What is Cervical Cancer?

Cervical cancer develops when abnormal cells on the cervix grow uncontrollably. The cervix, being the gateway between the uterus and the vagina, plays a crucial role in female reproductive health. There are two main types of cervical cancer: squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma begins in the thin, flat cells lining the outer part of the cervix, which projects into the vagina. Adenocarcinoma starts in the column-shaped glandular cells that line the cervical canal.

Statistics

Globally, cervical cancer is the fourth most common cancer among women, with an estimated 604,000 new cases and 342,000 deaths in 2020 alone . In India, cervical cancer is the second most common cancer in women, after breast cancer, with around 123,000 new cases and 67,000 deaths annually. The high incidence in developing countries is largely due to limited access to screening and vaccination programs.

Symptoms of Cervical Cancer

Cervical cancer may not produce noticeable symptoms in its early stages, which is why regular screening is essential. As the disease progresses, the following symptoms may manifest:

1. Abnormal Vaginal Bleeding

One of the most common symptoms is unusual bleeding, such as bleeding after intercourse, between menstrual periods, or after menopause. This symptom is often a red flag and should prompt immediate medical consultation.

2. Unusual Vaginal Discharge

A watery, bloody discharge that may be heavy and have a foul odor can be a sign of cervical cancer. Changes in the nature, color, or odor of vaginal discharge should be reported to a healthcare provider.

3. Pain During Intercourse

Pain or discomfort during sexual intercourse, known as dyspareunia, can be indicative of cervical cancer. This symptom warrants medical evaluation, as it may be linked to abnormal changes in the cervical cells.

4. Pelvic Pain

Persistent pelvic pain, unrelated to menstrual cycles, can be a symptom of cervical cancer. This pain might be constant or intermittent and can range from mild to severe .

5. Urinary Symptoms

Advanced cervical cancer can press against the bladder, causing symptoms such as frequent urination, painful urination, or difficulty emptying the bladder. Any significant changes in urinary habits should be discussed with a healthcare provider.

Causes of Cervical Cancer

Cervical cancer primarily develops due to changes in the DNA of cervical cells, often triggered by infection with the human papillomavirus (HPV). Understanding the causes can aid in prevention and early detection.

1. Human Papillomavirus (HPV) Infection

HPV is the most significant risk factor for cervical cancer. It is a group of more than 150 related viruses, with certain strains like HPV-16 and HPV-18 being highly associated with cervical cancer. HPV is typically transmitted through sexual contact.

2. Multiple Sexual Partner

Multiple sexual partners and especially unprotected intercourse is a major risk factor for Cervical cancer.

3. Smoking

Smoking has been linked to cervical cancer as it weakens the immune system’s ability to fight HPV infections. Carcinogens from tobacco can also affect the DNA of cervical cells, leading to cancerous changes.

4. Immunosuppression

Women with weakened immune systems, such as those with HIV/AIDS, are at a higher risk of developing cervical cancer. A compromised immune system is less effective at fighting off infections, including HPV.

5. Long-term Use of Oral Contraceptives

Long-term use (five years or more) of oral contraceptives has been linked to an increased risk of cervical cancer. The risk declines after stopping the pill.

6. Multiple Full-term Pregnancies

Women who have had three or more full-term pregnancies have an increased risk of developing cervical cancer. It may be due to hormonal changes and immune system suppression during pregnancy.

7. Early Sexual Activity

Starting sexual activity at a young age increases the risk of HPV infection, which in turn raises the risk of cervical cancer. The more partners one has, the greater the risk of HPV infection.

8. Other Sexually Transmitted Infections (STIs)

Other STIs, such as chlamydia, gonorrhoea, syphilis, and HIV, can increase the risk of cervical cancer. These infections may weaken the immune system, making it harder for the body to fight HPV.

Prevention and Early Detection

Preventing cervical cancer involves reducing risk factors and increasing protective measures. Early detection through regular screenings significantly improves treatment outcomes.

1. HPV Vaccination

The HPV vaccine is highly effective in preventing infection with the high-risk HPV strains most commonly associated with cervical cancer. The vaccine is recommended for preteens but can also be administered to young adults. Vaccination has led to a significant reduction in the incidence of cervical cancer in populations with high vaccination rates.

2. Regular Screening

Regular Pap tests (Pap smears) and HPV tests are critical for early detection of precancerous changes in the cervix. Early treatment of these changes can prevent cervical cancer from developing. Women are advised to start screening at age 21 and continue at regular intervals as recommended by their healthcare provider.

3. Safe Sexual Practices

Using condoms and limiting the number of sexual partners can reduce the risk of HPV infection. Safe sexual practices are essential for preventing HPV and other STIs.

4. Quitting Smoking

Quitting smoking can significantly reduce the risk of cervical cancer. Support and resources are available for those looking to quit, including counselling and smoking cessation programs.

Advances in Treatment

The treatment for cervical cancer depends on various factors, including the stage of cancer, the size of the tumour, and the patient’s overall health. Treatments may include surgery, radiation therapy, chemotherapy, or a combination.

1. Surgery

Surgical options range from local excision procedures to more extensive surgeries like hysterectomy, which involves the removal of the uterus. In the early stages, less invasive procedures such as loop electrosurgical excision procedure (LEEP) or conization can be effective.

2. Radiation Therapy

Radiation therapy uses high-energy X-rays or other particles to destroy cancer cells. It can be used alone or in combination with chemotherapy, especially for more advanced stages of cervical cancer.

3. Chemotherapy

Chemotherapy involves the use of drugs to kill cancer cells. It can be administered orally or intravenously and is often used in conjunction with radiation therapy to enhance its effectiveness.

4. Targeted Therapy

Targeted therapy uses drugs or other substances to precisely identify and attack cancer cells, usually while doing minor damage to normal cells. This type of therapy is a newer approach and is used in some advanced cases of cervical cancer.

Coping with Cervical Cancer

Being diagnosed with cervical cancer can be overwhelming, and patients need to seek support and take steps to manage their emotional and physical health during treatment.

1. Emotional Support

Support from family, friends, and healthcare professionals is crucial. Joining support groups where patients can share experiences and advice can also be very helpful.

2. Maintaining Physical Health

Maintaining a healthy diet, staying active, and getting adequate rest can improve the overall well-being of patients undergoing treatment. Managing side effects through medication and lifestyle changes can also enhance the quality of life during this challenging period.

3. Financial Planning

Cancer treatment can be expensive, and planning for the financial aspects of care is crucial. Patients should explore insurance coverage options and seek assistance from organisations that provide financial aid for cancer patients.

Conclusion

Cervical cancer remains a significant public health issue, but increased awareness, regular screening, and preventive measures like HPV vaccination can significantly reduce the incidence and mortality rates of this disease. Early detection through routine screening is vital for successful treatment and better outcomes. If you experience any symptoms or fall into high-risk categories, consult your healthcare provider for advice and appropriate screening.

Book an Appointment

For more detailed information and support, consider reaching out to healthcare providers and organisations dedicated to cancer prevention and treatment. Empower yourself with knowledge and take proactive steps to safeguard your health against cervical cancer.