Cervical Cancer - Its types, symptoms, causes, risk factors, diagnosis & treatment
Cervical Cancer is the second most common cancer in women in India. Every year more than 1 lac women are diagnosed with cervical cancer and it leads to more than 75000 deaths. Almost all women are at risk of having cervical cancer but occur more often over the age of 30.
This type of cancer starts in the cervix, the hollow cylinder that connects the vagina and the womb (Uterus). Almost all cervical cancer cases are linked to an infection caused by Human Papillomavirus (HPV), an extremely common sexually transmitted virus.
Types of cervical cancer
There are broadly two types of cervical cancer:
Squamous Cell Carcinoma: This type of cervical cancer develops in thin, flat cells of the squamous lining of the cervix. Most of the cervical cancers are squamous cell carcinoma
This type begins in the columnar-shaped glandular cells of the cervical canal.
Very rarely the other type of cells in the cervix can give rise to cancer.
Symptoms of cervical cancer
The symptoms are not always obvious and most of the time diagnosed at a very advanced stage. In most cases, abnormal vaginal bleeding is supposed to be the first noticeable symptom of cervical cancer. The bleeding might happen during or after intercourse, between menstrual cycle periods, or after attaining menopause. Other noticeable symptoms are pain and discomfort during intercourse, unusual or unpleasant vaginal discharge, and pain in the lower back or pelvis.
Causes of cervical cancer
Human Papillomavirus (HPV) is considered to be the cause of cervical cancer in almost all cases and there are more than 100 different types of HPV. Some types of HPV do not cause any noticeable symptoms and the infection gets cured even without any treatment. But at least 15 types of HPV are considered to be the high-risk virus causing cervical cancer. Cervical cancer usually takes years to develop, but the cells of the cervix start showing the changes from the early stage.
Regular screening can help detect these early changes in cell growth before any noticeable symptoms. This phase is called the pre-cancerous stage. Though this stage does not pose any immediate threat, when remained unnoticed, potentially develops into cancer.
Risk factors of cervical cancer
·More the sexual partners, the greater the chance of contracting HPV
·Sexual activity at a very early age increases the risk of cervical cancer. There are patients as early as 15 years of age.
·Having other types of STIs (Sexually Transmitted Infections) like chlamydia, gonorrhea, syphilis, HIV/AIDS increases the risk of contracting HPV
·Exposure to miscarriage prevention drugs used during the 1950s might lead to the increased risk of a certain type of cervical cancer
·Weakened immune system and severe smoking can also be the risk factors of cervical cancer
Diagnosis of cervical cancer
Pap Smear and HPV DNA testing are very effective screening modalities for the early detection of cervical cancer. If any abnormality is found in a screening test, colposcopy is recommended. It is a small device with a microscope and light to have a closer look at the cervix. It also collects small tissue samples for biopsy for further confirmation of the existence of cancerous cells. Doctors might advise undergoing a few blood tests, X-rays, CT scans, MRI to confirm the stage of cancer.
Determining the stage of cervical cancer or any type of cancer is very important.
· Stage 1 – the cancerous cells are limited to the cervix with no spread outside the cervix
· Stage 2 – cancer has spread outside the cervix and surrounding tissues but has not reached till lateral pelvic wall or the lower part of the vagina
· Stage 3 – cancer has spread through the lower part of the vagina or lateral pelvic wall
· Stage 4 – the cancerous cells have spread through the bowel, bladder, or other organs like lungs.
Treatment of cervical cancer depends on the stage it has attained. Hospitals use multidisciplinary teams to treat cervical cancers and tailor-made treatment programs for each patient. Surgery (removal of the parts of the cervix, womb), chemotherapy, radiotherapy , or a combination of all these procedures can be the treatment option.
Cervical cancer can be cured if diagnosed at an early stage.
There is a common myth that, post cervical cancer, a woman will not have a normal sex life. But the truth is, after treatment it is perfectly safe. If the patient underwent chemotherapy or radiotherapy, the use of a condom by the male partner is recommended.
One can have early menopause after the treatment like surgical removal of ovaries. One can experience symptoms like sudden hot flashes, irregular menstrual cycle, vaginal dryness, mood swing, urine leak during cough or sneeze, night sweats. In such conditions, regular consultation with a doctor is highly recommended.
· HPV Vaccine : HPV vaccination reduces the risk of cervical cancer and other related HPV-related cancers.
· Effective screening : Pap Smear test (every 3 yearly) or Pap smear along with HPV DNA testing (every 5 years) are recommended as screening tests. These tests detect precancerous conditions and can help in detecting cancer at a very early stage.
· Safe Sex : use of condoms has a proven track record in preventing sexually transmitted diseases. Since, the cause of cervical cancer is mostly due to HPV, practicing safe sex can reduce the risk of transmission of the virus.
Today, cervical cancer care is experiencing a paradigm shift. It is not only about the treatment but it is about comprehensive care, which requires dedication, commitment, expertise, advanced infrastructure, state-of-the-art equipment, and highly skilled doctors. The oncology team at Aakash Healthcare Super Specialty Hospital brings together the brightest minds in Surgical, Medical, and Palliative Oncology and provides tailor-made care to individual patients. It is one the best hospitals/centres in Dwarka Delhi for cancer treatment. The team certainly can be called the best oncology team in Delhi-NCR with the finest oncologist in the team.
Dr. Parveen Jain
Senior Consultant & HOD