Dr. Tariq Jagnarine
Fam Medicine
Cervical cancer affects the entrance to the womb. It may not cause any symptoms in the early stages, but symptoms may include pelvic pain, bleeding between periods, and vaginal discharge with a strong odor.
Human papillomavirus (HPV) causes most cervical cancer cases. The HPV vaccine successfully prevents HPV.
The Centers for Disease Control and Prevention (CDC) initially recommended the vaccine for all people aged 9–26. However, the CDC now advises that the vaccine is also available for all women and men aged 26–45 years who received the vaccine as a preteen.
In the early stages of cervical cancer, a person may experience no symptoms at all. As a result, women should have regular cervical smear tests or Pap tests.
A Pap test is preventive. 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:
• Bleeding between periods
• Bleeding after sexual intercourse
• Bleeding in post-menopausal women
• Discomfort during sexual intercourse
• Vaginal discharge with a strong odor
• Vaginal discharge tinged with blood.
• Pelvic pain
These symptoms can have other causes, including infection. Anyone who experiences any of these symptoms should see a doctor.
STAGES
Working out the stage of a cancer is important, as it helps a person decide the most effective type of treatment. Staging aims to assess how far the cancer has spread and whether it has reached nearby structures or more distant organs. A 4-stage system is the most common way to stage cervical cancer.
Stage 0: Precancerous cells are present.
Stage 1: Cancer cells have grown from the surface into deeper tissues of the cervix, and possibly into the uterus and to nearby lymph nodes.
Stage 2: The cancer has now moved beyond the cervix and uterus, but not as far as 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 present in the lower part of the vagina or the walls of the pelvis, and they may be blocking the ureters, the tubes that carry urine from the bladder. It may or may not affect nearby lymph nodes.
Stage 4: The cancer affects the bladder or rectum and is growing out of the pelvis. It may or may not affect the lymph nodes. Later in stage 4, it will spread to distant organs, including the liver, bones, lungs, and lymph nodes.
Undergoing screening and seeking medical attention if any symptoms occur can help a person access early treatment and increase the chances of survival.
RISK FACTORS
This increases their risk of developing cervical cancer.
• Smoking: This increases the risk of cervical cancer, as well as other types.
• A weakened immune system: The risk of cervical cancer is higher in those with HIV or AIDS, and people who have undergone a transplant, leading to the use of immunosuppressive medications.
• Birth control pills: Long-term use of some common contraceptive pills slightly raises a woman’s risk.
• Other sexually transmitted diseases (STD): Chlamydia, gonorrhea, and syphilis increase the risk of developing cervical cancer.
• Socio-economic status: Rates appear to be higher in areas where income is low.
CAUSES
Cancer is the result of the uncontrolled division and growth of abnormal cells. Most of the cells in our body have a set lifespan, and, when they die, the body generates new cells to replace them.
Abnormal cells can have two problems: they do not die, they continue dividing.
This results in excessive cell buildup, eventually forming 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: This is a sexually transmitted virus. More than 100 different types of HPV can occur, at least 13 of which may cause cervical cancer.
Having many sexual partners or becoming sexually active early: The transmission of cancer-causing HPV types nearly always occurs because of sexual contact with an individual who has HPV. Women who have had many sexual partners generally have a higher risk of HPV infection.
PREVENTION
Several measures can help reduce the chances of developing cervical cancer.
• Human papillomavirus (HPV) vaccine
The link between the development of cervical cancer and some types of HPV is clear. If every female keeps to the current HPV vaccination programs, they could reduce the frequency of cervical cancer.
• Safe sex and cervical cancer
The HPV vaccine only protects against two HPV strains. Other strains can cause cervical cancer. Using a condom during sex helps protect from HPV infection.
• Cervical screening
Regular cervical screening might help a person identify and deal with signs of cancer before the condition can develop or spread too far. Screening does not detect cancer but indicates changes to the cells of the cervix.
• Having fewer sexual partners
The more sexual partners a woman has, the higher the risk of transmitting the HPV virus becomes. This can lead to a higher risk of developing cervical cancer.
• Delaying first sexual intercourse
The younger a woman is when she has sexual intercourse for the first time, the higher the risk of HPV infection becomes. The longer she delays it, the lower her risk.
• Stopping smoking
Women who smoke and have HPV face a higher risk of developing cervical cancer than people who do not.
