Understanding Cervical Cancer: Key Information And Insights

Introduction 

Cervical cancer ranks as the fourth most common cancer among women worldwide, developing in the cervix (the entrance to the uterus from the vagina). HPV (Human Papillomavirus) commonly causes cervical cancer and often transmits through sexual contact. In 2022, doctors diagnosed an estimated 660,000 women with cervical cancer, and about 350,000 of them died from the disease globally.

However, it is completely treatable when diagnosed early, so for early diagnosis it is very important to know the cause, symptoms, risk factors, prevention approaches and treatment options. 

Source : Deep AI

From Causes to Risks: What You Need to Know?

• CAUSES  

 HPV (Human Papillomavirus) includes more than 200 related viruses. It ranks as the most common sexually transmitted infection (STI) worldwide. Not only does HPV cause cervical cancer, but it also leads to head and neck cancer, as well as genital warts in both men and women. Specifically, HPV types 16 and 18 are responsible for cervical cancer.

• RISK-FACTORS 

There are number of risk-factors that contributes, such as-

1. Non-sexual contact: HPV can take entry through cuts and wounds.
2. Family History: If any close family member had a history of cervical cancer then it indicates a genetic predisposition.
3. Contaminated Surfaces: Sharing towels, napkins, clothes and razors can be the reason for getting the infection.
4. Smoking: Cigarettes contain tobacco that have carcinogens which damages the DNA of cervical cells and increase the risk of cervical cancer.
5. Vertical Transmission: During childbirth, mothers can pass the HPV infection to their babies.
6. Pregnancy at an Early age: Engaging with sexual activity at an early age and getting pregnant may increase the risk.
7. Unprotected Intercourse: Having sexual activities or indulging with multiple sexual partners without barrier protection (eg. Condom) increases the risk of cervical cancer.
8. Long-term Oral Contraceptives: Prolonged use i.e.,(around 5+years) of oral contraceptive pills can increase your risk .
9. Weak Immune System: Individuals with weakened immune systems, including those with HIV/AIDS or on immuno-suppressive medications (used to lower immunity to manage certain autoimmune diseases), are at higher risk.
10. Lack of HPV Vaccinations: It is one of the reasons individuals get vulnerable to higher risks of HPV infections.

Symptoms to Check and an Early Detection for Better Prognosis

• SYMPTOMS 

It usually doesn’t show symptoms early that makes it difficult to detect. Symptoms usually appear when cancer has spread.

• When symptoms of early-stage cervical cancer appears it includes –

1. Vaginal Bleeding: Between periods or periods that are longer/heavier than normal, after sex and after menopause.
2. Vaginal Discharge: It is watery and has a strong odour and sometimes contains blood.
3. Pelvic pain or pain during sex.

• When symptoms of advanced-stage cervical cancer appears it includes –

1. Difficult / painful urination or blood in urine.
2. Abdominal pain.
3. Difficulty in bowel movement / bleeding from rectum during bowel movement.
4. Dull back-pain.
5. Swelling of legs.

If you notice 2 or more of these symptoms, seek professional help from a gynaecologist to ensure timely treatment and prevent potential complications.

• EARLY DETECTION 

Early detection helps to identify cervical cancer early and decrease its mortality and morbidity rate. There are many screening tests such as Pap- smear test, HPV test and VIA test that can help you to detect the disease and prevent it at its earliest.

Source: Canva

Staging and Diagnosis of Cervical cancer

• STAGING OF CERVICAL CANCER  A Cancer stage describes the extent of cancer in the body.
• STAGE-I: Cancer forms in only the cervix.
• STAGE-II: Cervical cancer has spread to the upper two- third of vagina or tissue around the uterus.
• STAGE-III: It has spread to the lower third of vagina or to the pelvic wall, involves lymph nodes and sometimes it causes kidney problems.
• STAGE-IV: It has spread beyond the pelvis or to the lining of the bladder / rectum or it has spread to other body parts (metastasis).

• DIAGNOSIS OF CERVICAL CANCER  

1. A physical examination and blood tests.
2. Colposcopy: It is a procedure to closely examine the cervix, vagina and vulva for signs of disease.
3. Biopsies including a loop excision of transformation zone (LLETZ) or cone biopsy.

Prevention of Cervical cancer

It is highly preventable and treatable if detected early.

• HPV Vaccination 

The vaccine safely and effectively decreases the risk of infection. The FDA recommends Gardasil-9 for females and males aged 9-45 years in the U.S.

The vaccine works best when administered before a person becomes sexually active. However, sexually active individuals may still benefit as it protects against HPV types they haven’t been exposed to yet.

• Safe-sexual practice 

Condoms, which prevent many sexually transmitted diseases, can lower the risk of HPV transmission as well. Condoms aren’t for complete prevention from it, there is a possibility that you can get exposure from areas which condom not covers.

• Regular Screening 

 HPV vaccine doesn’t protect against all HPV types that can cause cervical cancer, getting screening at regular intervals can help to prevent the burden of it.

   Treatments

• Surgery 

Performs under anaesthesia to remove cancerous parts of the body that keeps the potential to spread to other parts of the body.

• Radiation Therapy 

 Use high x-rays or other radiations to kill cancer cells or stop them to cause further damage.

• Chemotherapy 

 Uses drugs to stop growth of cancer cells, either it kills the cells or stops them from dividing.

• Target Therapy 

 Uses drugs/other substances to block the action of specific enzymes or proteins, involves in the growth and spread of cancer cells

• Immunotherapy 

 It helps a person’s immune system to fight cancer. Some biomarkers tests predict response from the immune system for certain immunotherapy drugs.

Conclusion

Early detection and prevention of cervical cancer through screening and HPV vaccination are crucial. Regular check-ups and safe practices can significantly reduce the risk and ensure timely treatment.

References

1.  https://www.who.int/health-topics/cervical-cancer#tab=tab_1
2. https://www.cancer.gov/types/cervical/symptoms
3. https://pmc.ncbi.nlm.nih.gov/articles/PMC9735321/
4. https://www.cancer.gov/types/cervical/causes-risk-prevention
5. https://www.cancer.gov/types/cervical/treatment