What You Should Know About Cervical Cancer
What is Cervical Cancer?
Cervical cancer is a type of cancer that starts in the cervix. The cervix is a hollow cylinder that connects the lower part of a woman’s uterus to her vagina. Most cervical cancers start in cells on the surface of the cervix.
Cervical cancer was once a leading cause of death among American women. This has changed since screening tests became widely available.
Cervical Cancer Symptoms
Many women with cervical cancer do not realize that they have the disease early because it does not usually cause symptoms until the late stages. When symptoms do occur, they are easily confused with common conditions such as menstrual periods and urinary tract infections (UTIs).
Typical cervical cancer symptoms:
- unusual bleeding between periods, such as after sex or after menopause
- vaginal discharge that looks or smells different from normal
- pain in the pelvis
- needing to urinate more often
- pain during urination
If you notice any of these symptoms, see your doctor for an examination. Find out how your doctor will diagnose cervical cancer.
Cervical Cancer Causes
Most cases of cervical cancer 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 type of HPV does not mean you will get cervical cancer. Your immune system usually clears up the vast majority of HPV infections within two years.
HPV can also cause other cancers in men and women. These include:
- vulvar cancer
- vaginal cancer
- penile cancer
- anal cancer
- rectal cancer
- throat cancer
HPV is a very common infection. The vast majority of sexually active adults will experience it at some point in their lives.
Cervical Cancer Treatment
Cervical cancer is very treatable if caught early. The four main treatments are:
- radiation therapy
- targeted therapy
Sometimes these treatments are combined to make them more effective.
The goal of surgery is to remove as much of the cancer as possible. Sometimes the doctor can remove the area of the cervix that contains the cancer cells. For the more common cancer, surgery may involve removing the cervix and other organs located in the pelvis.
Radiation kills cancer cells using high-energy X-ray beams. It can be delivered with a machine outside the hull. It can also be given inside the body using a metal tube inserted into the uterus or vagina.
Chemotherapy uses drugs to kill cancer cells in the body. Doctors give this treatment in cycles. You will have chemotherapy for a while. You will then stop the treatment to give your body time to heal.
Bevacizumab (Avastin) is a newer drug that works differently than chemotherapy and radiation. It inhibits the growth of new blood vessels, which helps the cancer grow and survive. This drug is usually given together with chemotherapy.
If your doctor discovers precancerous cells in your cervix, they can be treated.
Cervical Cancer Stages
Once diagnosed, your doctor will assign a stage to your cancer. Stage tells you whether the cancer has spread, and if so, how far. Staging your cancer can help your doctor find the right treatment for you.
There are four stages of cervical cancer:
- Stage 1: Cancer is small. It may have spread to the lymph nodes. It has not spread to other parts of your body.
- Stage 2: Cancer is bigger. It may have spread outside the uterus and cervix or to the lymph nodes. It still hasn’t reached other parts of your body.
- Stage 3: Cancer has spread to the lower part of the vagina or pelvis. It may be blocking the ureters, which are the tubes that carry urine from the kidneys to the bladder. It has not spread to other parts of your body.
- Stage 4: Cancer may have spread outside of the pelvis to organs such as your lungs, bones, or liver.
Cervical Cancer Test
The Pap smear test is a test doctors use to diagnose cervical cancer. To do this test, your doctor takes a sample of cells from the surface of your cervix. These cells are then sent to a lab to be tested for precancerous or cancerous changes.
If these changes are found, your doctor may recommend colposcopy, a procedure to examine your cervix. During this test, your doctor may take a biopsy, which is a sample of cervical cells.
The US Preventive Services Task Force (USPSTF) recommends the following screening program for women by age:
- 21-29 years: Have a Pap smear every three years.
- 30 to 65 years old: Get a Pap smear every three years, a high-risk HPV (hrHPV) test every five years, or a Pap smear plus hrHPV test every five years.
Cervical Cancer Risk Factors
HPV is the biggest risk for cervical cancer. Other factors that can increase your risk include:
- human immunodeficiency virus (HIV)
- to smoke
- family history of cervical cancer
- eating away from fruits and vegetables
- birth control pills
- having three full-term pregnancies
- being younger than 17 when you first become pregnant
Even if you have one or more of these factors, it is not certain that you will get cervical cancer.
Cervical Cancer Prognosis
For cervical cancer caught in the early stages, while still confined to the cervix, the five-year survival rate is 92 percent.
Once the cancer has spread to the pelvic area, the five-year survival rate drops to 56 percent. If the cancer spreads to distant parts of the body, the survival rate is only 17 percent.
Routine testing is important to improve the outlook for women with cervical cancer. This cancer is very treatable when caught early.
Cervical Cancer Surgery
Several different types of surgery treat cervical cancer. Which one your doctor recommends depends on how far the cancer has spread.
- Cryosurgery freezes cancer cells with a probe inserted into the cervix.
- Laser surgery burns the abnormal cells with a laser beam.
- Conization removes a cone-shaped section of the cervix using a surgical blade, laser, or electrically heated thin wire.
- Hysterectomy removes the entire uterus and cervix. When the top of the vagina is also removed, this is called a radical hysterectomy.
- Trachelectomy removes the cervix and upper part of the vagina, but leaves the uterus in place so a woman can have children in the future.
- Pelvic exenteration may remove the uterus, vagina, bladder, rectum, lymph nodes, and part of the colon, depending on where the cancer has spread.
Preventing Cervical Cancer
One of the easiest ways to prevent cervical cancer is to be screened regularly with a Pap smear and/or hrHPV test. Screening takes precancerous cells so they can be treated before they turn into cancer.
HPV infection causes most cases of cervical cancer. Infection can be prevented with the Gardasil and Cervarix vaccines. Vaccination is most effective before a person becomes sexually active. Both boys and girls can be vaccinated against HPV.
Here are a few other ways to reduce your risk of HPV and cervical cancer:
- limit the number of sexual partners you have
- always use a condom or other barrier method when you have vaginal, oral or anal sex
An abnormal Pap smear result indicates precancerous cells in your cervix.
Cervical Cancer Statistics
The American Cancer Society estimates that approximately 13,170 American women will be diagnosed with cervical cancer in 2019, and 4250 will die from the disease. Most cases are thought to be diagnosed in women between the ages of 35 and 44.
Hispanic women are the ethnic group most likely to develop cervical cancer in the United States. Native Americans and Alaska Natives have the lowest rates.
Over the years, the death rate from cervical cancer has decreased. Between 2002 and 2016, the death toll was 2.3 per 100,000 women per year. This decline is partly due to improved screening.
Cervical Cancer and Pregnancy
It’s rare to be diagnosed with cervical cancer while pregnant, but it can happen. Most cancers found during pregnancy are discovered at an early stage.
Treating cancer while pregnant can be complex. Your doctor can help you decide on a treatment based on the stage of your cancer and how advanced your pregnancy is.
If the cancer is at a very early stage, you can wait for delivery before starting treatment. For a more advanced case of cancer where treatment requires a hysterectomy or radiation, you will need to decide whether to continue the pregnancy.
Doctors will try to deliver your baby as soon as it survives outside the womb.
Healthline, Everything You Need to Know About Cervical Cancer, 2019
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