Cervical Cancer

Cervical Cancer

A Brief about Cervical Cancer:

The lowest part of a woman’s uterus is known as Cervix. Uterus is a reproductive organ of a woman’s body where the foetus turns into an embryo when a woman is pregnant. During different stages of pregnancy, the uterus develops and grows enormously in size. Normally, the uterus is a pear-shaped organ that sits between the rectum and the bladder of a woman’s body. During routine pelvic examination, the cervix can be sampled and visualized by professional surgeons.

 

Cervical cancer occurs due to uncontrollable  growth of cells in the cervix. This uncontrollable movement of cells can seize the space of nearby tissues and spread across the entire body. Eventually, this uncontrollable growth of cells is referred to as tumors. At the initial stage of cervical cancer, cells are slow growing, although can catch speed and spread quickly. 

 

Commonly found cervical cancer is known as Squamous cell carcinoma. The origin of this type of cervical cancer is due to the growth of a squamous cell that lies on the surface of the cervix. This type of cervical cancer contributes up to 80% of all kinds of cervical cancers. The development in the branch of sciences has substantially increased the survival rate for most cervical cancer patients. There are multiple factors that contribute to death of cervical cancer patients. As a study, comprehensive research and early medication is commonly seen as an approach by the doctors.

 

What are the types of Cervical Cancer?

On an individual level, every cervical cancer patient is different. Cervical Cancer starts due to abnormal growth of cells that line the cervix. If not treated at an early stage, these abnormal cells turn cancerous. As per study, cervical cancer types are stated as two: Squamous cell Carcinoma and Adenocarcinoma. 

  • Squamous cell carcinoma: The most common type of cervical cancer is squamous cell carcinoma which is usually witnessed near the areas of the body that is damaged by UV rays from the sun or due to tanning beds. A slow-growing type of cervical cancer, SCC spreads to the nearby tissues, bones, lymph nodes which results in urgent treatment and medication. Below are the reason due to which SCC is likely to develop:
  1. Older age problems
  2. Blonde or red hair
  3. Indefinite exposure to radiation
  4. Tanning beds and bulbs
  5. Exposure to chemicals like arsenic in the water
  • Symptoms of Squamous cell carcinoma:  This type of cervical cancer starts as a dome-shaped bump or an irregular red patch of skin. It looks rough and brittle and can result in bleeding when scratched by the patient. After which, large growths of these patches turn itchy and start hurting to an extent. Under such circumstances, consult a doctor immediately for cancer treatment.
  • Diagnosis: The doctor might refer a dermatologist when the condition looks chronic. An expert dermatologist will examine your past medical history, severe sunburns if any or signs of indoor tanning. After which, a physical examination is conducted to understand the cause, shape, color, texture of the spot. The dermatologist will also question about any other such spots on the body before further processing. After various cross checks, the dermatologist might send the sample of the spot to a lab for testing.
  • Treatments for Squamous cell carcinoma: At an initial stage, SCC can be treated with a minor surgery by experienced cancer hospitals. The size and the location of the squamous cell determines the further action taken by the  doctors:
  1. Surgery by using a small hand tool along with an electronic needle to kill the abnormal cancer cells.
  2. Excision:  Trimming the area near the spot along with the infected area and stitching the entire wound.         
  3. Mohs Surgery: Along with the technique of excision, inspecting the excised skin through a microscope. As a result, the wound requires to be stitched.
  4. Topical Chemotherapy: A specific kind of cream is applied on to the skin through the method of microneedling.
  5. Dermabrasion: Sanding the affected area with a particular equipment which results in formation of new skin layers.
  6. Superficial Radiation Therapy.
  • How to protect yourself: Under most circumstances, it is advised to consult your respective dermatologist for routine skin checks. Also, avoid going outside and exposure to the sun during peak hours like 12 noon. For delicate skin tissues, use a sunscreen daily to avoid irritation and itchy skin. Avoid tanning beds as well.

       

The next type of cervical cancer is known as:

  • Adenocarcinoma: This type of cancer can occur in places like colon, breasts, esophagus, pancreas, lungs or prostate. A type of cancer that begins in the glands that are a lining to the organs.  Adenocarcinoma gets the growth of cells out of control and spread to others places harming the healthy tissues of the body. Adenocarcinoma can happen in the following places
  1. Colon and Rectum: Colon, also known as large intestine is a long-tube that absorbs all the water and nutrients from the food that the human body consumes. Adenocarcinoma starts with a small polyp at first but can turn into cancer. Under rectum, this cancer type can start where the leftover waste called stool, is excreted from the body.
  2. Breasts:   Adenocarcinoma starts by uncontrollable growth of tissues in the glands of the breast where the milk is formed.    
  3.  Esophagus: A tube like structure that carries everything that is consumed by the human body from the mouth to the stomach. This type of cancer begins in mucus glands that provides a lining to the lower part of the esophagus.  
  4. Pancreas: The function of pancreas is to collectively circulate enzymes to the entire body that help in digestion of consumed food. Adenocarcinoma starts in the ducts of this organ.
  5. Lungs: Commonly found, adenocarcinoma affects the outer part of the lungs and starts developing slowly. Habits like smoking results in Adenocarcinoma Lung cancer.
  6.  Prostate: A gland located below the bladder in men. Functions to make fluids that protect sperm cells. Adenocarcinoma attacks these cells that make the fluid and result in excessive fluid formation.
  • Symptoms of Adenocarcinoma:  Acute pain, diarrhea, abnormal bleeding, unusual fatigue are some of the symptoms of this disease. Consult a doctor for some physical examinations if you feel major swelling of certain body parts.
  • Treatments done for Adenocarcinoma:  Treatments done by cancer surgeons depend on the type of adenocarcinoma and the stage of this cancer type. Listed below are the treatments offered to cancer patients:
  1. Surgery:  Mostly, surgeons probably remove the tumor and the tissue around it. 
  2. Chemotherapy: After medical examination and viewing past medical history, certain medicinal drugs are prescribed to either kill adenocarcinoma cells, slow their growth or even cure the disease. 
  3. Radiation: Experts operate on the basis of high-energy X-Rays to kill cancer cells effectively.

 

What are the early signs of Cervical cancer?

Usually, there are no signs and symptoms of a precancer. For most women, within the early stage of cervical cancer, early signs do typically appear depending on the severity of the tissue and to which level the disease has spread. Potential symptoms of cervical cancer is as follows:

  • Infrequent spotting or light bleeding between or after periods
  • Menstrual bleeding exceeds usual days taken.
  • Abnormal Bleeding after intercourse, douching or after a pelvic examination
  • Increased vaginal flow of discharge
  • Bleeding after complete menopause
  • Chronic back pain, Persistent Pelvic Pain

 

If any of the above cervical cancer signs and symptoms are observed, report to a doctor immediately. The earlier precancerous cells can be treated with medical facilities and minor surgery. If there is frequent experience of any of the above symptoms, consult a doctor. The concerned physicians will examine your medical history and question you about how often you’ve been experiencing the symptoms. This will help for further diagnosis.

 

For signs of cervical cancer, palliative or supportive care is released to the patient. It is often started after complete diagnosis and continued throughout the treatment.

 

What are the causes of Cervical Cancer?

During recent years, there has been a lot of development and progress in comprehending as to what happens to the cells in the cervix when a form of cancer develops. There are several causes of cervical cancer that have been identified stating the odds that a woman might develop cervical cancer. Human cells often develop, fall dead and restore depending on the information present in the cells’ DNA.  The chemical which is present in the cells that make up our genes is known as DNA. Some of the genes function on controlling when a cell grows, divides and dies:

  • Oncogenes: A type of gene that has the potential to cause cancer. In the cases of tumor cells, oncogenes are often mutated or expressed at high levels
  • Tumor Suppressor gene: This is a gene that manages a cell during cell division and duplication. If there is an abnormal growth of cells, then it leads to cancer.

 

Cancers are generally caused by DNA mutations, also known as gene defects that specifically turn on oncogenes or turn off tumor suppressor genes. HPV, short abbreviation for Human Papillomaviruses contain two proteins named as E6 and E7 which deactivate some of the tumor suppressor genes, known as P53 and Rb. As a result, this allows the cells lining the cervix grow invariably and develop additional genes leading to cancer.

 

As per study, HPV is not the definite cause of cervical cancer. Majorly, women with HPV dont get cervical cancer, and other risk factors like smoking and HIV infection become the main reason why women are exposed to developing cervical cancer.

 

Risk Factors involved in Cervical Cancer:

Risk factors concerning the growth of cancer in the cervix are due to multiple reasons. The chances of getting damaged by the cancerous growth is high in cases of cervical cancer. However, having cervical cancer symptoms does not automatically mean you can fall prey to it. According to recent study, Expert cancer hospitals have identified proper risk factors based on studying women affected by cervical cancer.  In most cases, cervical cancer is caused by HPV, a common virus that can be passed from one person to another during sexual intercourse. There are types of HPV which can either cause changes in a woman’s cervix or cause genital and skin warts. Other factors that can increase the risk of cervical cancer are listed below:

  • Diagnosed with HIV or another condition that makes the immunity of the body weaker.
  • Aggressive smoking
  • Consumption of birth control pills for a longer period of time
  • Having several sexual partners.

Prevention of Cervical Cancer:

It is vitally important to make the necessary changes in the lifestyle to reduce the risk of getting cervical cancer. There are multiple things noted that a woman can do to prevent cervical cancer. This includes:

  1. Regular Pap Testing: The major reason that women of a certain age develop cervical cancer tissues resulting in deaths.
  2. Proper Vaccination: Three vaccines named as Gardasil, Gardasil 9, and Cervavix have been developed to maintain immunity balance and increase fighting powers of cells. The HPV Vaccine is recommended for individuals ranging from 12-26 years of age. These vaccines are found to be effective in preventing infection with some strains of HPV.
  3. HPV can also lead to vulvar, vaginal, penile and anal cancers if proper vaccination is not taken.
  4. Quit smoking if you are already a smoker. And don’t start smoking if you have quit. Smoking in recent years has been the  major reason for decrease in immunal balance in most cases.
  5. Limiting the preferences of sexual partners by delaying the onset of sexual activity can happen to reduce the risk of infection found in cervical cancer stages.
  6. Using condom during sexual intercourse may decrease areas that are exposed to abnormal growth of cells.

 

Diagnosis of Cervical Cancer:

Showing symptoms of cervical cancer will require immediate diagnosis. The diagnosis of cervical cancer is made after detecting certain abnormal growth of cells in the routine checks. List of diagnostic procedures are as follows:

Colposcopy: When diagnosed with cervical cancer, the next step usually referred is colposcopy. This test looks for any abnormalities in the cervix and is conducted by a nurse, who is specifically called a colposcopist. The concerned colposcopist will use a device named speculum to open the woman’s vagina ( also a part of cervical screening). To look at the cervix, using a microscope is recommended which stays outside the body. 

To understand the growth of cancerous cells, a small part of the tissue is collected as a sample which is called biopsy while examining the cervix. After a biopsy is taken, the patient can encounter vaginal bleeding for a time period of 6 weeks.

It is strongly mentioned that the abnormalities do not confirm cancer symptoms, consult a gynaecologist for further procedures.

Further Diagnostic Testing:

After the colposcopy is confirmed positive, confirming cervical cancer then it involves the risk of spreading to healthy tissues. Some further tests are prescribed for detailed report analysis:

  • A Pelvic examination done earlier under general anaesthetic- that is womb, vagina, rectum and bladder will be checked for cancerous cells.
  • Blood tests: Some blood tests are given to assess the condition of liver, kidneys and bone marrow.
  • A CT Scan: A CT scan report will help the gynae to identify cancerous tumours cells and whether they have started to spread to nearby areas.
  • An MRI Scan: With CT Scan, this scan is prescribed to check whether the cancer has spread or not.
  • A Chest X-Ray: To understand the state of lungs and whether the tumour has reached the lungs.
  • A PET Scan: This test is combined with a CT Scan to see if the cancerous cells have started to grow uncontrollably and also to check if the patient is responding to the current medication prescribed.
  • PAP Smear: Also known as PAP Test, Pap smear is a procedure to test for cervical cancer in women This test involves collecting the cells from the cervix. Detection of cervical cancer through the test of pap smear gives you a greater chance at a cure.

What are the treatment options for Cervical Cancer?

Cancer treatments are often complex, cancer patients are given proper medication to fight cancer. Best cervical cancer treatments involve using multidisciplinary teams, MDTs to treat cervical cancer and adapt the treatment programme to the cancer patient. Under most cases, the cancer team recommends the best treatment options depending on the severity of the situation:

  • For early cervical cancer: Surgeries are performed to remove the cervix, or radiotherapy is conducted or a combination of both.
  • For advanced cervical cancer: Radiotherapy with or without chemotherapy is conducted as per the medication entitled to the cancer patient.

Cervical Cancer is curable when diagnosed at an initial stage. Under crucial circumstances, when cervical cancer is not curable, to slow its growth and provide a lifespan, palliative care is given. The following are the treatment options for cervical cancer:

  1. Large Loop Excision of the Transformation Zone (LLETZ): Under this cancer treatment, using a fine wire with an electric current the cancerous cells are removed. This treatment is done by giving local anaesthetic and can be performed at the same time as colposcopy
  2. Cone Biopsy: During this surgery, surgeons remove a cone-shaped area of the abnormal tissue. This is usually performed under general anaesthetic.
  3. Trachelectomy: When cervical cancer is identified at the initial stage, then this treatment is best suited for the cancer patient. During this procedure, the cervix and the upper section of the vagina are removed. The womb sits at its original place and will be reattached to the lower section of the vagina. Also, it is advised to wait for a period of 6 to 12 months to conceive as the womb and vagina needs time to heal.
  4. Hysterectomy: Recommended for early cervical cancer signs. Hysterectomy is followed by a course of radiotherapy to prevent the cancer from coming back. There are two types of hysterectomies that are designed to treat cervical cancer:
  • Simple Hysterectomy: Some parts of the woman’s reproductive system namely the cervix, womb, ovaries and fallopian tubes are removed. 
  • Radical Hysterectomy:  Preferred mode of treatment only when the cancer reaches stage 1 or an early stage 2 cervical cancer. The cervix, womb, top of the vagina, surrounding tissue, lymph nodes, fallopian tubes and if advised, ovaries are all removed.              
  1. Pelvic Exenteration: This cancer treatment option is usually recommended when the cervical cancer hits back after its first treatment and diagnosis. This surgery is performed if the cancer returns to the pelvis but has not started to spread beyond that area. A pelvic exenteration has two phases:
  • The cancerous cells along with the vagina are removed. Under some cases, it might involve removing the bladder, rectum or lower section of the bowel.      
  • Stomas holes are created in the tummy which allows passage of stool and pee out of the body into pouches known as colostomy bags.
  1. Radiotherapy: Radiotherapy can be used with another form of surgery for early-stage cervical cancer patients. Radiotherapy can be delivered either:
  • Externally: A machine with high-radiative energy is used to beam waves into the pelvis to remove cancerous cells.
  • Internally:  In such cases, a radioactive implant is planted beside the tumor inside the vagina. This treatment is known as Brachytherapy which aims to lessen the harm to the surrounding tissue by waving the radiation closer to the tumour.
  1. Chemotherapy: This treatment option involves using either a single chemotherapy drug or a merger of different medical drugs to destroy the cancer cells. This treatment is used to slow the progression of cancer cells and relieve its symptoms. Chemotherapy is given directly into the vein using a drip.

What are the stages of Cervical Cancer?

Staging is a measurement to know how far the cancer has spread. After conducting various cancer tests, the cervical cancer stages are analysed. The following are the cancer stages:

In stage I, cancer cells are detected and can be found in the cervix only. Stage I is then divided into stages IA and IB, depending on the size of the tumour and the deepest point of invasion.

  • STAGE IA: Under this stage, there are sub categories known as IA1 and IA2, depending on the deepest point of tumor invasion.
  • STAGE IA1: Small amounts of cancerous cells are seen with the help of microscope. The deepest point of tumour invasion is 3 millimeters or less.
  • STAGE IA2: The deepest point of invasion is more than 3 millimeters but less than 5 millimeters. This stage can be seen under a microscope in the tissues of the cervix.

Next is STAGE IB: STAGE IB is categorized into stages IB1, IB2, IB3 respectively based on the size of the cancer cell and the deepest point of tumor invasion.

  • STAGE IB1: Under this stage, the tumor cell is sized upto 2 centimeters or smaller and the point of invasion is more than 5 millimeters.
  • STAGE IB2: The cancerous tumor is larger than 2 centimeters but lesser than 4 centimeters.
  • STAGE IB3:  Under this stage, the tumor is seen under a microscope and is larger than 4 centimeters.

STAGE II: Under STAGE II, the cancerous cells have reached the upper two–thirds of the vagina and across the tissue around the uterus. STAGE II is divided into STAGES IIA and IIB, depending on how far the tumour cells has spread:

  • STAGE IIA:  In this case, the cancer cells have spread from the cervix to the upper two-thirds of the vagina but have not reached to the tissues around the uterus. STAGE IIA is categorized into STAGES IIA1 and IIA2, based on the size of the tumor.
  • Under STAGE IIA1: The cancerous tumor is 4 centimeters or smaller
  • Under STAGE IIA2: The tumor is larger than 4 centimeters.
  • STAGE IIB: The cancer has escalated from the cervix to the tissue surrounding the uterus.

STAGE III: In the section of STAGE III, the cancer has spread to the lower third of the vagina and/or to the pelvic wall, and/or has caused kidney issues. STAGE III is categorized into STAGES IIIA, IIIB and IIIC, depending on how far the cancer has spread.

  • STAGE IIIA: The tumor has spread to the lower section of the vagina but not to the pelvic wall
  • STAGE IIIB: Cancer has crossed the pelvic wall; and/or the tumor has grown enough to block one or both the ureters or has caused any of the kidney to function abnormally.
  • STAGE IIIC: STAGE IIIC is divided into further two stages; IIIC1 and IIIC2, depending on the increased rate of cancer cells to the lymph nodes:
  • STAGE IIIC1: Cancer has advanced to the lymph nodes in the pelvis.
  • STAGE IIIC2: Cancer has now reached to the lymph nodes in the abdomen near the aorta.

STAGE IV: Under STAGE IV, the tumor has spread beyond the pelvis or has spread nearly to the lining wall of the bladder or rectum, or has extended to the other tissues of the body. STAGE IV is divided into further two stages IVA and IVB:

  • STAGE IVA: The cancer has developed in the nearby organs such as the bladder or rectum.
  • STAGE IVB: Cancer has passed on to the other parts of the body like liver, lungs, bones or distant lymph nodes.

What does Remission Look Like?

Remission means that there are no signs or little signs of cancer in the body. Cervical cancer survivors need to make changes in their lifestyle to process remission. Symptoms like acute fatigue, unusual pain may laso ease up or stop completely.  Under remission, it is recommended to see a doctor for regular routine checkup to make sure it doesn’t start up again.  Remission are of two types:

Partial: The medical examinations and treatments given have destroyed the cancerous cells to an extent, but tests show they might still have some side effects.

Complete: All signs of cancer and its signs are gone.

Various treatments options can help the cancer patient get to remission:

  • Drugs like Chemotherapy or subjected therapies
  • Radiation therapy
  • Surgeries
  • Hormone therapy
  • Immunotherapy
  • Bone marrow or stem-cell therapy

All cervical cancer treatments have some side effects that might stay for a time period. Consult a gynecologist to decide which treatment suits best. Once in Remission, take these healthy steps to keep the cancer at bay:

  1. Consume a balanced die that involves in take of fresh fruits, veggies and whole grains
  2. Quit smoking and don;t smoke if you do.
  3. Maintain a balanced weight by exercising and practicing fitness regimes
  4. Avoid alcohol consumption to a moderate extent
  5. Participate in anger management or stress management classes. Enroll in cancer survivors clubs to understand the routine and details.

How can the best cervical cancer hospital help?

  1. Getting emotional support: Most cancer patients undergo depression and anxiety after undergoing treatment plans. But everyone can benefit from support groups, professional counsellors, friends and family and others.
  2. Be Positive and Calm: Cervical Cancer is stressful that undoubtedly messes up an entire routine by affecting overall health. However, staying calm and positive can reduce stress and maximize the growth of healthier tissues that enhances strong metabolism. Practice gratitude, meditate often, and other factors can help a cancer patient stay all normal.

Manage Lifestyle: Making certain lifestyle changes is necessary. Keeping the diet compact and health for better fitness goals is mandatory. Take care and be aware of hazardous substances in the environment by maintaining through hygiene and sanitation. Choose secure home decor systems that supply cancer-proof materials resulting in sustainable living.