Cervical Cancer- Are you aware of it?

Understanding Cervical Cancer

Cervical cancer is one of the most dreadful cancers common among women. It is the third type of cancer most prevalent in women. The uterus (womb in female) has a lower part called the cervix which connects the uterus to the vagina. Most cervical cancers start in the cells lining the cervix. Though it occurs mostly in mid aged women but has also been seen in women of lesser age. Cancer of the cervix is due to HPV that is Human Papilloma Virus. This virus causes infection in the cervix that leads to cervical cancer. There are many known strains of HPV and not all of them cause cervical cancer. It is not a direct process. The cervical cells first transform into pre-cancerous cells, which then gradually change into invasive cancer. This change from pre- cancerous to invasive state may take many years. The pre cancerous changes that occur in the body are called cervical intraepithelial neoplasia, squamous intraepithelial lesion or dysplasia. The precancerous stage is detectable through Pap test and its early detection can stop its progression to the invasive state. Also one should know that all cervical pre cancers may not develop into invasive cancers in every case. An early detection followed by the treatment can save a woman from the deadly stage later. However it’s not clear as to which type of cervical pre-cancer stages develop into invasive cancer so the only way to be safe is by testing and screening the stage early.

You must worry if…

It is noticed that women with early invasive cervical cancer do not show up symptoms. There are times when the symptoms are visible only after the cancer enters into the invasive stage. At this stage the cancer starts spreading to the nearby tissues also. The symptoms at this stage that may be visible are-

Abnormal vaginal bleeding like bleeding after menopause or intercourse
Bleeding and spotting between periods
Heavier and longer periods than normal
An unusual vaginal discharge that may have blood too

In cases when the cancer spreads to other parts of the body that is the advanced stage one may see symptoms like pain in the back and bones, fatigue, loss of appetite, weight loss, pelvic pain and single leg swelling.

Tests for screening

The various tests done to detect cervical cancer are divided into two parts. The first part is the screening that checks whether a woman is suffering from cervical cancer or not. The screening is usually done by the following tests.

Pap smears- this test is painless and very simple in procedure. A cotton swab or a brush is used to collect cells from the cervix and then spread over a glass slide and examined under a microscope to detect cancerous cells.
Colposcopy in which the doctors examine the cervix closely with the help of a device that is called colposcopy. It helps the doctors examine the cervix closely and clearly and is not painful for the patient.
Cone biopsy in which the doctor removes a cone shaped tissue from the cervix. It is also used as a treatment sometimes to remove the cancerous tissues from the body. Cone Biopsy is also known as conization.

In the second step the doctor may want to check up to which parts the cancer has spread. This step is called staging and the tests done to determine the stage of the cervical cancer are-

X-ray of the chest to check if the cancer has spread to the lungs of the patient.
CT Scan to check if the cancer has spread to the lymph nodes in the abdomen and pelvis of the patient's body. This test can also be done to detect the spread of cancer in other parts like the lungs or liver.
MRI scan to detect if cancer has spread to the brain or spinal cord. It is also used to detect pelvic tumors in a patient.
Intravenous pyelogram or Intravenous urography is basically an X-ray of the urinary system to detect abnormalities in the urinary tract.
Positron Emission Tomography to detect the cancer spread in the lymph nodes.

Treatment for cervical cancer

The treatment for the cervical cancer depends upon the stage of the cancer, the size of the tumor, the woman’s age and her needs that include if she wants to have children in future. Pre cancers conditions are easily treatable so if detected one should not panic and immediately go for treatment. The treatment for cervical cancer is available at most of the government health centers and private hospitals too.

Loop electrosurgical excision procedure (LEEP) It is a type of biopsy like procedure to remove the abnormal cells or tissues from the body of the infected woman. It uses electricity to remove the cancerous cells or tissues.
Cryotherapy is a procedure in which the abnormal cells or tissues are frozen
Laser therapy in which light is used to burn or break the tumor or the abnormal tissues

These procedures are simple and do not require long stay at the hospital after the surgery. These can be done under local anesthesia.

Hysterectomy is also an important procedure that involves removal of the uterus in case a woman has undergone repeated LEEP surgeries.
Use of chemotherapy to treat cervical cancer includes the intake of drugs like 5 FU, ifosfamide, carboplatin, paclitaxel and cyclophosphamide. After the treatment regular checkups may be advised to the patient after regular time periods.

It is important that women visit the doctor once in 6 months or a year to keep them safe of cervical cancer. This should be done because there are certain complications that are linked with cervical cancer like the following:-

Recurrence of the cancer, it may come back
In some cases the patient’s body may not respond well to the treatment
Surgery and radiation treatments pose various risks to the women

Prevention and risk factors of cervical cancer*

Almost all cervical cancers are caused by the virus HPV that is Human Papilloma Virus. There are many strains of HPV but all do not cause cervical cancer. HPV is generally transmitted through sexual intercourse and may also lead to other diseases infections like warts. The common strains that cause cervical cancer are HPV 16 AND HPV 18. HPV vaccines are given to girls in their teens to prevent cervical cancer. These vaccines are given as a series of 3 injections over 12 months to reduce the risk of cervical cancer in women. However it is not yet proved that these vaccines have 100 percent efficiency in protection and these have not yet been incorporated in India.

The greatest prevention step one may take is to go for regular checkups for early detection of the cancer.
A woman must have a safe sexual life and should avoid getting involved with multiple partners to reduce the risk of cervical cancer.
Use of condoms to prevent infections.
Poor genital hygiene adds to the spread of the infection so one must take care of their body hygiene not neglecting the private parts.
Tobacco consumption should be stopped.
Smoking makes one twice more prone to the risk of cervical cancer than non smoking women.
A family history of the disease may make one more prone to the disease.
Long intake of oral contraceptive pills may increase the risk of cancer of the cervix.
An improper diet with low intake of fruits and vegetables in the diet.
An HIV infected woman is at higher risk of cervical cancer due to suppression of her immunity that occurs due to HIV. The cancer cells may fast develop and turn into invasive cancer in a women whose immune system is weaker.
Early onset of sexual activity poses threat
Multiple pregnancies at short intervals also is a risk
Have a diet that includes Vitamin A, Vitamin B12, Vitamin C, Vitamin E and beta-carotene.
One must start cervical cancer screening at the age of 21.

The sad statistics in India

The disease is common in developing countries an one reason may be attributed to the lack of awareness among women in the countries. Worldwide it is the fifth most common cancer in women. It is shocking that 80% of the cases are from the developing countries.

There are 15-20 new cases of cervical cancer per 1, 00,000 women in India every year.
Cervical cancer is higher among rural women. It is up to 1.5 to 2 times higher in case of rural areas.
An estimated 1, 82,027 new cases of cervical cancer were recorded in India in 2010.
Around 77,096 deaths due to cervical cancer were recorded in the year 2010.
India is one of the countries with high number of cancer cases in women due to widespread use of tobacco.