurately.
Treatments of cervical cancer:
Cervical cancer has different stages-
- First stage-when the cancer is only confined to the cervix.
- Second stage-The cancer has spread to the lymph node
- Third stage-where the cancer has spread to the other parts of the body.
- Surgery-There are certain types of surgery which are known to know the stage of cervical cancer and also removing surgical cancer.
- Laser surgery or cryosurgery-Where laser or cold metal probe is used to destroy abnormal cells in cervix or to remove a tissue from cervix for further diagnosis.
- Simple hysterectomy-The uterus is remove in this surgery but not the structures next to uterus, Vagina and lymph nodes are not removed. This surgery would lead to infertility.
- Radial hystersctomy-Here, the uterus is removed along with the structures next to uterus (the parametria and the uterosacral ligaments) and 1 inch of the vagina is removed. Ovaries or fallopian tubes are not removed. Any type of hysterectomy would lead to infertility (inability to have children).
- Radiation therapy-If the cancer has spread beyond cervix, then surgery would not be a god method. Radiation therapy is the use of high dose X-rays to destroy cancer cells and other shrink tumors.
- External beam radiation-To target the cancer cells from outside the body. Here, the radiation dose use is quite stronger. Chemotherapy along the radiation therapy are used in the treatment of cervical cancer. There may be possible side effects such as fatigue, diarrhea or vomiting, skin changes etc.
- Brachytherapy-An internal beam radiation, where a radian source is taken near to cancer. This is a short range radiation Useful only for cervix and the walls of vagina. Dose depend on the condition of the cancer. side effects for this method may be nausea, diarrhoe, low blood counts and irritation of the bladder.
- Chemotherapy-Chemo may be used to treat cancers that have spread to other organs and tissues. It can also be helpful when cancer comes back after treatment with chemoradiation. The chemo drugs most often used to treat advanced cervical cancer include:
- Paclitaxel (Taxol®),
- Gemcitabine (Gemzar®)
Combinations of these drugs are often used the side effects of this method may include nausea and vomiting, loss of apetite, loss of hairs, mouth sore and fatigue.
- Targeted Therapy-Drugs which specifically target to the changes of the cancer cells. Certain drugs are angiogenesis inhibitor, which starve the cancer cells of oxygen to die.
- Bevacizumab (Avastin®) is an angiogenesis inhibitor that can be used to treat advanced cervical cancer. Possible side effects with this method may include high blood preesure, loss of apetite and fatigue.
Cervical cancer is the most preventable cancer, and it can be prevented by preventing any of the risk factors which can increase the chance of cervical cancer.