Cervical Cancer

Overview

  • Cervical cancer begins in the cervix, the narrow organ at the bottom of the uterus that connects to the vagina. The cervix dilates during childbirth to allow for passage of a baby.
  • Infection of the cervix with human papillomavirus (HPV) is the most common cause of cervical cancer. However, not all women with an HPV infection will develop cervical cancer.
  • The early stages of cervical cancer usually do not have any symptoms. This is why it is important to have screening Pap tests.
  • As a tumor grows in size, it can produce a variety of symptoms including: abnormal bleeding (including bleeding after sexual intercourse, in between periods, heavier/longer lasting menstrual bleeding, or bleeding after menopause), abnormal vaginal discharge (may be foul smelling), pelvic or back pain, pain on urination and blood in the stools/urine.
  • Routine Pap testing is the best way to detect abnormal changes to the cervix before they develop into cancer. Because of this, women who do not regularly have a Pap test are at increased risk of developing the disease

Risk Factors

  • Human papilloma virus (HPV) infection
  • Lack of regular PAP tests
  • Smoking
  • Weakened immune system
  • Chlamydia infection
  • Diet
  • Being overweight
  • Use of oral contraception
  • Multiple full-term pregnancies
  • Young age at the first full-term pregnancy: Women with their first full-term pregnancy before the age of 17 are twice as likely to develop cervical cancer
  • Family history
  • Diethylstilbestrol (DES): Use of this hormonal drug to prevent miscarriages increases the risk for cervical cancer

Symptoms

  • Abnormal vaginal bleeding
  • Bleeding that occurs between regular menstrual periods
  • Bleeding after sexual intercourse, douching, or a pelvic exam
  • Menstrual periods that last longer and are heavier than before
  • Bleeding after going through menopause
  • Increased vaginal discharge
  • Pelvic pain
  • Pain during sex

Diagnosis

Although symptoms may suggest that cancer is present, the use of diagnostic imaging, biopsies and other tests can help confirm whether the cancer really exists.The following are tests that may be conducted in diagnosing cervical cancer:

  • Colposcopy
  • Cervical biopsies
  • Cytoscopy, proctoscopy, and examination under anesthesia
  • Chest x-ray
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan
  • Positron emission tomography (PET) scan
  • Ultrasound

Treatment Options

Treatment options may consist of surgery, chemotherapy, radiation therapy, other localized therapies or any combination of these treatments.

Surgery may consist the following options:

  • Radical trachelectomy: Removal of the cervix, part of the vagina, and the lymph nodes in the pelvis.
  • Total hysterectomy: Removal of the cervix and uterus.
  • Radical hysterectomy: Removal of the cervix, some tissue around the cervix, the uterus, and part of the vagina
  • Chemotherapy: is a cancer treatment that uses anti-cancer drugs to kill or stop the growth of cancer cells.
  • Radiation therapy is a cancer treatment that uses high-energy radiation beams to eliminate cancer cells or stop them from growing.

Radiation therapy consists of external beam radiotherapy and brachytherapy or internal radiation therapy.

External beam is a treatment option that uses localized high energy radiation beams to eliminate cancer cells and keep them from growing.
Brachy therapy uses a radioactive substance, usually in the form of seeds which are placed directly into or near the cancer which helps to shrink the tumor.