Cervical Cancer: Its Symptoms, Causes, And Treatment

Cervical cancer is one of the most commonly seen gynecological cancers in women in India . The cervix is situated at the lowermost portion of the uterus and is a cylindrical passage connecting the vagina and the uterus. 

The primary functions of the cervix include: 

• Production of cervical mucus during menstruation.
• Helping the sperm travel into the uterus from the vagina.
• Permitting the passage of the baby during birth by opening up the birth canal.
• Protecting the uterus from bacteria and other foreign material.

The report released by the Indian Council Of Medical Research (ICMR) 2021 reported that, Cervical cancer accounted for 15.2% of all cancers occurring in women. Here’s an insight into what cervical cancer is, its symptoms, causes, and treatment.

What Is Cervical Cancer?

Cervical cancer is a type of gynecological cancer that begins on the surface of the cervix cells. Cervical cancer occurs when the cervix cells start to change into precancerous cells. However, not all precancerous cells will convert into cancer.

In most cases, cervical cancers occur due to sexually transmitted infection of  the Human Papillomavirus (HPV). When screened early, cervical cancers are one of the most treatable cancers. Even in their later stages, cervical cancers can be controlled with appropriate treatment and palliative care.

There are two types of cervical cancers. They are:

• Squamous cell carcinomas: It is a type of cervical cancer that occurs in the thin and flat squamous cells that line the outer area of the cervix.
• Adenocarcinomas: It is a type of cervical cancer that begins in the mucus producing column-shaped glandular cells lining the cervical canal.

Cervical Cancer Symptoms

In its earlier stages, cervical cancers wont show prominent symptoms, however, as the cancer advances, the following symptoms are observed:

• Unusual or abnormal vaginal bleeding: Bleeding post-menopause, bleeding after sex, mensural bleeding that’s longer and heavier than usual, bleeding or spotting while not on period.
• Unusual or abnormal vaginal discharge: Abnormal discharge with blood, foul odor, watery consistency, change in discharge color to pink, pale or brown color.
• Pelvic pain: Pain in the pelvis may occur.
• Urine changes: Frequent urge to urinate, pain while urinating, blood in the urine.
• Unexplained loss of weight and appetite, feeling fatigued.
• Swelling in the legs and mild backache.
• Painful bowel movements.

What Causes Cervical Cancer?

Human Papillomavirus (HPV):  Human Papillomavirus (HPV) infection is what causes cervical cancer most commonly.. Out of all the strains, there are two types of HPV strains that most commonly cause cancer, and they are HPV-16 and HPV-18. Being infected with HPV doesn’t always mean that you’ll get infected with cervical cancer, as the body’s immune system fights and eliminates most HPV infections within two years.

Risk Factors Of Cervical Cancer

• Family history
• Smoking
• Excessive use of oral contraceptives
• Having multiple sexual partners
• Weakened immune system

Treatment For Cervical Cancer

Cervical cancer is treatable when detected early. Lets learn about the various treatment options for cervical cancer.

A. Surgery: 

The primary focus of the surgery is to remove cancer. Surgery can be performed to remove a part of the cervix that consists of the cancer cells or sometimes may also involve removing the cervix and other organs of the pelvis based on its spread. The most common types of surgery performed are:

• Conization: In this process, the cancerous tissue is removed in the form of a cone-like shape, after which it is then checked under a microscope to determine if the whole tumor was removed. Conization is used for both diagnosis and treatment.
• LEEP: It involves a loop electrosurgical excision that removes the cancerous tissue with the help of an electrically heated wire.
• Trachelectomy: This surgical procedure involves complete removal of the cervix to eliminate cancer completely.
• Simple Hysterectomy: This procedure involves removing the uterus if cancer has spread to areas other than the cervix.
• Radical hysterectomy with pelvic lymph node dissection: In this procedure, the cervix, the uterus with its surrounding tissue parametrium, a small portion of the upper vaginal part, and pelvis lymph nodes are removed.
• Pelvic exenteration: It is similar to radical hysterectomy. However, this procedure involves the removal of the vagina, the bladder, rectum, and a portion of the colon, depending upon the spread of cancer.
   

B. Radiation Therapy: 

Radiation therapy involves using high beam radiation directed towards the cancer cells to destroy them. Types of radiation therapy are:

• External radiation therapy: External Beam Radiation Therapy (EBRT) is performed by targeting x-rays or gamma rays to provide treatment to cancer affected areas. It is done using machines. External radiations are often combined with chemotherapy, otherwise called chemoradiation.
• Internal radiation or Brachytherapy: In this method, an implant (catheter, rod, sed) is sealed along with a radioactive substance. This implant is then placed inside the uterus to provide radiation therapy.

C. Chemotherapy: 

Chemotherapy uses medications to kill cancer cells throughout the body. It is often used to treat locally advanced cancer or cancer that has spread to other parts of the body. Medications used for chemotherapy include Cisplatin, Topotecan. 

D. Immunotherapy: 

Immunotherapy is given to help the immune system fight cancer.  It helps the immune system to recognise cancer cells and destroy them only. Example: Pembrolizumab 

E. Targeted drug therapy: 

It destroys cancer cells by identifying and attacking some types of cancer cells without harming the healthy cells . Example: Bevacizumab 

Better Safe Than Sorry 

Taking the right precautions at the right time can prevent the chances of getting cervical cancer. Regular screening and getting vaccinated for HPV might seem tedious, but they are essential preventive measures. Other than that, simple measures like limiting or eliminating the habit of smoking, having protected sex, etc might look small but they are necessary to safe guard the overall health as “An ounce of prevention is worth a pound of cure.”