The most aggressive form of cervical cancer is small cell cervical cancer
- It usually affects less than 3 in every 100 (3%) women diagnosed with cervical cancer.
- Cancer develops in cells within the neuroendocrine system in the body, which is a system made up of gland and nerve cells. The name ‘small cell’ describes the way these cancer cells look under the microscope. Usually, they are small with an enlarged nucleus (the part of the cell that contains the genetic material).
- There is some evidence that like other types of cervical cancer, it may be linked with infection with high-risk human papillomavirus (HPV) in some cases.
- Small cell cervical cancer can also be found in combination with other more common forms of cervical cancer, such as squamous cell carcinoma and adenocarcinoma. However, small cell cervical cancer grows faster and is more aggressive than other types of cervical cancer.
Apart from small cell cervical cancer, HPV-negative cervical cancer is more aggressive but is rare. Such cervical cancers are more frequently diagnosed at advanced stages, with more metastasis and reduced survival.
What are the symptoms of small cell cervical cancer?
Usually, small cell cervical cancer always presents some symptoms. Below are a few common symptoms seen in patients with small cell cervical cancer:
- Unusual vaginal bleeding: during or after sexual intercourse or between periods
- Postmenopausal vaginal bleeding
- Unusual vaginal discharge
- Discomfort or pain during sex
- Lower back pain
How is small cell cervical cancer diagnosed?
Many cervical tumors are found as abnormal findings in Pap smears, but many women have normal Pap smears up until the tumor is found. Pap smears are designed to detect premalignant disease. As small cell does not have a known premalignant state, Pap tests often do not detect them. Most cases are diagnosed because of symptoms or a gynecologist notices an abnormal-appearing cervix on a microscopic exam (colposcopy) and performs biopsy of it.
How is small cell cervical cancer treated?
Similar to other forms of cervical cancer, the exact treatment pathway depends on the extent of cancer. Small cell cervical cancer is treated more aggressively as it involves more chemotherapy than more common types of cervical cancer. It also usually involves a combination of both radiotherapy and chemotherapy. Chemotherapy is often given before and after radiotherapy treatment; it may also be given during radiotherapy to increase the effectiveness of the therapy. Surgery may also be performed if the cancer is considered operable.
What is the outlook of small cell cervical cancer?
Patients with small cell neuroendocrine cervical cancer have a poor outcome. Their course is frequently characterized by the development of widespread metastasis and recurrence. Brain metastases and lung metastases are also seen in such rare types of cancer.