Cervical cancer is the third most common type of cancer affecting women worldwide. It can be successfully treated if detected in the early stages and women must be aware of its signs and symptoms including what is normal for their bodies. If detected early, cervical cancer is one of the most successfully treatable cancers. Cervical cancer tends to appear during midlife. Over half of the women diagnosed are between the ages of 35 and 55. It rarely occurs in women under 20 and only 20% of the infected women are over 65 years of age.
Cervical cancer is a disease in which cells in the cervix become malignant (cancerous). The two main types of cells covering the cervix are squamous cells (on the exocervix) and glandular cells (on the endocervix). The place where these two cell types meet is called the transformation zone. Cervical cancer is slow-growing and does not have immediate symptoms but with regular Pap smear tests (a procedure in which cells are scraped from the cervix and looked at under a microscope) it can be found. Cervical cancer is almost always caused by the Human Papillomavirus (HPV) infection. Cervical cancer starts as a pre-cancerous condition called dysplasia. This pre-cancerous condition can be detected by a Pap smear and is 100% treatable. That is why it is so important for women to get regular Pap smears done. Most women who are diagnosed with cervical cancer today have not had regular Pap smears or they have not followed up on abnormal Pap smear results. Undetected pre-cancerous changes can develop into cervical cancer. From there it can spread to the bladder, intestines, lungs, and liver. Patients usually start experiencing problems when the cancer is already advanced and has spread.
Risk factors for cervical cancer include:
- HPV infection: Cervical cancer is mainly caused by the Human Papilloma Virus (HPV), a common virus spread through skin to skin contact, body fluids, and sexual intercourse, which increases risk.
-Women living with HIV are at increased risk of developing cervical cancer and experience a much more rapid progression of the disease.
- Having sex at an early age.
-Having many sexual partners.
-Smoking tobacco products increases one’s risk.
- Using oral contraceptives.
- Having a weakened immune system.
- Poor economic status (may not be able to afford regular Pap smears or have limited access to
screening services).
- Sexual partners who have multiple partners or who participate in high-risk sexual activity.
-Parity: HPV is less common among women with decreased parity .
- Ineffective management and treatment of sexually transmitted infections (STI’s).
Furthermore, being overweight, inactive, consuming alcohol, poor dietary habits, smoking and exposure to chemicals increases risk.
The above risks can be lowered by:
- Having regular pap smears that can detect abnormal cells in the cervix (lower part or mouth of the womb), that could develop into cervical cancer. Screening involves taking a swab of the cervical cells. It is uncomfortable but painless.
Who should have a pap smear?
-All women sexually active should start having Pap smears.
-Every eligible woman should preferably have a Pap smear at least every 3 years.
- Reduce risks by educating the community about the importance of vaccination of all girls against HPV.
-The primary underlying cause of cervical cancer is the Human Papilloma Virus which is transmitted through skin to skin contact and is a very common virus infecting most people at some point in their lives. So getting the HPV vaccine before becoming sexually active is an important thing to do. The human papilloma virus vaccination should be offered to all girls and boys aged 11 to 12 years, and can also be given as early as age 9 and through 26 years of age.
HIV positive people are at higher risk of HPV infection and persistence. Research shows that they are infected with a broader range of HPV strains. Research has also found that those who are treated with Highly Active Antiretroviral Therapy (HAART), have a longer lifespan and are at a significantly higher risk to develop cancer of the cervix.
High -risk HPV is estimated to cause 70% of cervical cancers, 50% of vaginal & vulvar cancers and 20% of head and neck cancers. Medical male circumcision helps to reduce Human Immunodeficiency Virus (HIV) acquisition and transmission, and is protective for Human Papilloma Virus (HPV) in males, thus reducing the risk of initial or re-infection of HPV among women.
Early signs and symptoms of cervical cancer In women include:
- Abnormal vaginal bleeding between periods, after intercourse, or after menopause.
- Any bleeding after menopause.
- Continuous vaginal discharge, which may be pale, watery, pink, brown, bloody or foul-smelling.
- Periods becoming heavier and lasting longer than usual (Signs and symptoms of progressed cervical cancer).
- Some of the common symptoms observed during the later stages of cervical cancer are Vaginal bleeding after sexual intercourse.
- Pelvic pain: Pain during sexual intercourse.
- Offensive vaginal discharge may occur (pink, pale, brown, blood-streaked, and foul-smelling).
- Abnormal bleeding between menstrual periods.
- Heavy bleeding during the menstrual period.
- Increased urinary frequency.
- Bleeding after menopause.
- Painful urination.
- Pelvic pain that is not related to the normal menstrual cycle.
- Low back pain.
- Leg pain.
- Single swollen leg.
- Bone fractures.
- Weight loss.
- Urethritis or urinary infection can be a sign of cervical cancer.
Treatment of cervical cancer depends on:
- The stage of the cancer.
- The size and shape of the tumor.
- The woman’s age and general health and,etc.
- Hysterectomy (removal of the uterus).
-Internal Radiation Therapy.
Radiation Therapy may be used to treat cancer that has spread beyond the pelvis, or cancer that has returned.
Follow-up checks will continue for some years after treatment. At first, follow-up checks may be conducted every few months, becoming gradually less and less frequent. Follow-up checks may include:
- Having a physical examination by the medical practitioner.
- Pap smear.
- Colposcopy.
- Blood tests for tumor markers
