You’ve recently visited your gynecologist for regular medical screening. But when the doctor asked you about any abnormalities you had seen in the past few months,. You answered ‘Yes’. Upon further investigation, your doctor confirms that you’re suffering from cervical cancer. It’s quite shocking news for you, isn’t it?
All over the world, cervical cancer is the main cause behind the increased deaths of women recorded every year. Somehow, the mortality rate varies from developed nations to developing ones. In underdeveloped countries, cervical cancer is the 2nd leading cause of mortality and the 12th most prevalent cancer in women.
According to the American Cancer Society, cervical cancer affects about 12,000 American women each year. But the death rate is very much higher in developing nations. In developing nations, about 370,000 women die annually due to misdiagnosed or undiagnosed cervical cancer.
Lacking information about cervical cancer, the dearth of awareness programmes, and irregular medical checkups are the root causes of the increased mortality of cervical cancer, especially in developing countries.
Cervical cancer: the silent killer
The female reproductive system is one of the most complicated systems in the body. And if any part of this system is affected, the entire system can have a negative impact. Cervix is the lowest part of the uterus. It is the connection between the uterus and the vagina.
But when the cervix size starts to grow at an uncontrollable rate, it indicates something is going wrong. The wrong time to start treatment can spread cancer to surrounding tissues or the whole body.
The extent of the disease determines the stage of cervical cancer, which aids in selecting the most effective course of treatment. The staging system commonly used for cervical cancer is the FIGO (International Federation of Gynecology and Obstetrics) staging system. The stages range from 0 to IV, with subcategories denoted by letters (e.g., IA, IB, IIA, IIB, etc.). Here is an overview of the stages:
Stage 0 (Carcinoma in situ)
At this stage, aberrant cells are exclusively seen in the cervix’s inner layer (epithelium). It is also known as carcinoma in situ or pre-cancer.
Stage 1
- IA: Cancer is confined to the cervix and is not visible without a microscope.
- IB: The cancer is visible without a microscope but is still confined to the cervix.
Stage 2
- IIA: The malignancy has gone beyond the cervix but not to the pelvic sidewall or lower vagina.
- IIB: Cancer spreads to the pelvic sidewall or lower part of the vagina, but not fully.
3rd Stage
- IIIA: The cancer has spread to the lower third of the vagina but not to the pelvic sidewall.
- IIIB: The cancer has extended to the pelvic sidewall, causes kidney problems (hydronephrosis), or involves nearby lymph nodes.
Stage 4
- IVA: The cancer has spread to the bladder or rectum.
- IVB: Distant metastasis has occurred, which may involve organs such as the lungs, liver, or bones.
Keep in mind that each stage has different specifics, and the treatment may vary depending on the malignancy. Advances in cancer research and staging may also change the staging method. It’s important for people with cervical cancer to connect with their healthcare team for individualized information.
Alarms for cervical cancer
Routine screening is crucial for the early detection and prevention of cervical cancer. The primary screening method for cervical cancer is the Pap smear (Pap test) and, in some cases, the HPV (human papillomavirus) test. These tests help detect abnormal cells or the presence of HPV, which is a major risk factor for cervical cancer.
While there may not be specific “alarms” for cervical cancer in the way we think of alarms for emergencies, there are important reminders and guidelines to ensure regular screenings and follow-ups. Here are some key points:
Regular Pap Smears
Women should undergo regular Pap smears as part of routine gynecological exams. The frequency may vary based on age, health history, and risk factors, so it’s important to discuss this with a healthcare provider.
HPV Vaccination
Teens and young adults should have HPV vaccinations to prevent cervical cancer from high-risk HPV strains. The vaccine is most effective when administered before the onset of sexual activity.
Health Check-ups
Follow your healthcare provider’s advice and get regular health screenings. These visits can help detect any abnormalities early on.
Know Your Body
Be aware of any unusual symptoms, such as abnormal bleeding, pelvic pain, or pain during intercourse. If you experience any of these, consult with your healthcare provider promptly.
Stay Informed
Stay informed about cervical cancer, its risk factors, and the importance of early detection. Knowledge empowers individuals to make informed decisions about their health.
Follow-Up Care
If you’ve had abnormal Pap smear results or a positive HPV test, follow through with any recommended follow-up tests or procedures. Early intervention can prevent the progression of cervical cancer.
Remember that early detection greatly increases the chances of successful treatment. If you’re worried about cervical cancer or haven’t been screened, talk to your doctor about screening options and frequency.
Causes of cervical cancer
The primary cause of cervical cancer is a persistent infection with high-risk types of human papillomavirus (HPV). HPV is a sexually transmitted infection, and certain types of this virus are strongly linked to the development of cervical cancer. Here are key factors and causes:
- HPV Infection: Persistent infection with high-risk HPV types, particularly HPV-16 and HPV-18, is the primary cause of cervical cancer.
- Sexual Activity: The early onset of sexual activity increases the risk of exposure to HPV.
- Multiple Sexual Partners: Having multiple sexual partners or having sexual partners who have had multiple partners increases the risk of HPV infection.
- Weakened Immune System: Individuals with a weakened immune system, such as those with HIV/AIDS, are at a higher risk of HPV persistence and progression to cervical cancer.
- Smoking: Smoking is a known risk factor for cervical cancer. It can increase the risk of progression if an HPV infection is present.
- Long-Term Use of Oral Contraceptives: Long-term use of oral contraceptives (birth control pills) has been associated with a slightly increased risk of cervical cancer.
- Not Getting Screened:Lack of cervical cancer screening (Pap smears or HPV tests) can delay abnormality diagnosis and increase cervical cancer risk.
- Family History: A family history of cervical cancer may contribute to a higher risk, although most cases are not hereditary.
It’s important to note that while these factors increase the risk of cervical cancer, not everyone with these risk factors will develop the disease. Cervical cancer is largely preventable through vaccination against HPV, regular screenings, and early treatment of precancerous lesions. Vaccination, early detection, and lifestyle choices play crucial roles in reducing the incidence and impact of cervical cancer.
Medical screening tests are available for cervical cancer
Cancer of the cervix is considered a preventable disease. A Pap smear test is the hallmark for the early detection of pre-cancerous growth in the cervix. During the pap smear test, your doctor takes the cervical cells and sends them to the lab for further lab analyses. The pain scale of this test varies from extreme pain to no pain.
The Pap smear test is effective, although it’s contraindicated during menstruation. Both the Pap smear and HPV tests are done simultaneously. Here is a quick list of who the candidate for the pap smear test is and what the significance of HPV is in specific age groups.
Age 21–29:
Every 3 years, you should go for a Pap test. If the Pap test shows abnormal results, then the HPV testing can be done as a follow-up test.
Age 30-65:
Both the HPV test and the Pap test should be done every 5 years. As an alternative, you can have a pap test alone as well.
Above 65 years:
If the Pap test has been clear in the past few years, then you should stop testing.
Principal concerns:
If your uterus or cervix is medically removed, you don’t need a pap test. If your doctor suspects cervical cancer, obtain the HPV test. No matter your vaccination status, you should get a pap test regularly.
Biopsy, CT scans, and MRI are other modalities that can help to figure out the density, spread, and nature of the lesion. Having a compromised immune system due to HIV infection or any other disease can worsen cancer. Perhaps you should be very careful about your health when your immunity is not functioning at its optimal level.
Treatment strategies
Treatment strategies for cervical cancer depend on the stage of the cancer, the patient’s overall health, and other individual factors. Here are key treatment modalities for cervical cancer:
Surgery
- Hysterectomy: Removal of the uterus is a common surgical option, especially for early-stage cervical cancer.
- Lymph Node Dissection: Removal and examination of lymph nodes in the pelvis to determine if cancer has spread.
Radiation Therapy
- External Beam Radiation: Targeted radiation from outside the body to destroy cancer cells.
- Brachytherapy: internal radiation involving the placement of radioactive sources directly into or near the tumor.
Chemotherapy
- Systemic medications are drugs that circulate throughout the body to kill cancer cells or inhibit their growth.
- Neoadjuvant chemotherapy is used to reduce malignancies before other therapies.
Targeted Therapy: Monoclonal antibodies are drugs that target specific proteins on cancer cells to interfere with their growth.
Immune Checkpoint Inhibitors: Boosting the body’s immune response to target and destroy cancer cells.
Combination Therapy: Combining surgery, radiation, and chemotherapy for comprehensive treatment.
Clinical Trials: Participation in research studies to explore new treatments and interventions.
Palliative Care: Focus on improving the quality of life through symptom management and emotional support.
Regular Monitoring: After treatment, regular check-ups and imaging are necessary to monitor for any recurrence.
The choice of treatment depends on the cancer stage, the extent of spread, and the overall health of the patient. Multiple specialists, including oncologists, surgeons, and radiation oncologists, collaborate to decide the best treatment. Patients and their doctors should examine the pros, cons, and predicted consequences of each treatment.
Conclusion
In conclusion, cervical cancer treatment must be tailored to the patient’s health and disease features. Medical advances offer early detection through testing and treatment choices such as surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy.
The emphasis on multidisciplinary collaboration underscores the complexity of cervical cancer care. Open communication with healthcare practitioners, comprehending tests, and knowing treatment options improve outcomes.
Further research, better prevention methods, and more accessible healthcare can improve cervical cancer management and lessen its impact.