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Cervical Cancer

Cervical Cancer

What is cervical cancer ?


Cervical cancer, also known as cervical cancer, develops on the cervix's surface. Squamous cell carcinomas and adenocarcinomas are the two most common kinds of cervical cancer. Squamous cell carcinomas account for 80 to 90 percent of all cancers, whereas adenocarcinomas account for 10 to 20 percent.

What is the cervix, exactly?


The lowest section of the womb is called the cervix (uterus). The uterus is divided into two sections: the upper portion (body) where the baby develops and the lower part (stomach) (cervix). The cervix links the uterus's body to the vaginal canal (birth canal).

What signs and symptoms do you have if you have cervical cancer?


Cervical cancer does not cause pain or other symptoms in its early stages. The following are likely to be the earliest signs of the disease:

  • Vaginal discharge that is watery or bloody and has a bad odor may be heavy.
  • Vaginal bleeding that occurs after sexual activity or exertion, in between menstrual cycles, or after menopause.
  • Periods might be heavier and linger longer than usual.


Symptoms of cancer that has spread to adjacent tissues include:

  • Urination that is difficult or painful, with blood in the pee.
  • Diarrhea, or discomfort or bleeding from the rectum after a bowel movement.
  • Fatigue, weight loss, and a lack of appetite.
  • A broad sense of bad health.
  • Swelling in the legs or a dull pain.


If irregular bleeding, vaginal discharge, or any other symptoms persist for more than two weeks without explanation, you should see a gynecologist for a full gynecological checkup, including a PAP smear.

DIAGNOSTIC ANALYSIS AND TESTS


How is cervical cancer diagnosed? 


Most occurrences of cervical cancer may be detected with a combination of pelvic examinations and Pap screenings. Your doctor will visually inspect the cervix and obtain a tissue sample of any obvious abnormalities for biopsy in order to make an accurate diagnosis.

Whether the biopsy reveals cancer, other testing will be performed to see if the illness has spread (metastasized). Liver and kidney function tests, blood and urine tests, and X-rays of the bladder, rectum, intestines, and abdominal cavity are all possible testing. This is referred to as staging.

What are the stages of cervical cancer and how can you know if you have it?


Stage I: Only the cervix is affected by cancer.
Cancer has gone beyond the cervix but not yet reached the pelvic wall in Stage II (the tissues that line the part of the body between the hips).
Stage III: The cancer has migrated to the bottom part of the vaginal wall and perhaps to adjacent lymph nodes.
Cancer has progressed to the bladder, rectum, or other regions of the body at this stage.
Is it vital to get a pelvic exam on a regular basis?
National authorities and medical organisations can't agree on whether a woman needs a pelvic check if she hasn't had her cervical cancer screening in years. Some medical organizations leave it up to the clinician and patient to determine if a pelvic exam is essential, while others oppose it owing to patient discomfort and the risk of excessive follow-up for innocuous results. Unfortunately, there has never been any evidence that a pelvic check may prevent cancer, particularly malignancies that women are most concerned about, such as ovarian cancer.

Young women aged 25 and under who have participated in sexual activity should have a chlamydia screening test done once a year.

TREATMENT AND MANAGEMENT


What is the treatment for cervical cancer?


A gynecologic oncologist (a specialist who specializes in cancers of the female reproductive organs) will be part of a woman's treatment team if she has cervical cancer. Treatment for cervical cancer is determined by a number of criteria, including the disease's stage, the patient's age and general health, and the woman's desire to have children in the future. Radiation, chemotherapy, and surgery are the three basic therapies for cervical cancer. A mix of therapies may be used in certain cases. Cancer that has gone beyond the pelvis (Stage IV) or cancer that has recurred may be treated with radiation or chemotherapy.

Radiation therapy of cervical cancer is divided into two types:

A device containing radioactive pellets is inserted into the vaginal canal near the malignancy and left there for a period of time.
During visits to the radiotherapist, an external equipment blasts radiation into the target locations.
Chemotherapeutic medicines, either alone or in combination, are employed. Before or after surgery, radiation and chemotherapy may be administered.

Cervical cancer is treated with a variety of surgical procedures. The following are some of the most prevalent types of cervical cancer surgeries:

Laser surgery for cervical cancer : A laser beam is used to burn away cells or remove a tiny sample of tissue for analysis.
A cone-shaped piece of tissue is taken from the cervix during a cone biopsy.


Simple hysterectomy for cervical cancer : This procedure removes the uterus but not the tissue that surrounds it. The lymph nodes in the vaginal and pelvic regions are not removed.
The uterus, surrounding tissue termed the parametrium, a tiny amount of the upper part of the vagina, and lymph nodes from the pelvis are all removed during a radical hysterectomy and pelvic lymph node dissection.
The illness may be cured in its early stages by removing the malignant tissue. A simple hysterectomy or a radical hysterectomy may be done in various instances.

 

Robotic surgery for cervical cancer : Robot-assisted procedures are being increasingly incorporated in gynecologic oncology. Several studies have confirmed the feasibility and safety of robotic radical hysterectomy for selected patients with early-stage cervical cancer. It has been demonstrated that robotic radical hysterectomy offers an advantage over other surgical approaches with regard to operative time, blood loss, and hospital stay. Also initial evidences concerning oncological outcomes seem to confirm the equivalence to traditional open technique. Despite the fact that costs of robotic system are still high, they could be partially offset by several health-related and social benefits: less pain, faster dismissal, and return to full activity than other surgical approaches. The development of robotic technology may facilitate the spread of minimally invasive surgery in gynecologic oncology, overcoming some drawbacks of laparoscopic technique for challenging intervention such as radical hysterectomy. Further studies are needed to evaluate overall and disease-free survival of this technique and associated morbidity after adjuvant therapies.

PREVENTION


What are the elements that put you at risk for cervical cancer?


Cervical cancer is often connected to established risk factors for the illness. Some risks can be avoided, while others are unavoidable. The following are some of the risk factors:

A history of irregular screening for cervical cancer : Women who have not had a Pap test (smear) on a regular basis are at a higher risk of cervical cancer.


HPV Infection: Human papillomavirus (HPV) may infect the cervix and is transferred sexually. Cervical HPV infection is the most common cause of cervical cancer. Cervical cancer develops in a very tiny proportion of women who are infected with HPV and go untreated.
Females who start having sexual relations before the age of 16 and females who have had numerous sexual partners are more likely to get HPV and develop cervical cancer. Cervical cancer risk is reduced by preventing sexually transmitted illnesses.
Tobacco use: Tobacco use has been linked to an increased risk of cervical cancer.
HIV Infection: Women who have been infected with HIV are at a greater risk of acquiring cervical cancer than the general population.


Is it possible to avoid cervical cancer?


Cervical cancer may be avoided if women take certain precautions. The most essential things that women may take to avoid cervical cancer are having regular gynecological checkups and receiving Pap tests. Additional cervical cancer preventive advice may be found in the "risk factors" section.

Cervical cancer screening should begin when a woman reaches the age of 21. Women without a history of abnormal Paps should be screened every three years. If any aberrant cells are discovered, or if HPV is present, more regular screening may be required.
Beginning at the age of 30, women who have had three consecutive normal Pap test results should be examined every five years with both a Pap smear test and a screening test for HPV infection (high-risk type). Another alternative is to have simply the Pap test performed every three years. Women with specific risk factors, such as prenatal exposure to diethylstilbestrol (DES), HIV infection, or a compromised immune system as a result of organ transplant, chemotherapy, or chronic steroid usage, should be checked regularly.
Women aged 65-70 who have had three or more normal Pap tests in a run and no abnormal Pap test results in the previous 20 years should discontinue getting cervical cancer screening. Women with a history of cervical cancer, prenatal DES exposure, HIV infection, or a compromised immune system should continue to be screened as long as their health permits.
Unless they have a history of cervical cancer or precancer, women who have undergone a complete hysterectomy (removal of the uterus and cervix) should discontinue getting cervical cancer screening. Women who have undergone a hysterectomy but not a cervix removal should continue to follow the following rules.
What are the screening guidelines for cervical cancer?
The following suggestions have been agreed upon by national societies:

Regardless of sexual history, cervical cancer screening should begin at the age of 21.
Screening with simply a Pap test is advised every three years for women aged 21 to 29 years (no HPV test).
Co-testing with Pap and HPV should be done every 5 years for women 30 years and older, or a Pap test alone every 3 years.
In women who have undergone a complete hysterectomy for benign reasons and have no history of CIN (cervical intraepithelial neoplasia) grade 2 or higher, routine Pap testing should be ceased.
Women who have had two consecutive normal co-test results or three consecutive normal Pap test results in the last 10 years, with the most recent normal test completed in the previous 5 years, may stop getting cervical cancer screening at age 65.
Women who have had sufficient treatment for CIN grade 2 or above will be required to continue screening for another 20 years, even if they are over 65.
Women who have HIV, are immunocompromised (have a weak immune system), have a history of DES in utero exposure, and have not been appropriately tested are exempt from the aforementioned criteria.

It's crucial to note that if a woman is experiencing new symptoms, such as unusual bleeding, a diagnostic Pap test may be performed sooner.
In addition, women who are being followed for an abnormal Pap test or who have been treated for an abnormal Pap test will have a different follow-up plan than those listed above.

What is the cervical cancer vaccination and how does it work?
Gardasil®, a cervical cancer vaccination, is licensed for girls and women aged 9 to 26 and prevents them from developing cervical cancer. The vaccine, which also protects against genital warts (and has been authorized for males for this reason), works by causing the body's immune system to target particular strains of human papillomavirus (HPV), which have been related to a high number of incidences of cervical cancer. It is preferable to acquire the immunization before to beginning sexual activity. The vaccination comprises of three doses, the second of which is given two months after the first and the third of which is given six months after the first.