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Cervical Cancer

Cervical cancer is a cancer that occurs in the cervix, which is a hollow cylinder connecting the lower part of the uterus to the vagina. Most cases of cervical cancer develop in the cells on the surface of the uterus.  Cervical cancer is a leading cause of death in women in the developing world.


Possible symptoms of more advanced disease may include abnormal or irregular vaginal bleeding, pain during sex, or vaginal discharge. Notify your healthcare provider if you experience:

•    Abnormal bleeding, such as
           •  Bleeding between regular menstrual periods
           •  Bleeding after sexual intercourse
           •  Bleeding after douching
           •  Bleeding after a pelvic exam
           •  Bleeding after menopause
•    Pelvic pain not related to your menstrual cycle
•    Heavy or unusual discharge that may be watery, thick, and possibly have a foul odor
•    Increased urinary frequency
•    Pain during urination

These symptoms could also be signs of other health problems, not related to cervical cancer. If you experience any of the symptoms above, talk to your doctor.


The majority of cervical cancer cases are caused by sexually transmitted human papillomavirus (HPV) ; the same virus that causes genital warts and has more than a hundred strains but only a few actually cause cervical cancer. HPV-16 and HPV-18 are the two leading strains that cause the cancer but even getting infected with cancer causing strains of HPV doesn’t mean you’ll get cervical cancer as the body will eliminate most of the infection itself within a year or two at max. HPVs can cause other cancers apart from cervical cancer as well and HPV is a very common disease with more than fifty percent of all sexually active adults getting some HPV at least once.

Risk Factors

Risk factors that can lead to cervical cancer obviously include HPVs but the others are HIV (human immunodeficiency syndrome), smoking, being obese, family history, birth control pills, low fruit and vegetable consumption, three full term pregnancies or more or getting pregnant before the age of seventeen.


Precancerous cervical cell changes and early cancers of the cervix generally do not cause symptoms. For this reason, regular screening through Pap and HPV tests can help catch precancerous cell changes early and also prevent the development of cervical cancer.


Like all cancer: if detected in stage 1 there are significant chances of cure and this reduces as the detection gets delayed. The treatment is as follows

Combination of chemotherapy and Radiation therapy


Surgery is meant to physically remove as much of the cancer as possible but sometimes the affected part of the cervix might be removed altogether. In case the cancer has advanced and spread: the entire cervix and other pelvic organs might need to be removed.

Radiation therapy involves using high energy X Ray beams to target and destroy cancer cells and is done using an external machine. Once the external beam radiation therapy is completed, internal radiation is given with the help of a metal tube placed within the cavity.

Chemotherapy is generally given in combination with radiation. It involves the use of drugs to kill cancer cells in the body. There are treatment cycles that the doctor will decide and give medications accordingly.

Targeted Therapy basically is using new drugs like Bevacizumab (Avastin) that work differently from chemotherapy and radiation by blocking the growth of new blood vessels that help the cancer grow and survive. Often this is given in the setting of recurrent disease.

Testing for Cervical Cancer

The Pap Smear Test is used specifically to detect cervical cancer. A doctor will collect a sample of cervical surface cells and send them for lab testing in order to see if there are cancerous changes in the cells. If so, a Colposcopy will be recommended in order to examine the cervix with the help of a biopsy. Women are advised to take Pap Smear tests once every three years and HPV tests once every five years.


As it is well known that 95% of cervical cancers are associated with HPV infection which is transmitted sexually.

It would be rational to consider that immunization with the HPV vaccine could reduce the very impact of cervical cancer.

The HPV vaccine is routinely recommended for girls and boys ages 11 or 12 although it can be given as early as age 9. It is most suitable to receive the vaccine before having sexual contact (before being exposed to HPV) because the vaccine might not be as effective or might not be effective at all if someone is already infected with HPV CDC recommends that  all 11-12 year olds receive to doses of HPV vaccine at least six months apart. 15- 26 years teens and young adults should receive three doses of the vaccine. Catch up HPV vaccinations are recommended for all people above 26 years who are not adequately vaccinated.

Gardasil 9 is an HPV vaccine approved by FDA and can be used for both girls and boys. In addition to provide protection against the cervical cancer it also prevent:

Vaginal cancer
Vulval cancer
Anal cancer
Genital warts and many sexually transmitted benign diseases
Contraindications for HPV vaccine
Allergic reactions to the components of vaccine

Dr. Chandragouda Dodagoudar
Medical Oncology

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