Cervical Cancer: Causes, Symptoms & Treatment

All you need to know about Cervical Cancer A Comprehensive Guide to Cervical Cancer Care What Every Woman Should Know About Cervical Cancer: Causes, Symptoms & Treatment. The reproductive health of women is incredibly vital to their overall well-being. Yet several women keep these issues affecting their reproductive health shrouded in secrecy, misinformation, and stigma. One such critical female reproductive health issue warranting attention is cervical cancer. This blog provides science-based insights on what fuels cervical tumour formation, warning signs and symptoms, pathways to diagnosis, therapeutic discoveries, and more. You’ll also gain perspective on life beyond cancer – including intimacy, fertility, and new beginnings after treatment.

What Causes Cervical Cancer?

• HPV Infection: Human papillomavirus infection or HPV is extremely common, and it can spread through vaginal, anal, or oral sex. In most people, the immune system eliminates the virus naturally. But in some, HPV evades the body’s defences, embedding in cervical cells. Persistent infection causes progressive cell abnormalities, eventually evolving into cancer.
• Smoking: Chemical carcinogens in cigarette smoke can damage cervical cells, making cancer more likely. Nicotine may also affect immune function, enabling HPV to linger.
• Weak Immune System: People with HIV or autoimmune disorders have increased cervical cancer risk. A compromised immune system cannot effectively fight HPV, raising the chances of chronic infection, precancerous cell changes, and tumour formation.
• Multiple Full-Term Pregnancies: Having given birth to three or more children correlates to higher incidence of cervical malignancies. Hormonal fluctuations or physical irritation of the cervix during pregnancy could promote abnormal cell growth.
• Long-Term Oral Contraceptives: Some analyses associate taking birth control pills for 5 to 10 years with elevated cervical cancer risk, possibly due to prolonged hormone exposure. 
• Becoming Sexually Active Before 18: Becoming sexual activity before the age of 18 heightens vulnerability to HPV infection. The adolescent cervix is still developing and more prone to persistent HPV colonisation. Delaying first intercourse reduces cancer risk.

Types of Cervical Cancer

  There are two main types of cervical cancer:

Squamous Cell Carcinoma: 

• Represents 80-90% of cervical cancer diagnoses. 
• Originates in flat, scale-like squamous epithelium cells lining the outer part of the cervix. 
• Tends to grow slowly and often doesn’t spread for some time, improving the chances of early detection.

Adenocarcinoma: 

• Accounts for 10-20% of the total cases. 
• Starts higher up near the opening of the uterus in the column-shaped glandular cells of the cervical canal, which produce mucus. 
• Slightly more aggressive with higher recurrence potential after treatment.

Symptoms of Cervical Cancer

Early cervical cancer and precancerous lesions frequently have no symptoms. As abnormal cells multiply silently, cancer can advance unnoticed to advanced stages. This underscores the importance of getting regular screening. Possible signs and symptoms of cervical cancer include:

Abnormal bleeding: Abnormal vaginal bleeding between menstrual periods, primarily after intercourse or menopause. 

Abnormal discharge: Watery or bloody discharge, possibly heavier than usual or with a foul odour

Pain: Pelvic pain and discomfort

Dyspareunia – pain during sexual intercourse

Dysuria – painful urination

Hematuria – blood in urine or stools

Feeling tired: Fatigue, unexplained weight loss, lack of appetite

Swelling: Swelling or edema in lower extremities

If you experience any unusual pelvic symptoms, see your gynaecologist promptly for evaluation. Don’t assume occasional minimal bleeding or discharge as normal. Investigating troubling signs as soon as possible is crucial. Cervical cancer found early while still confined to its site of origin boasts very high survival rates with proper treatment.

Diagnosing Cervical Cancer

  Doctors utilise a combination of procedures to diagnose cervical malignancies including:

• Medical History & Pelvic Exam: Your physician may ask about risk factors, your gynaecological health in general, sexual history, and any current symptoms or complaints. They’ll visually inspect your cervix for potential lesions, growths, discharge, or other visible abnormalities.
• Pap Smear Test: Cells collected from your cervix and upper vagina are scoped under a microscope for pathological changes, potentially signalling the development of cancer. Precancerous alterations are often detectable years before the actual malignancy occurs. That’s why routine Pap testing is so vital for getting ahead of cancer before it starts.
• HPV Test: DNA analysis checks cervical cells for strains of human papillomavirus connected to a majority of cervical and other genital cancers. A positive result means you harbour cancer-associated HPV types in cervical tissue.
• Colposcopy: After an abnormal Pap result, your doctor examines the cervix through a special magnifying instrument allowing very close inspection of the morphological structure. Suspicious areas are biopsied.
• Biopsy: Removing small tissue samples from visually abnormal zones of the cervix provide pathological confirmation of cancer. There are several biopsy methods.

If cancer is confirmed, your medical team may order imaging and other tests to pinpoint the extent of spread (staging), assessing prognosis and guiding treatment planning. These tests may include: 

• CT scan: Cross-sectional X-ray views of internal organs to detect tumour size and cancer infiltration into lymph nodes, lungs, liver or elsewhere.
• MRI Scan: Detailed imaging using powerful magnetic fields and radio waves defines the extent of the local tumor with precision.
• PET Scan: Injection of special contrast dye illuminating malignant tissue metabolism displays invading cancer.
• Chest X-ray: Checks lungs for cancer spread.
• Cystoscopy: A tube with a small camera is inserted through urethra into the bladder letting doctors view the surrounding area for cancer invasion.
• Proctoscopy: A lighted tube with a lens enables inspection of the rectum and sigmoid colon for cancer encroachment.
• Blood Tests: Track cancer cell blood markers and evaluate organ function.

Stages of Cervical Cancer

Cervical cancer progression involves four main stages, graded 1 to 4. Early, localised disease confined to its tissue of origin portends better outcomes compared to late stage, widely disseminated cancer harder to treat.

Stage 1: Cancer remains fully restricted to the cervix, measuring less than 4 centimetres. It hasn’t invaded deeper than 5 millimetres at this stage.

Stage 2: Tumour extends beyond the cervix to adjoining upper vagina and parametrial connective tissues but remains inside the pelvic area.

Stage 3: Cancer reaches the lower third of vagina with possible additional pelvic sidewall involvement. It may disturb kidney ureters causing kidney issues. Also, nearby lymph nodes may be affected.

Stage 4: Advanced metastatic cancer spreads extensively via bloodstream and lymph drainage to distant sites like lungs, liver, or bones. It’s also termed Stage IV or recurrent cancer. It is harder to cure but still treatable.

Treatment Options

Doctors customise cervical cancer treatment regimens based on the cancer’s stage, tumour location, patient age, pregnancy plans, and overall health status. Common components include:

• Surgery: Surgery involves removing cancerous tissue or body parts containing invasive cancer. Surgery procedures range widely in terms of invasiveness depending on needs. Common surgeries for cervical cancer treatment include:
  • Cryosurgery or Cold Knife Cone Biopsy: Freezing or excising aberrant zones on the cervix.
  • Laser Surgery: Using concentrated light beams to vaporise lesions.
  • Hysterectomy: Removing the uterus, and/or the cervix and upper vagina and supporting ligaments. Types of hysterectomy include:
    • Simple hysterectomy leaving ovaries and lymph nodes.
    • Radical hysterectomy and pelvic lymph node dissection is more extensive.
  • Trachelectomy: Removing the cervix but preserving the uterus for childbearing.
  • Pelvic Exenteration: Most radical option entailing resection of all pelvic organs including bladder and/or colon plus lymph nodes depending on degree of local cancer spread.

• Radiation Therapy: This procedure entails leveraging targeted high-energy radiation to demolish cancer cells and reduce tumour bulk. 

• External Beam Radiotherapy (EBRT): External radioactive waves

• Brachytherapy” Internal placement of radioactive implants

• Chemotherapy: Involves powerful intravenous cytotoxic drugs that kill rapidly dividing cancer cells. It is often combined with radiation therapy. 

• Targeted Drug Therapy: Involves tailored medicines to obstruct specific cervical cancer cell growth pathways.

• Immunotherapy: Harnesses the body’s own immune defences against malignancy.

Clinical trials testing the latest medical innovations may provide additional choices. Optimal long-term oversight including regular follow-up visits are vital too.

Prevention

  There are some ways by which one can prevent cervical cancer. These include: 

• Get regularly screened. Pap tests and HPV tests can detect precancerous cell changes early.
• Make sure you get the HPV vaccine. It’s recommended for ages 9 to 45 and protects against cancer-causing HPV infection.
• Use condoms as barriers for protection and lower the risk of contracting HPV.
• Avoid having multiple sexual partners. 
• Don’t smoke/use tobacco

Conclusion

Cervical cancer was once a leading cause of cancer deaths in women. Thanks to the increased awareness around this condition, screening, and vaccination, cases and mortality have declined dramatically. Still, thousands of cases of cervical cancer are reported annually.  While cured cervical cancer survivors can enjoy long productive lives, delayed diagnosis and treatment may impact areas like childbearing, bladder/bowel function, and sexuality.

Doctors can help manage these issues proactively. Staying vigilant with follow-up care is key too. Women coping with cervical cancer have more reasons for hope now than ever before. Advancements in risk stratification, screening, diagnosis, tumour characterization, precision therapies and supportive care promise even better outcomes ahead.