Cervical Cancer
Published on March 2nd 2021. Information will be updated.
Cervical cancer is a cancer located in the cervix. The cervix is the lower part of the uterus connecting to the vagina. There are two types of this cervical cancer which are squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma is when cancer cells originate in flat cells that line the outer part of the cervix. This carcinoma is more common than adenocarcinoma. Adenocarcinoma is when cancer originates in the column-shaped glandular cells which line the cervical canal. The cervix will later become inflamed and the cancer cells will spread to other parts of the body. Human papillomavirus (HPV) can cause cervical cancer by the small strains being spread into the uterus.
Causes
There are several causes, but like every other cancer, the cause is unknown. The cervix starts off healthy, but as life progresses there may be DNA changes in the patient’s genetic information (also known as mutations). Healthy cells would multiply at a constant rate, and die accordingly. However, mutated cells multiply uncontrollably and they don’t die so easily. These mutated cells would eventually create big abnormal cells which will create tumors. As the disease progresses, the tumor would be able to metastasize (or spread) in other parts of the body and therefore become cancer cells. Although this is the cause for cancers, there isn’t a known cause coming from the environment. However, it is known that HPV plays a role in cervical cancer. Although people with HPV don’t usually develop cervical cancer, it is a possibility that other environmental factors are coordinated with this virus to develop cervical cancer.
Risk Factors
There are several risk factors for cervical cancer in which the majority is sex related. Clearly, one of the risk factors is females because females can only get this disease as the uterus is involved. Secondary, if the patient has multiple sex partners, or their partner had multiple sex partners, then there will be a greater chance for HPV to occur which could possibly develop into cervical cancer. If the patient is having sex at an early age, then patient has a higher chance to get HPV. When the people have sexually transmitted infections (STIs) such as HIV/AIDS and gonorrhea they will have a greater possibility to receive HPV as it falls into the same STI category. If the patient has a weakened immune system by another condition or HPV, the patient has an increased risk of getting cervical cancer. Patients that smoke have a higher chance of getting squamous cell carcinoma. Lastly, patients exposed to diethylstilbestrol (DES) from their mothers are more likely to get clear cell adenocarcinoma.
Signs and Symptoms
Symptoms depend which stage the cancer the patient is at. Almost no symptoms occur in the stage one of cervical cancer. However, in stages 2-4, they may experience vaginal bleeding after intercourse whether it is between periods or after menopause. Other symptoms such as pelvic pain and watery, bloody vaginal discharge (usually has a bad odor) may occur if the cervical cancer is around stage 3 or 4.
Diagnosis
The diagnosis for cervical cancer calls for screening to identify cancerous or precancerous cells. However, this procedure must be done after the age of 21, so the diagnosis cannot be performed on younger patients. There are two types of screening tests which are the Pap test and the HPV DNA test. The pap test takes cells from the cervix with a small brush and plastic spatula using a vaginal speculum to open up the vagina. These tissues are taken for lab examinations to identify the development of the cell. The HPV DNA test involves the same procedure of taking the cervical tissue and later identifying if HPV is present. If the physician suspects cancer either screening, the doctor must perform a thorough examination of the cervix such as performing a biopsy, endocervical curettage, or electrical wire loop. After it has been confirmed that the patient has cervical cancer, the physician must figure out which stage the patient is at for further treatment options. Physicians may use imaging tests such as x-rays, MRIs, and CT scans to determine if the cancer cells spread throughout the body. Alternatively, the physician may visually examine the patient’s bladder and rectum with either a colposcope or the vaginal speculum.
Treatment
Fortunately, there are a lot of treatments for cervical cancer, but it won’t be entirely cured if it was at stage 3 or 4. Surgery is usually a treatment for patients who are in their early stage of cervical cancer to further prevent from developing. Surgery can take place to either remove the affected tissue of the cervix, remove the cervix, or remove both the cervix and uterus (also known as hysterectomy). If the patient does the first two options, they can become pregnant if they chose to, but patients won’t get pregnant when taking the third option because the uterus is removed. If surgery is not an option, the patient may take radiation therapy, chemotherapy, targeted therapy, immunotherapy, or supportive care. Radiation therapy kills cancer cells by using high-powered energy beams. Chemotherapy uses drugs to kill cancer cells by the physician injecting the drug or a pill is taken. Targeted therapy uses drugs to target the weaknesses of the cancer cells which will eventually make the cancer cells die. Immunotherapy uses drugs that strengthen the immune system to fight cancer cells. Lastly, palliative (supportive) care is used to relieve pain and symptoms of another illness.
Prevention
Luckily, there are precautions to prevent cervical cancer if the patient is at high risk for it. The number one precaution that needs to be taken is to discuss with the physician about the HPV vaccine and see if you are eligible. Physicians recommended patients at the age of 21 to take Pap tests to see if there are any precancerous cells present in the cervix. Patients must perform safe sex to prevent HPV or other STIs by using a condom and limiting the number of partners the patient has. Lastly, avoid smoking as much as possible as it can promote squamous cell carcinoma from developing.
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Resources
Cervical cancer - Symptoms and causes. (2019, July 31). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cervical-cancer/symptoms-causes/syc-20352501