Cervical Cancer

Cervical Cancer at a glance

• Cervical cancer, the uncontrolled growth of cells, begins in the cells lining the cervix, which is the lower part of the uterus.
• According to the American Cancer Society, more than 13,000 women will be diagnosed with cervical cancer this year, most often in women over the age of 30.
• Most cervical cancers are caused by the human papillomavirus (HPV) acquired through sexual activity and can be prevented by the HPV vaccine, though many people choose not to get it.
• Cervical cancer, if diagnosed early, is highly treatable by surgery, chemotherapy or radiation.

What is cervical cancer?

Cervical cancer starts in the cells lining the cervix, the lower part of the uterus. The cervix connects the uterus to the vagina. In this area, there are two types of cells, glandular and squamous. These cells meet in an area of the cervix known as the transformation zone. This zone is where most cervical cancers develop.

The affected cells in the transformation zone do not immediately become cancerous. They instead develop into pre-cancerous cells, which can be detected by Pap smears and treated to prevent the cells from becoming cancerous. This means cervical cancer is preventable and treatable.

There are two main types of cervical cancer.

• Most cervical cancers are squamous cell carcinomas. This type of cancer affects the squamous cells that line the outer part of the cervix and protect the vagina.
• Adenocarcinoma cervical cancer develops in the glandular cells that line the cervical canal.

There are also cancers caused by a combination of these two types.

Causes and risk factors of cervical cancer

HPV

The main cause of cervical cancer is human papillomavirus (HPV). According to the Centers for Disease Control and Prevention, HPV is the cause of almost all cervical cancers. HPV is the term for a number of related viruses, most of which cause warts to develop on the skin including the hands, chest, feet and arms.

• Low-risk HPV can cause these warts on or around the genitals. They rarely cause cancer.
• High-risk HPV include HPV 16 and 18. These types of HPV can cause cancer in both women and men. The pre-cancerous cells linked to HPV 16 and 18 are more likely to grow to become cancer.

While there is no complete prevention, there are options to help lower the chances of infection. This includes using condoms, limiting sexual partners and getting the HPV vaccine. The vaccine can prevent HPV infection and works best when administered at or before age 11 or 12, but can be administered to women up to age 26 and men until age 21.

According to the CDC, the HPV vaccine is extremely effective with close to a 100 percent prevention rate in clinical trials. Since 2006, there has been a significant decrease in HPV infections in teen girls in the U.S. This is currently the only vaccine which is proven to prevent cancer.

Human papillomavirus infections are very common and contracted through skin-to-skin contact, typically during sex. The American Cancer Society has found that most men and women who have had sex will get a form of HPV at some point in their lives, though not necessarily types 16 and 18. Most of these infections will not develop into cancer. Smoking and HIV infections can increase the chances of HPV becoming cervical cancer.

Smoking

Women who smoke are almost twice as likely to develop cervical cancer than nonsmokers. Chemicals in cigarettes may damage the DNA of the cervix thus increasing the risk of cancer. Smoking also diminishes the immune system.

Weak immune system

Women being treated for an autoimmune disease or who have received an organ transplant are at a risk for cervical cancer due to the medication prescribed to suppress their immune response. Those with HIV (human immunodeficiency virus) also have compromised immune systems, which could cause pre-cancerous cells in the cervix to develop into cancer at a faster rate.

Oral birth control

Taking oral contraceptives for a long amount of time can increase the risk of cervical cancer. This risk can be mitigated by finding an alternative birth control method.

Multiple pregnancies

Those who have had three or more full-term pregnancies have an increased risk of developing this type of cancer. The reason for this is unclear.

Cervical cancer symptoms and signs

Cervical cancer often presents no signs or symptoms in the early stages. The symptoms typically do not appear until the cancer has spread into nearby tissue.

The most common symptoms are:

• Unusual discharge from the vagina that may be watery, bloody or foul smelling.
• Abnormal vaginal bleeding, including
  • Bleeding after sex.
  • Bleeding or spotting between periods.
  • Bleeding after menopause.
• Pain during or after intercourse.
• Pelvic pain.

Because these symptoms can also be associated with conditions not related to cervical cancer, it is important to see a doctor if any of these symptoms manifest.

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Diagnosis and treatment

Cervical cancer is often diagnosed by using a biopsy, an examination of tissue, or endocervical curettage, a procedure during which a small, spoon-shaped instrument is used to scape a tissue sample from the cervix. This is then examined under a microscope to identify if the cells are normal, pre-cancerous or cancerous.

Treatment for cervical cancer depends on the severity of the cancer as well as any other health complications. Typically, this type of cancer is treated through surgery, chemotherapy, radiation or a combination of the three.

Surgery

A hysterectomy, the removal of the uterus, is often the treatment method for early-stage cervical cancer. Hysterectomy options include removing the cervix and uterus, known as a simple hysterectomy, or removing the cervix, uterus, lymph nodes and part of the vagina, known as a radical hysterectomy.

This treatment option makes it impossible to become pregnant.

Chemotherapy

Chemotherapy kills cancer cells through the administration of medication, typically injected into a vein. Chemotherapy is often combined with radiation therapy.

Radiation

This type of treatment uses high-powered energy beams to kill cancer cells. Radiation may be administered externally, through directing a beam to the affected area, or internally, by placing a device filled with radioactive material inside the vagina.