Cervical cancer is a strain of cancer that specifically attacks the woman’s cervix area. Although it was hoped that this aggressive form of cancer was being battled with some success, it is now recognised as one of the biggest killers of women in the world. In India alone, more than 62,000 women lost their lives to cervical cancer in 2016. According to the Indian Council of Medical Research, this is almost a quarter of the total cancer deaths in India. Although breast cancer is officially the largest cause of cancer deaths amongst woman on the worldwide stage, cervical cancer is running a very close second. However, these trends can change and this article takes a closer look at cervical cancer and the symptoms, causes, treatment and possible prevention. If you read this content and feel at any point that you may be at risk of cervical cancer, please do not hesitate to contact your family doctor as soon as possible.
Symptoms of cervical cancer
Unlike many forms of cancer, cervical cancer is almost without symptoms until it reaches the advanced stages. When this form of cancer does reach the advanced stages, it can be sometimes too late for any effective treatment. However, it can show itself by some form of vaginal bleeding during or after sexual intercourse. Sometimes, the patient will also experience some vaginal discharge and this can be somewhat excessive. For those women who are in the menopause stage of life, bleeding may occur and this in itself should be sounding the alarm bells. Lower back twinges may start to appear along with unusual pain and discomfort during sexual intercourse. If you have had any of these symptoms recently and for no particular reason, we advise you to seek out a second opinion from your family doctor or clinic. The sooner that cervical cancer has been diagnosed and treated, the higher chance there is of a successful outcome for the patient. As with most forms of cancer, it is also possible that the symptoms include excessive tiredness and unexplained pain around your body. But usually, any form of heavy vaginal bleeding will point towards the possibility of cervical cancer and just be on the lookout for this and the other symptoms that we have discussed here.
Diagnosis of cervical cancer
Early and successful identification of any form of cancer is crucial as far as survival is concerned and that is certainly the case here. There are a number of tests that are carried out to diagnose this form of cancer and they are usually run in a particular order as follows:
- Pelvic examination – This form of diagnosis typically involves the specialist having a visual examination of the patient’s pelvis area. Usually the medical professional will be either a gynaecologist or a GP. The results of this test will decide what happens next and usually a cervical smear and a bimanual examination will be undertaken. The cervical smear test involves a small brush-like device being scraped across the surface of the cervix and the resulting cells are sent off to a laboratory for testing. The bimanual examination involves the doctor using his or her fingers to look or feel for any potential abnormalities in the vaginal area.
- Colposcopy – This medical procedure is carried out using a specialist instrument that allows the doctor to take a much closer look at the cervix. The colposcope resembles a small pair of binoculars and these effectively magnify the subject matter in a way that allows us to examine the results. The doctor will also apply a substance that will turn any unhealthy surface into a white colour. These areas are then removed in a safe way that allows for further examination at a later date. The resulting biopsy usually takes place with 2 or 3 days and the results are then discussed before any further tests take place.
- Cone biopsy – If there are abnormal cells diagnosed form the results of the previous biopsy, usually a cone biopsy is the next stage. This typically involves a cone-shaped piece of tissue being removed from the cervix area of the patient. General or local anaesthetic is part of the procedure and the resulting test will usually be carried out within one week.
More tests are part of the process if it has been decided that cervical cancer has been diagnosed, the following tests are also carried out:
- Bone scan
- Ultrasound scan
- Computed tomography scan
- MRI scan
- Positron emission tomography scan
Causes of cervical cancer
As with most types of cancer, there are a number of recognised cause of this particular strain and some are more familiar than others:
- Sexual activity – This seems to be one common denominator in women that develop cervical cancer because it is extremely rare amongst those who have never had sexual intercourse. The human papillomavirus, known as HPV, causes cervical cancer and this common viral infection affects almost 80% of women during their lives. Most will clear themselves but certain types carry a high risk of the carrier being able to develop cervical cancer. Women who typically have multiple sexual partners are putting themselves at a higher risk of being exposed to cervical cancer.
- Smoking – You may be surprised to learn that the old enemy is back again and causing thousands of women’s deaths by cervical cancer. This is because of the way that heavy smoking affects our health in such a negative way. It’s not only lung cancer that we risk developing so why do so many young and not so young people put their very lives at risk?
- DES – Diethylstilboestrol was a drug that was given to pregnant women during the 1970’s and it was originally given to reduce that chances of miscarriage. The daughters of these women are at an increased risk of developing cervical cancer and this is due to a weakened immune system.
Treatment of cervical cancer
Okay, so we have discussed the symptoms and potential causes of cervical cancer, now let’s look at how those who have developed this disease can possibly treat it with a successful outcome. As with any type of cancer, the very best chance of survival comes with early diagnosis and the actual age and health status of the patient. Treatment involves a mixture of chemotherapy, surgery and radiotherapy, usually a combination of all three:
- Early treatment – If the diagnosis is early enough then the treatment will be decided by the medical team at the time. Cone biopsy is used once more and this involves the potential removal of all of the cancer cells. Laser surgery can also be an effective treatment of cervical cancer as the laser is used in a similar way to a knife. The light actually destroys the cancerous cells in a painful yet effective way. Cryosurgery is almost the opposite and it essentially freezes the affected cells whilst destroying them at the same time. Large loop excision involves an electrical charge that destroys the cancerous cells and will also need a local anaesthetic for this somewhat painful procedure.
- Surgical Treatment – This is usually required when cancer has spread somewhat and will involve the removal of some part pf the female reproductive organs. The trachelectomy is when the cervix is totally removed, leaving just the uterus behind. This is usually offered when the patient is a young woman and this allows her the real possibility of bearing children at a later stage in life should the cancer be removed successfully. Hysterectomy is typically the recommended treatment when cervical cancer hasn’t actually spread past the pelvic area. The total hysterectomy involves the removal of the uterus and cervix whilst the radical hysterectomy is when the uterus, cervix and the upper part of the vagina are removed. The pelvic lymph nodes are sometimes removed to avoid further spreading and will usually be part and parcel of the radical hysterectomy operation. Recovery from these operations will depend on the age and health of the patient.
- Other treatments – These are a combination of radiotherapy and chemotherapy and are used when it cervical cancer has spread to other parts of the patient’s body. Both of these treatments involve large machines that target and destroy the cancer cells. Side effects can be serious and it has been known to leave the patient sterile after treatment has been completed. Hair loss, fatigue, nausea and alterations to the menstrual cycle are also known side effects.
Prevention of cervical cancer
Prevention is always better than any cure and as far as cervical cancer is concerned, that is certainly the case. Of course, living a healthy life and avoiding smoking and obesity are two rules that apply here, but there are also some other ways that should be noted:
- Cervical screening tests – These are now fairly common and in some countries, are carried out as a routine for all women aged between 20 and 70. They can spot the early stages of cervical cancer and have saved countless lives since their introduction. They involve a simple cervical smear test that is examined for any signs of abnormality. These are recommended every two or three years and should be on offer to all women in that particular age group. As mentioned before, cervical cancer is extremely rare in women that have never had sexual intercourse. When examining the result of the cervical smear, the specialist is looking for abnormal cells that have the potential to develop into cancer. These are known as dysplasia and treatment is needed before they can develop further.
- HPV Vaccine – although only currently available in New Zealand, HPV vaccine targets the main 4 infections that can lead to cervical cancer. Offered to women aged between 9 and 45 years, this vaccine is also offered to males in the same age group as it deals with infections that also affect their sexual health conditions.
We hope that this short article was useful to you and if you feel as if you need more information about cervical cancer, please speak to a doctor. Cervical cancer is still one of the biggest killers of women in India so please don’t be a statistic and get some advice now.