Cervical cancer is the fourth most common type of cancer in women, but often goes unnoticed until it is too late, and causes thousands of deaths every year. Here’s what you can do to protect yourself from the risk.
What is cervical cancer?
It’s a type of cancer that starts in the cervix, that is, the canal connecting the uterus to the vagina. Much like other cancers, it can spread to other parts of the body, and is often present in varied ‘stages,’ or levels of advancement. There are four of these stages of cervical cancer:
- Stage I occurs when the tumorous cells remain contained within the uterus and the cervix.
- Stage II occurs when the cancer spreads to nearby areas, such as cervical tissue, but does not reach the pelvic wall.
- Stage III occurs when the cancer spreads to the abdomen, and can affect the kidney and the lymph nodes. One or both kidneys may stop functioning and may experience swelling, known as hydronephrosis.
- Stage IV involves the cancer spreading to other parts of the body, beyond the pelvic wall.
Cervical cancer most commonly occurs in those above 30 years old, and rarely in those below 20, though it can affect women of any age. Cells in the cervix mutate and multiply, which can spread throughout the body and cause harm. Two types of cervical cancer exist – squamous cell carcinoma, in the outer lining of the cervix, accounting for 70% of all cervical cancers, and adenocarcinoma, which is more difficult to diagnose, as it occurs in the upper cervix.
What causes it?
The main risk factor for cervical cancer is human papillomavirus, HPV, which over fifty per cent of people get at some point in their lives; it is transmitted through sexual activity. Typically, the virus shows no symptoms and causes no harm, leaving the body on its own, but its prolonged presence can cause cancer in the cervix. Though this risk factor cannot be prevented, many others can, including:
- Having HIV, or another disease/infection that affects the immune system and makes it difficult for the body to fight off HPV;
- Regularly using birth control pills for long periods of time, though this may reduce the risk of ovarian and uterine cancer;
- Giving birth to three or more children;
- Engaging in sexual activity with multiple people;
What can I do to reduce my risk?
The most effective method is to be administered with the HPV vaccine, increasing your immune strength to the virus. This vaccine can be taken by girls as young as 9 but is usually administered in doses from the age of 15 or 16. Regular screenings can also help recognise precancers and cancers in their early stages so that they can be cured before they become fatal. And of course, as earlier mentioned, it is also important to quit smoking and engage in protected sexual intercourse.
What are the symptoms?
Cervical cancer in its premature stages does not often show noticeable symptoms, only becoming obvious in its more advanced stages. Signs of developed cervical cancer include vaginal discharge/bleeding (including after menopause,) unusually prolonged/heavy menstruation, pelvic pain, lower back pain, and swelling in the legs. However, since these symptoms only occur in later stages, when the cancer is increasingly dangerous, it is necessary to make regular appointments with your GP or OB/GYN and be tested, especially if you are at a higher risk.
How can I be diagnosed?
Pap tests, or Pap smears, are a common test for cancerous cells. They can be regularly taken from the age of 21 to recognise precancers before they become harder to treat. If your pap test result is abnormal, your doctor may recommend a colposcopy, which is a more advanced test for cell changes. Alongside this, there is an HPV test which checks your cells for the presence of the virus. This does not recognise cancer, per se, but if you are infected with HPV it is often a good idea to go through screening as well.
If your initial test results show indications of cell mutation in the body, you may have to go through further tests as well. A colposcopy was earlier referred to and can include a biopsy, during which the doctor will examine cervix surface cells to check for changes. You may also require a pelvic examination, done under anaesthesia, or blood tests, CT scans, MRI scans, PET scans, and X-rays to identify where cancer has spread; it can affect the lungs, kidneys, uterus, and bone marrow, amongst other areas of the body. It’s incredibly critical to visit a doctor often and ensure they are testing you for cancers, such as cervical cancer, because if not diagnosed early, they can cause many further complications and are typically problematic to treat.
What are the treatment options available?
First and foremost, you should be referred to a gynecologic oncologist, who can probably suggest an ideal treatment plan for you based on the spread and stage of cancer. If recognised at a stage where the tumour is still small, you may go through a cone biopsy surgery, which will remove it from the body by cutting away the affected area of the cervix. In stages where cancer has grown larger, there may be further surgery or alternate treatments required.
- If cancer has grown, but still remains in the cervix, you may require a trachelectomy. The cervix, but not the uterus, will be removed via surgery. This means pregnancy is still a possibility, though surgery can decrease chances of conception.
- Cancer that has developed further may require a hysterectomy. The cervix, uterus, and possibly surrounding tissue will all be removed, so pregnancy is no longer possible, though cancer will be cured and potentially won’t recur.
- In the case of further spread, a bilateral salpingo-oophorectomy can be carried out. The ovaries and oviducts are also removed, again nulling the opportunity to become pregnant.
For advanced stages of cervical cancer, surgery might not be an option. Radiotherapy, chemotherapy, or a combination of both are used as treatment. Radiotherapy can be internal or external and is administered by either beam of radiation aimed at the afflicted area, or through a radioactive device being placed inside your body. Both methods use radiation energy to kill the tumour. It can cause menopause and drastically reduces the probability of conceiving. Chemotherapy is also known as chemo for short, and you have probably heard of it as it’s a common cancer treatment. It uses different chemicals either taken as pills or by injection to kill cancerous cells in the body. Both forms can be used alongside targeted drug therapy, which attacks weaknesses in cancer cells, or immunotherapy, which helps your immune system fight cancer. However, all these treatments have side effects like hair loss, fatigue, body pain, and others, so it’s always a good idea to start treatment as early as possible to remove cancer faster.
Are there complications?
As with other forms, cervical cancer can recur, especially if it is not removed through surgery, or develops to a late stage. It can be life-threatening and affects the reproductive and excretory systems even in its early stages. Depending on the form of treatment, it can take anywhere from 6 weeks to several months to recover. Premature menopause and permanent damage to your immune system are complications that typically occur.
So make sure you get tested regularly, vaccinated early, and keep yourself safe before it’s too late. Living with cervical cancer can be difficult, but with the right treatment, it’s often curable as well.
Get an expert opinion on your cancer diagnosis now! Visit www.cancerx.co.in/medical_query/.