Nowadays, due to the modern methods of diagnosis, a lot of dangerous and potentially life-threatening diseases can be disclosed on early stages and one of them is cervical cancer. Cervical cancer symptoms may be missing while a tumor is small. The choice of cervical cancer treatment depends on a range of factors, but usually includes surgical intervention, chemotherapy and radiotherapy. At the same time, doctors prescribe a combination of the abovementioned treatments more and more often. Below, we will review this condition, its treatment and diagnosis methods in detail.
Cervical cancer is a condition which occurs when abnormal cells on the cervix grow out of control. Cervical cancer is one of the major cancers found in women worldwide and is mostly caused by a virus called the human papillomavirus (HPV). HPV is usually contracted through sexual intercourse with someone who has it. Not all HPV infections cause cancer, some lead to warts.
Cervical cancer can be treated if found in it early stage; pap tests can be carried out to test for cervical cancer. Pap testing detects precancerous changes in the cervix such as dysplasia identified as Squamous Intraepithelial Lesion (SIL) which is not cancerous but may lead to cancer. Cervical Intraepithelial Neoplasia (CIN) is another term used in describing precancerous changes in the cervix. These precancerous changes can be treated.
The cervix consists of two types of cells namely the squamous cells (the lining cells of the outer cervix) and the cells that line the interior channel of the cervix. These interior cells have types of glandular cells. The transition zone is the area where the squamous and glandular cells meet and is the area where most cervical pre-cancers and cancers begin. Most cervical cancers arise from the squamous cells which are referred to as squamous cell carcinomas. Those that arise from glandular cells are referred to as adenocarcinomas.
ALTERNATIVES TO PELVIC EXAMINATION FOR DETECTING CERVICAL CANCER
Pap smear is an alternative method to pelvic examinations (uncomfortable test) in detecting cervical cancer. All sexually active women are advised to undergo these tests once every year.
I ONLY HAVE ONE SEXUAL PARTNER, MUST I STILL UNDERGO PAP SMEAR?
It is highly advised that all women who have had sexual partners undergo a Pap smear test at least once in three years. This is so as to detect cervical cancer In its early stage for treatment.
ON DIAGNOSIS OF CERVICAL CANCER, CAN ONE STILL HAVE SEXUAL INTERCOURSE?
The answer is yes, after the course of radiotherapy treatment. Ways in which can keep the vagina lubricated and prevention of vaginal tightness will be taught so as sexual intercourse is not painful.
IS CERVICAL CANCER CONTAGIOUS?
Cervical cancer is not contagious, though the various which lead to it can be transmitted from one person to another.
CAN CERVICAL CANCER BE PREVENTED?
Cervical cancer can often be prevented through vaccination and modern screening techniques that detect pre-cancerous changes in the cervix. Pap screening is one of the modern screening techniques which have contributed to the decline of cervical cancer in the world.
The vaccines available are those that prevent the cervical cancer causing virus that are, HPV from growing. Gardasil, Gardasil-9 and Cervarix are the three available HPV vaccines. Gardasil has been shown to be effective in preventing infection by four common HPV types (6, 11, 16, 18), Gardasil-9 is the improved version of Gardasil which is used for 9 HPV types (6, 11, 16, 18, 31, 33, 45, 52 and 58) while the Cervarix is only used for HPV types 16 and 18.
Vaccination should be done before any sexual activity occurs so as to get the full benefit of the vaccine. CDC recommends that girls between ages 11 and 12 should receive the HPV vaccine and young women from the age of 13 to 26 should get vaccines if they were not gotten at all or just parts.
TESTS TO FIND OUT STAGE AND TREATMENT
The tests carried out to find out the stage of cervical cancer include:
- Chest x-ray to check the lungs.
- CT scan which makes use of x-ray to look inside the body.
- Ultrasound which makes use of sound waves to check internal tissues and organs.
- MRI which uses magnets to see the internal body.
- PET scan to check for cancer that has spread to other parts of the body.
- Biopsy which makes use of fine needle aspiration.
CERVICAL CANCER SYMPTOMS
Symptoms of cervical cancer include:
- Abnormal vaginal bleeding that occurs between menstrual periods, after sex or after menopause.
- Pain during sex.
- Abnormal vaginal discharge.
- Significant unexplained change in the menstrual cycle.
Advanced cervical cancer symptoms may include:
- Constant pelvic, leg or back pain.
- Urinary problems due to kidney or ureter blockage.
- Leakage of urine or stool into the vagina.
- Weight loss
CERVICAL CANCER TREATMENT OPTIONS
The treatment of cervical cancer depends on the stage of the cancer when it is diagnosed. They include:
This is a form of treatment undergone when the cancer is detected at an early stage. This could include removal of the uterus (hysterectomy), but other procedures which preserve the ability of a woman to get pregnant can be done. This is in cases where the tumour is small. These procedures include cone biopsy (removal of the inside of the cervix) and trachelectomy (removal of the upper vagina and cervix). In a more advanced case, the surrounding lymph nodes, uterus and parts of other organs surrounding the cancer, pelvic exenteration is recommended.
This treatment is common for cervical cancers. This treatment makes use of external beam radiation therapy (from an outside source of radiation) and brachytherapy (insertion of radioactive sources near the tumour for a fixed period of time) for cervical cancer. They can either be used together or separately. Radiotherapy causes side effects such as fatigue, diarrhoea, nausea, skin changes, vomiting irritation of the bladder and vagina, early menopause if the ovaries are exposed.
This may be recommended together with radiation therapy (chemo-radiation), it may be given before or after radiation treatment. Chemotherapy drugs that are commonly used for cervical cancer treatment include Cisplatin and 5-fluorouracil. The side effects usually experienced during this treatment include nausea, fatigue, vomiting, hair loss and mouth sores.
This refers to the use of drugs which have been specifically developed to interrupt cellular processes that promote cancer cells growth. Bevacizumab is an example of a targeted therapy drug; it deters the ability of tumours to make new blood vessels required for growth. This is used in cases of advanced cervical cancer.
DIAGNOSING CERVICAL CANCER
- Early detection: Pap test is a highly recommended routine screening test for the detection of abnormal cell changes of the cervix and cervical cancer. Recommended Pap test schedule is based on age and things that increase the risks.
- Medical history and physical exam: Questions about periods, symptoms and family history are asked by the doctor and physical exam includes performing a routine Pap smear.
- Colposcopy and cervical biopsy: This test finds out if there are cancer cells and where they are on the surface of the cervix.
- Endocervical biopsy (curettage): This test is carried out to find out if there are cells in the cervical canal.
- Cone biopsy or Loop Electrosurgical Excision Procedure (LEEP): This test is carried out by removing cervical tissue for microscope examination.