Dr. Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes
Cervical cancer is a type of cancer that starts in the cervix. Most cervical cancers begin in cells on the surface of the cervix. Cervical cancer used to be a leading cause of death, but that’s changed since screening tests became widely available.
Most cases will be diagnosed in people with a cervix between the ages of 35 and 44. Hispanic, Indigenous and African women are the ethnic groups most likely to get cervical cancer. The death rate from cervical cancer has dropped over the years. From 2002 to 2016, the number of deaths was 2.3 per 100,000 women per year. In part, this decline has been due to improved screening.
RISK FACTORS
HPV is the biggest risk for cervical cancer. Other factors that can increase the risk include:
• HIV
• Chlamydia
• Smoking
• Obesity
• Family history of cervical cancer
• Diet low in fruits and vegetables
• Birth control pills
• Three or more full-term pregnancies
• Younger than 17 when you got pregnant for the first time
Even if persons have one or more of these factors, they’re not destined to get cervical cancer.
CAUSES
Most cervical cancer cases are caused by the sexually transmitted human papillomavirus (HPV). This is the same virus that causes genital warts. There are about 100 different strains of HPV. Only certain types cause cervical cancer. The two types that most commonly cause cancer are HPV-16 and HPV-18.
Being infected with a cancer-causing strain of HPV doesn’t mean people will get cervical cancer. The immune system eliminates the vast majority of HPV infections, often within 2 years.
HPV can also cause other cancers in women and men. These include:
Vulvar cancer
Vaginal cancer
Penile cancer
Anal cancer
Rectal cancer
Throat cancer
SYMPTOMS OF CERVICAL CANCER
Many women with cervical cancer don’t realize they have the disease early on, because it usually doesn’t cause symptoms until the late stages. When symptoms do appear, they’re easily mistaken for common conditions like menstrual periods and urinary tract infections (UTIs).
Typical cervical cancer symptoms are:
• Unusual bleeding, like in between periods, after sex, or after menopause
• Vaginal discharge that looks or smells different than usual
• Pain in the pelvis
• Needing to urinate more often
• Pain during urination
CERVICAL CANCER STAGES
After being diagnosed, the doctor will assign the cancer a stage. The stage tells whether the cancer has spread, and if so, how far it’s spread. Staging cancer can help with the right treatment.
Cervical cancer has four stages:
Stage 1: The cancer is small. It may have spread to the lymph nodes. It hasn’t spread to other parts of the body.
Stage 2: The cancer is larger. It may have spread outside of the uterus and cervix, or to the lymph nodes. It still hasn’t reached other parts of the body.
Stage 3: The cancer has spread to the lower part of the vagina or to the pelvis. It may be blocking the ureters, the tubes that carry urine from the kidneys to the bladder. It hasn’t spread to other parts of the body.
Stage 4: The cancer may have spread outside of the pelvis to organs like the lungs, bones, or liver.
TREATMENT
Cervical cancer is very treatable, once diagnosed early. The four main treatments are:
Surgery
Radiation therapy
Chemotherapy
Targeted therapy
Sometimes these treatments are combined to make them more effective.
• Surgery
The purpose of surgery is to remove as much cancer as possible. Sometimes the doctor can remove just the area of the cervix that contains cancer cells. For cancer that’s more widespread, surgery may involve removing the cervix and other organs in the pelvis.
• Radiation therapy
Radiation kills cancer cells using high-energy X-ray beams. It can be delivered through a machine outside the body. It can also be delivered from inside the body using a metal tube placed in the uterus or vagina.
• Chemotherapy
Chemotherapy uses drugs to kill cancer cells throughout the body. Doctors give this treatment in cycles. They will get chemo for a period of time, then stop the treatment to give the body time to recover.
• Targeted therapy
Bevacizumab (Avastin) is a newer drug that works in a different way from chemotherapy and radiation. It blocks the growth of new blood vessels that help cancer grow and survive. This drug is often given together with chemotherapy.
