Cervical cancer (cancer of the cervix) is a disease in which malignant cells develop in the cervix. The cervix is the narrow end of the uterus. It has a small opening to the vagina, which allows passage of menstrual blood. Besides that fact that it allows passage of menstrual blood, the cervix acts as a barrier and has an important role in preventing uterine infections (preventing infection penetration into the uterus). The cervix plays an important role during birth, when opening, allowing the baby to be born. Cervical cancer the most common form of cancer in young women.
Cervical Cancer Causes
Cervical cancer is caused by cellular abnormalities that occur in the cervix. Initially, cellular outgrowth occurs in the cervix, and this is because the area is subject to constantly cyclical changes , depending on the period. In this physiological process, chances are that the cells suffer mutations , favoring the appearance of abnormal developed cells.
Human Papiloma Virus. There are more than 100 types of human papilloma virus, of which about 30 can be the cause of genital infections. While some viruses are responsible for genital warts, others can be blamed for the occurrence of cervical cancer or other genital cancers. Other types of HPV can cause warts in other parts of the body.
Some experts say that most women and men sexually active will contact the human papiloma virus at some point in their life. The most disturbing fact is that human papiloma virus infection most often does not cause symptoms. In most cases, however, the body has the ability to destroy the infection within two years of exposure to HPV.
Cervical Cencer Risk Factors
The following are considered risk factors for cervical cancer:
- Papilloma virus or HPV infection
- Chronic infection with Chlamydia
- Long term administration of oral contraceptives
- Multiple pregnancy
- Treatment with drugs containing diethylstilbestrol (DES)
- History of cervical cancer in the family.
Infection with human papilloma virus is the most important risk factor by far. There are over 80 identified strains of HPV . Human papilloma virus types 16 and 18 are responsible for cervical cancer in 70% of the cases. But not all women infected with the virus will develop cervical cancer.
Cervical Cancer Symptoms
Signs of cervical cancer may include:
- Abnormal vaginal bleeding
- Bleeding that occurred after intercourse
- Unusual vaginal discharge
- Pelvic pain
In advanced cervical cancer, symptoms change as follows:
- Anemia due to uncontrollable blood loss
- Pelvic pain occurs, lower limb or lumbar pain
- Abnormal communication between the vagina and rectum, a condition called vaginal fistula. This is due the cancer expansion to the adjacent tissues.
- Weight loss (several pounds in a few weeks, months)
Once you start to experience these symptoms, the wisest thing to do is a gynecological exam:
- Peristant pelvic pain
- Heavy menstruation or prolonged menstruation
- Bleeding between periods
- Pain during intercourse
- Difficulty in urination
- Vaginal bleeding or pelvic pain that occurs suddenly and intense should never be overlooked
Cervical Cancer Diagnosis
The Pap test is generally recommend to women older than 35 years, but for an early diagnosis, any woman, regardless of age, must do this test at least once a year (ideal – each 6 months). The Pap test, or in other words, cyto-vaginal exam, consists of microscopic analysis of cells from the vaginal secretion. This test can detect any changes in vaginal mucosa and can detect malignant (cancerous) changes and even different types of infections and diseases such as candida or trichomonas infection. Colposcopic guided biopsy and in some cases endocervical curettage seal the cervical cancer diagnosis.
Diagnosis of invasive lesions: visible (macroscopic) lesions of the cervix are biopsied ,possibly endocervical curettage is done and if the lesion extends into the cervical canal, microscopic examination of the excised material sets the malignancy diagnosis. After the malignancy confirmation, pre-therapeutic evaluation of the case is required along with other investigations: normal examinations (chest radiography, blood tests, ECG) and other complementary tests useful for assessing disease extension:
- Abdominal-pelvic computed tomography,
- Cystoscopy or possibly rectoscopy (examination of the rectum using an endoscope) if invasion of neighboring organs is suspected.
Cervical Cancer Treatment
Treatment depends on the stage and evolution of cervical cancer lesions. In simple precancerous stages abnormal tissue is destroyed by laser surgery, by refrigeration or electricity. In precancerous stage (severe dysplasia), surgery is needed (conization)- consists of removal of a portion of the cervix. In more advanced stages of cancer (invasive cancer), cancer treatment depends on the stage extension. Surgery, radiotherapy and possibly chemotherapy, alone or combined, depending on the situation will be required.