Cervical Cancer

Cervical cancer is a disease in which cancer cells grow in the cervix. The cervix is the lower, narrow part of the uterus (womb) that connects the uterus with the vagina.

Cancer occurs when cells in the body (in this case, epithelial cervix cells lining the cervical canal) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissue and spread to other parts of the body. A benign tumor does not invade or spread.

Research suggests that some sexually transmitted viruses (eg, human papilloma virus ) can cause the nuclei in cervical cells to begin the changes that can lead to cancer.

Scientists believe several risk factors act together. These include:

• Being a woman whose mother took the drug diethylstilbestrol (DES) during pregnancy
• History of cervical dysplasia (a precancerous condition)
• Age: over 25 years old
• First pregnancy prior to age 20
• HIV/AIDS
• Infection of the cervix with the human papillomavirus (HPV)—the primary risk factor for cervical cancer
• Multiple sexual partners
• Sexual activity prior to age 18
• Smoking

Symptoms usually do not appear until the abnormal cells become cancerous. They invade nearby tissue. When this happens, the most common symptom is abnormal bleeding, which may include:

• Vaginal bleeding after menopause
• Bleeding after sexual intercourse, douching, or a pelvic exam (most common)
• Bleeding between regular menstrual periods
• Increased vaginal discharge that is not blood
• Menstrual bleeding that lasts longer and is heavier than usual

These symptoms may also be caused by other, less serious health conditions. If you experience these symptoms, see you doctor.

• Pap test—This is a test used to screen healthy women for cervical cancer. It will also detect cervical dysplasia. The doctor collects a sample of cells from the cervix to be tested.
  • If you are aged 21-29 years—It is recommended that you have the Pap test every two years.
  • If you are aged 30 or older—It is recommended that you have the Pap test every three years.
  • If you are aged 65 or older—You may be able to stop having Pap tests if you have had three normal results in a row and no abnormal results in the past 10 years.
  • Note: You will need to have Pap tests done more often if you have abnormal results or certain conditions, like a suppressed immune system or a history of cervical dysplasia or cervical cancer. Talk to your doctor about the right screening schedule for you.
• HPV test—The same cervical sample obtained from the Pap test can be tested for the HPV virus.

Tests to diagnose cervical cancer include:

• Biopsy —This is done on any suspicious areas observed during the colposcopy. The removed tissue is tested for the presence of cancer cells.
• Colposcopy —This is an exam of the vagina and cervix. The procedure uses a lighted magnifying instrument. It is needed if the Pap test suggests the presence of cervical dysplasia (precancer) or cancer.

Once cervical cancer is found, further tests are performed to find out if the cancer has spread beyond the cervix, and, if so, to what extent. This process is called staging. Treatment depends on the stage of the cancer.

Treatments include:

If you are diagnosed with cervical cancer, follow your doctor's instructions .

Finding and treating precancerous tissue in the cervix is the most effective way to prevent cervical cancer. Talk to your doctor about when you should have pelvic exams and Pap tests done. Another effective approach is to reduce your risk of exposure to the HPV virus. There are currently two methods to accomplish this:

• HPV vaccines —The vaccines protect you against some types of HPV. One vaccine, called Gardasil, is used to prevent cervical cancer by protecting against four types of HPV. Another vaccine, called Cervarix, is also approved for prevention by protecting against two HPV types. The vaccines are routinely given to girls aged 11-12 years old, and a "catch-up" vaccine is given to young women who haven't been vaccinated.
• Safe sexual practice—Limit the number of sexual partners and use latex condoms.