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Cervical cancer is a type of cancer that occurs in the cells of the cervix (mouth of the uterus that opens in the vagina).
Cervical cancer is a type of cancer that occurs in the cells of the cervix (mouth of the uterus that opens in the vagina). This cancer can affect the deeper tissues of the uterus and may spread to other parts of the body, which are often the lungs, liver, bladder, vagina and rectum.
In the early stages, cervical cancer may have no symptoms. A few common early signs and symptoms of cervical cancer are
- Vaginal bleeding or spotting (either after intercourse, between periods, or post-menopause)
- Pain during intercourse
- Abnormal vaginal discharge (heavy or with a foul odor)
- Continuous vaginal discharge that is pale, pink, or watery
- Lower abdominal pain
- Lower back pain
- Pain and swelling in the legs
- Unexplained weight loss
- Decreased appetite
Advanced cervical cancer is very uncommon. Its symptoms are
- Excessive tiredness
- Severe constipation and feeling of the presence of stools despite evacuating the bowel
- Leaking of urine or feces from the vagina
- Bone pain and fractures with minor trauma
- Kidney dysfunction
- Generalized body pains with weakness
Although these symptoms can also be caused by other conditions or medicines, it is very important to rule out cervical cancer, especially in high-risk women.
How can you get cervical cancer?
One of the strongest risk factors for cervical cancer is the infection with human papillomavirus (HPV). HPV is a sexually transmitted infection and asymptomatic in most people. In a small percentage of people, the virus survives for years, contributing to the process that causes some cervical cells to become cancer cells. A few common risk factors that can trigger cervical cancer in HPV infected individuals are
- Having sex before the age of 16 years or within a year of starting period
- Multiple sexual partners
- Smokers
- Weakened immune system (human immunodeficiency virus or HIV infected patients, transplant recipients)
- Exposure to sexually transmitted diseases (STDs)
What are the different stages and types of cervical cancer?
Five main stages of cervical cancer are
- Stage 0: Abnormal cells in the innermost lining of the cervix may become cancerous.
- Stage I: Cancer is in the cervix only.
- Stage II: Cancer is beyond the cervix, but it is not in the pelvic wall or the lower third of the vagina.
- Stage III: Cancer is in the lower third of the vagina or the pelvic wall. Cancer may be causing problems in the kidneys.
- Stage IV: Cancer has spread past the pelvis, and it is in the lining of the bladder, rectum, or distant organs, such as the lymph nodes, lungs, liver or bone.
With regular screening and early diagnosis, most cervical cancers can be detected in time. Three main types of cervical cancer are:
- Squamous cell carcinoma (cancer) develops in the lining of the cervix. It is found in 80 to 90 percent of cervical cancer cases.
- Adenocarcinoma is a cancerous tumor that develops in the cells that produce mucus in the cervix. Approximately 10 to 20 percent of cervical cancers are adenocarcinomas.
- Adenosquamous or mixed carcinoma (cancer) involves both adenocarcinoma and squamous cell carcinoma.
Other types of cancer may be found in the cervix, including neuroendocrine, melanoma, sarcoma and lymphoma; however, these are rare.
How cervical cancer is usually treated
Cervical cancer is usually treated using the following methods:
- Surgery: If the cancer is only limited to the surface of the cervix, the doctor may remove the cancerous cells with procedures, such as LEEP (loop electrosurgical excision) or cold knife conization. If cancerous cells have passed through a layer called the basement membrane (which separates the surface of the cervix from underlying layers), the patient may need invasive surgery. If the disease has invaded deeper layers of the cervix but has not spread to other parts of the body, the doctor may recommend surgery to take out the tumor. If it is spread into the uterus, the doctor will probably recommend a hysterectomy (removing the entire uterus to decrease the chances of cancer spread).
- Radiation therapy (or radiotherapy): It uses high-energy X-rays to damage cancer cells and stop their growth. Sometimes, a small capsule containing radioactive material is placed in the cervix. The implant puts cancer-killing rays close to the tumor while sparing most of the healthy tissue around it.
- Chemotherapy: It uses powerful drugs to kill cancer cells. Doctors often use it for cervical cancer that has locally advanced when the cancer has a high chance to spread to other parts of the body.
- Biological therapy or immunotherapy: This targets checkpoints in the immune cells that are turned on or off to set off an immune response. A medicine called Keytruda (pembrolizumab) blocks a protein on the cells to shrink tumors or slow their growth. Doctors use it if chemo isn’t working or if the cancer has begun to spread.