Cervical Cancer: Definition, Types, Stages, Symptoms, Causes, Diagnosis, and Treatment

Cervical-Cancer

According to the Cancer Council cervical cancer is a serious health concern that affects women around the world. So in this article we’ll explore what cervical cancer is, its causes, symptoms and the importance of prevention through vaccination and regular screening.

What is Cervical Cancer?

It is a type of cancer that starts in the cells of the cervix, the lower part of the uterus that connects to the vagina. Most cervical cancers are caused by the human papillomavirus (HPV), a common virus transmitted through sexual contact. The American Cancer Society estimates that doctors will diagnose around 13,170 new cases of cervical cancer by the end of 2019 in the United States. Additionally, more than 4200 women in the U.S. are expected to die from cervical cancer this year. Initially, the Centers for Disease Control and Prevention (CDC) recommended the vaccine for individuals aged 9-26 years. However, the CDC now advises that the vaccine is also available for all women and men aged 26-45 years who did not receive the vaccine as a preteen.

What are the Types of Cervical Cancer?

Cervical cancer and cervical pre-cancers are classified by how they look in the lab with a microscope. The main types of cervical cancers are squamous cell carcinoma and adenocarcinoma. Most (up to 9 out of 10) cervical cancers are squamous cell carcinomas. These cancers develop from the cells in the exocervix. Squamous cell carcinoma most often begins in the transformation zone where the exocervix joins the endocervix. Most other cervical cancers are adenocarcinomas. Adenocarcinomas are cancers that develop from glandular cells. Cervical adenocarcinoma develops from the mucus-producing gland cells of the endocervix. Less commonly, cervical cancers have features of both squamous cell carcinoma and adenocarcinomas. These are called adenosquamous carcinomas or mixed carcinomas. Although almost all cervical cancers are either squamous cell carcinomas or adenocarcinomas, other types of cancer also can develop in the cervix. These types, such as melanoma, sarcoma, and lymphoma, occur more commonly in other parts of the body.

What are the Symptoms of Cervical Cancer?

In the early stages of cervical cancer, a person may experience no symptoms at all. Therefore, it’s important for women to have regular cervical smear tests, or Pap tests. A Pap test is a preventive measure. It aims not to detect cancer but to reveal any cell changes that indicate the possible development of cancer so that a person can take early action to treat it. The most common symptoms of cervical cancer are:

  • Vaginal bleeding between periods
  • Bleeding after sexual intercourse
  • Menstrual bleeding that is longer or heavier than usual
  • Pain during intercourse
  • Bleeding after intercourse
  • Pelvic pain
  • A change in your vaginal discharge such as more discharge or it may have a strong or unusual color or smell
  • Vaginal bleeding after menopause

These symptoms can be caused by other conditions but if you are worried or symptoms persist, contact your doctor. This is important for anyone with a cervix, whether you are straight, lesbian, gay bisexual or transgender.

What are the Stages of Cervical Cancer?

Determining the stage of cancer is crucial as it guides the choices of treatment that will be most effective. Staging is done to evaluate how far the cancer has spread and whether it has reached nearby structures or distant organs. The most common staging symptoms for cervical cancer is a 4 stages system.

  • Stage 0: Precancerous cells are present.
  • Stage 1: Cancer cells have grown from the surfaces into deeper tissues of the cervix, possibly reaching the uterus and nearby lymph nodes.
  • Stage 2: The cancer has spread beyond the cervix and uterus but hasn’t reached the walls of the pelvis or the lower part of the vagina. It may or may not affect nearby lymph nodes.
  • Stage 3: Cancer cells are found in the lower part of the vagina or the walls or the pelvis, possibly blocking the uterus. It may or may not affect nearby lymph nodes.
  • Stage 4: The cancer affects the bladder or rectum and has grown out of the pelvis. It may or may not involve the lymph nodes. In later stages, it spreads to distant organs like the liver, bones, lungs, and lymph nodes.

Regular screening and seeking medical attention for any symptoms can lead to early treatments, improving the chances of survival.

What are the Causes of Cervical Cancer?

Almost all causes of cervical cancer are caused by the persistent infection with some high-risk types of the human papillomavirus (HPV); this is the biggest risk factor for cervical cancer. The other main risk factor for cervical cancer is smoking. There is some evidence that women who have taken the contraceptive pill for five years or more are at increased risk of developing cervical cancer in people with HPV. The risk is small and taking the pills has also been shown to reduce the risk of other cancers such as ovarian and uterine. Other risk factors includes:

  • Smoking and passive smoking
  • A weakened immune system

If your mother was prescribed diethylstilbestrol (DES), an artificial form of the female hormone osteogenic during pregnancy (between 1939 and 1971). Around 8 out of 10 women will become infected with genital HPV at some time in their lives. Most women who have the HPV infection never get cervical cancer; only a few types of the HPV result in it. This results in an excessive buildup of cells, which eventually forms a lump, or tumor. Scientists are not completely sure why cells become cancerous. However, some risk factors might increase the risk of developing cervical cancer. These include:

  • HPV
  • Having many sexual partners or becoming sexually active early
  • Smoking
  • A weakened immune system
  • Birth control pills
  • Other sexually transmitted disease (STD)
  • Socio-economic status

What are the Risk Factors of Cervical Cancer?

Risk factors for cervical cancer include:

  • Smoking tobacco
  • Increasing number of sexual partners
  • Early sexual activity
  • Other sexually transmitted infections
  • A weakened immune system
  • Exposure to miscarriage prevention medicine
  • HPV infection
  • Smoking
  • Weakened immune system
  • Long term use of birth control pills
  • Having many children

What is the Diagnosis of Cervical Cancer?

Early diagnosis of cervical cancer significantly increased the chances of successful treatment. The American Cancer Society (ACS) provides the following guidelines for routine screening:

  • Under 25 years: Screening is not recommended by the ACS.
  • Ages 25-65 years: Individuals should undergo an HPV test every five years for cervical cancer.
  • Over 65 years: Screening is not recommended by the ACS for those who have had adequate screening in the past, unless they are at high risk of cervical cancer. Individuals who have had a hysterectomy with removal of the cervix do not require screening unless they have had precancerous lesions or cervical cancer in the past.

While these are the general screening recommendations, it’s important for individuals to consult with their doctor to determine their specific screening needs.

  • Cervical smear test
  • HPV DNA testing

If there are signs and symptoms of cervical cancer, or if the Pap test reveals abnormal cells, a doctor may recommend additional tests. These include:

  • Colposcopy
  • Examination under
  • Biopsy
  • Large loop excision of the transformation zone (LLETZ) or cone biopsy
  • Cone biopsy
  • LLETZ
  • Blood tests
  • CT scan
  • MRI
  • Pelvic ultrasound

What are the Treatments of Cervical Cancer?

Treatment for this cancer depends on several factors, such as the stages of the cancer, other health conditions you may have and your preferences.

Surgery:

So small cervical cancers that haven’t grown beyond the cervix are typically treated with surgery. The size of your cancer, its stage and whether you would like to consider becoming pregnant in the future will determine which operation is best for you. The options might include:

  • Surgery to cut away the cancer only
  • Surgery to remove the cervix, called a trachelectomy
  • Surgery to remove the cervix and uterus called a hysterectomy

Radiation Therapy:

Radiation therapy uses powerful energy beams to kill the cancer cells. The energy can come from X-rays, protons, or other sources. Radiation therapy is often combined with chemotherapy as the primary treatment for it that has grown beyond the cervix. It can also be used after surgery if there’s an increased risk that the cancer will come back. Radiation therapy can be given:

  • Externally, called external beam radiation therapy. A radiation beam is directed at the affected area of the body
  • Internally, it is called brachytherapy. A device filled with radioactive material is placed inside your vagina, usually for only a few minutes
  • Both externally and internally

Chemotherapy:

Chemotherapy uses strong medicines to kill the cancer. So that has spread beyond the cervix, low doses of chemotherapy are often combined with radiation therapy. This is because chemotherapy may enhance the effects of the radiation. Higher doses of chemotherapy might be recommended to help control symptoms of very advanced cancer. Chemotherapy may be used before surgery to reduce the size of the cancer.

Targeted Therapy:

Targeted therapy uses medications that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Targeted therapy is usually combined with chemotherapy. It might be an option to advance it.

Immunotherapy:

So it is a treatment with medications that helps your immune system kill the cancer cells. Because your immune system fights off disease by attacking germs and other cells that shouldn’t be in your body. Cancer cells survive by hiding from the immune system. It helps the immune system cells find and kill the cancer cells. It might be considered when the cancer is advanced and other treatments aren’t working.

Palliative Care:

It is a special type of health care that helps you feel better when you have a serious illness. If you have  cancer, palliative care can help relieve pain and other symptoms. A team that can include doctors, nurses, and other specially trained professional’s provider’s palliative care. A team goal is to improve the quality of life for you and your family. You can have palliative care at the same time as strong cancer treatments, such as surgery, chemotherapy, and radiation therapy. Using palliative care along with all other appropriate treatments can help people with cancer feel better and live longer.

What are the Preventions of Cervical Cancer?

To reduce your risk of cervical cancer;

  • Ask your doctor about the HPV vaccine
  • Have routine Pap tests
  • Safe sex and cervical cancer
  • Cervical screening
  • Having fewer sexual parents
  • Delaying first sexual intercourse
  • Don’t smoke

Human papillomavirus (HPV) vaccines are designed to prevent infection by specific types of human papillomavirus. There are different HPV vaccines available, offering protection against two, four, or nine of HPV. All HPV vaccines safeguard against at least HPV types 16 and 18 which pose the highest risk for cervical cancer. The Papanicolaou test, also known as the Pap test, is a screening method used to detect potentially precancerous and cancerous conditions in the cervix or, less commonly, the anus.

What to Know About Endometrial Cancer and Ovarian Cancer?

Ovarian cancer and endometrial cancer are two types of cancer that can occur in individuals assigned female. While both affect the reproductive system they originate in different organs. Although ovarian and endometrial cancers share some symptoms due to their impact on the reproductive system, ovarian cancer presents additional symptoms that are not typical of another cancer. Endometrial cancer affects the lining of the uterus while ovarian cancer impacts one or both ovaries. Although these cancers share some similarities they also have distinct characteristics. Let’s delve into these differences below.

What are the Differences Between Endometrial Cancer and Ovarian Cancer?

Ovarian cancer is a type of cancer that develops in the tissues of the ovary which is one of the two female reproductive glands responsible for producing eggs. Most ovarian cancers fall into two categories like ovarian epithelial cancers which start in the cells on the surfaces of the ovary and malignant germ cell tumors, which begin in egg cells. On the other hand, endometrial cancer is a type of cancer that develops in the tissues lining the uterus, which is a small, hollow, pear shaped organ in a woman’s pelvis where a fetus develops. The majority of endometrial cancers are adenocarcinomas, which are cancers that start in the cells that produce and release mucus and other fluids.

What is Ovarian Cancer?

Ovarian cancer originates in the ovaries and fallopian tubes. Read on to discover more about the differences between ovarian cancer and cervical cancer. According to the American Cancer Society (ACS), ovarian cancer ranks as the fifth leading cause of cancer-related deaths among individuals assigned female at birth. It results in more deaths than cancers affecting any other part of the female’s reproductive system. Based on the data from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute, an estimated 19,880 new cases of ovarian cancer are projected to be diagnosed in the United States in 2022.

What are the Symptoms of Ovarian Cancer?

The most common symptoms of ovarian cancer are:

  • Abdominal bloating
  • Pain in your pelvis or abdomen
  • Feeling full very quickly after eating
  • Frequent or urgent urination
  • Other potential symptoms of ovarian cancer include:
  • Fatigue
  • Atypical vaginal bleeding, such as periods that are noticeably heavier or irregular, vaginal bleeding between periods, vaginal bleeding after menopause
  • Pain during sex
  • Back pain
  • Unintentional weight loss
  • Indigestion
  • Constipation

What are the Causes of Ovarian Cancer?

It’s unknown exactly what causes ovarian cancer. However, we do know several factors that can increase a person’s risk of developing ovarian cancer. These include:

  • Being at an older age
  • Having a personal history or breast cancer
  • Having a family history of certain cancers, especially at younger ages, including: Ovarian cancer, Breast cancer, Colorectal cancer
  • Having inherited genetic changes that increase cancer risk, such as changes in the BRCA1 or BRCA2 genes
  • Having endometriosis
  • Having hormone replacement therapy after menopause
  • Having overweight or obesity
  • Using in vitro fertilization
  • Not having children or having children later in life
  • Not breastfeeding
  • Smoking

What is the Diagnosis of Ovarian Cancer?

There are currently no screening tests available for ovarian cancer. If you have symptoms suggestive of ovarian cancer, it’s important to consult with a doctor. They will conduct a physical examination including a pelvic exam. If the results of these exams raise concerns about ovarian cancer, further tests may be recommended to confirm the diagnosis. These tests may include:

  • Imaging tests
  • Laparoscopy
  • A biopsy
  • Blood tests

What is the Treatment of Ovarian Cancer?

The treatment for ovarian cancer typically involves a combination of surgery and chemotherapy. During surgery, doctors remove cancerous tissues through an operation. Chemotherapy involves using special medications to shrink or kill the cancer cells. These drugs can be taken orally as pills or administered through intravenous injections. In some cases, both methods may be used together for more effective treatment.

What is Endometrial Cancer?

Endometrial cancer and ovarian cancer both occur in the female’s reproductive system. Endometrial cancer affects the lining of the uterus, while ovarian cancer affects one or both ovaries.

What are the Symptoms of Endometrial Cancer?

The most common symptoms of endometrial cancer according to trusted sources is abnormal vaginal bleeding. This can include:

  • Bleeding between periods
  • Bleeding after menopause
  • Having a period that’s much heavier or more irregular than usual
  • Abnormal vaginal discharge
  • Pelvic pain
  • Abdominal bloating
  • Difficult or painful urination
  • Changes in bowel habits, like constipation or diarrhea

Other potential symptoms or cervical cancer include:

  • Fatigue
  • Constipation
  • Difficulty urinating
  • Blood in your urine
  • Unintentional weight loss
  • Swelling in your legs

What are the Risk Factors of Endometrial Cancer?

Endometrial cancer begins in the lining of the uterus known as the endometrium. Being overweight or obese significantly raises a woman’s risk of developing endometrial cancer. Other risk factors include

  • Having a family history
  • Age
  • Having polycystic ovary syndrome
  • Previous use of the breast cancer treatment drug tamoxifen
  • Smoking
  • Use of an intrauterine device (IUD)
  • Diet and exercise
  • Having had a endometrial hyperplasia in the past
  • Treatment with radiation therapy to the pelvis to treat another cancer
  • Things that affect hormone levels, like taking estrogen after menopause, the number of menstrual cycles, over a lifetime, pregnancy, certain ovarian tumors and polycystic ovarian syndrome (PCOS)
  • Using birth control pills for a long time
  • Having a weakened immune system, such as from taking immunosuppressive drugs or living with HIV/AIDS

What is the Diagnosis of Endometrial Cancer?

Diagnosing endometrial cancer. Such as:

  • Pelvic exam
  • Transvaginal ultrasound
  • Hysteroscopy

So here are some different types of tests and procedures used to diagnose the endometrial cancer include:

  • Examining the pelvis
  • Imaging tests
  • Use a scope to examine your endometrium, called a hysteroscopy
  • Removing a sample of tissues for testing, called a biopsy
  • Performing surgery to remove tissue for testing

What is the Treatment of Endometrial Cancer?

Treatment options for endometrial cancer include:

  • Surgery
  • Chemotherapy
  • Hormone therapy
  • Targeted therapy
  • Immunotherapy
  • Palliative care
  •  Radiation therapy

During surgery, doctors remove cancerous tissues through an operation. Chemotherapy involves using special medicines to shrink or kill the cancer cells. These drugs can be taken orally as pills or administered through intravenous injections, or sometimes both methods are used together for more effective treatment.

FAQs:

Is stage 4 cervical cancer 100% death?

Stage 4 cancer is not always terminal. While it is typically advanced and may require more aggressive treatment, terminal cancer specifically refers to cancer that is not curable and ultimately leads to death. Therefore, while stage 4 cancer often indicates a more serious and advanced disease, it does not necessarily mean that it is terminal.

Can you live 10 years after cervical cancer?

Approximately, 60 out or every 100 people or around 60% will survive their cancer for 5 years or more after diagnosis. Additionally, around 50 out of every 100 people or around 50% will survive their cancer for 10 years or more after diagnosis.

What is stage 5 cancer?

The term stage 5 cancer isn’t used with most types of cancers. Most advanced cancers are grouped into stage 4. An exception is Wilms tumor, or neuroblastoma, a childhood cancer that originates in the kidneys. Stage 5 Wilms tumors are those that affect both kidneys.

Is cervical cancer 100% prevention?

More than 12000 women get it every year. Up to 93% of it is preventable. Human papillomavirus (HPV) vaccination helps prevent infection with the HPV types that cause most cervical cancers.

Is cervical cancer a big killer?

Each year about 13000 people in the United States are diagnosed with it. About 4000 people die from it every year. 

Can you have kids after cervical cancer?

In most cases, doctors recommend waiting 6 to 12 months after conization or trachelectomy before attempting to conceive. This waiting period allows for sufficient healing. However, even after this time there remains a risk of pregnancy complications and infertility following cervical cancer treatment.

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