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Health Information
Cervical Cancer -
(Cancer of the Cervix)
Definition
Cervical cancer
is a disease in which cancer cells grow in
the cervix. The cervix is the lower, narrow
part of the uterus (womb) that connects the
uterus with the vagina.
Cancer occurs
when cells in the body (in this case,
epithelial cervix cells) divide without
control or order. Normally, cells divide in
a regulated manner. If cells keep dividing
uncontrollably, a mass of tissue forms,
called a growth or tumor. The term cancer
refers to malignant tumors, which can invade
nearby tissue and spread to other parts of
the body. A benign tumor does not invade or
spread.
Causes
Research
suggests that some sexually transmitted
viruses (eg,
human papilloma virus) can cause the
nuclei in cervical cells to begin the
changes that can lead to cancer.
Risk Factors
A risk factor is
something that increases your chance of
getting a disease or condition. Scientists
believe that cervical cancer develops when
several risk factors act together. Risk
factors include:
- Infection
of the cervix with the human
papillomavirus (HPV)—the primary risk
factor for cervical cancer
- History of
cervical dysplasia (a precancerous
condition)
- Being a
woman whose mother took the drug
diethylstilbestrol (DES) during
pregnancy
-
HIV/AIDS
- Age: over
25 years old
- Multiple
sexual partners
- Sexual
activity prior to age 18
- First
pregnancy prior to age 20
- History of
not having
Pap tests
-
Smoking
Symptoms
Symptoms of
cervical cancer usually do not appear until
the abnormal cells become cancerous and
invade nearby tissue. When this happens, the
most common symptom is abnormal bleeding,
which may include:
- Bleeding
between regular menstrual periods
- Bleeding
after sexual intercourse, douching, or a
pelvic exam (most common)
- Menstrual
bleeding that lasts longer and is
heavier than usual
- Vaginal
bleeding after
menopause
- Increased
vaginal discharge that is not blood
These symptoms
may also be caused by other, less serious
health conditions. If you experience these
symptoms, see you doctor.
Diagnosis
Tests to
diagnose cervical cancer include:
Pap Test
The Pap test
detects cervical cancer as well as
precancerous tissues in the cervix,
called cervical dysplasia. The doctor
collects a sample of cells from the
cervix to be tested. The performance of
an annual Pap smear or test is the
single greatest success story in the
reduction of cancer in developing
countries. However, cervical cancer is
still the second leading cause of cancer
death in women worldwide.
It is
important that a sexually active woman
receives an annual Pap test, and that
she follows up with any abnormal results
by getting future tests as described by
her physician. New studies indicate that
women over the age of 30 who have had
three or more normal annual Pap tests
can safely lengthen the Pap screening to
once every three years.
HPV Test
During an
HPV test, the same material from the Pap
test can be tested for the HPV virus
itself.
Colposcopy
Colposcopy is the examination of the
vagina and cervix using a lighted
magnifying instrument called a
colposcope. Colposcopy is needed if the
Pap test suggests cervical dysplasia
(precancer) or cancer.
Biopsies
Biopsies are then performed on any
suspicious areas and tested for the
presence of cancer cells.
Treatment
Once cervical
cancer is found, staging tests are performed
to find out if the cancer has spread and, if
so, to what extent. Treatments for cervical
cancer depend on the stage of the cancer.
Treatments
include:
Surgery
The
cancerous tumor, nearby tissue, and
possibly nearby lymph nodes are
surgically removed. If the cancer has
reached deeper layers of the cervix but
has not spread beyond the cervix, the
doctor may remove only the tumor and
surrounding normal tissue. In some
cases, a
hysterectomy (removal of the entire
uterus) is necessary. Sometimes the
ovaries and fallopian tubes also are
removed.
Radiation Therapy (Radiotherapy)
Radiation therapy is the use of
radiation to kill cancer cells and
shrink tumors. Radiation may be
administered in two ways:
-
External radiation therapy—radiation
directed at the tumor from a source
outside the body
-
Internal radiation
therapy—radioactive materials placed
in or near the cancer cells. It is
very important that you receive your
internal radiation therapy from an
experienced radiation oncologist.
You should inquire as to how many
cases that doctor performs annually,
and whether you will receive
high-dose or low-dose therapy.
Chemotherapy
Chemotherapy is the use of toxic
drugs to kill cancer cells. Chemotherapy
may be given in many forms including:
pill, injection, and via a catheter. The
drugs enter the bloodstream and travel
through the body killing mostly cancer
cells, but also some healthy cells.
Chemotherapy alone rarely cures cervical
cancer. It may be used in addition to
surgery and/or radiation.
Chemotherapy
and radiation therapy together have been
shown to be more effective than
radiation therapy alone. Chemotherapy
may also be used to help control
symptoms (pain and bleeding) when a cure
is no longer possible.
Chemoradiotherapy or Combined Modality
Therapy
For most
cervical cancers, chemotherapy and
radiation therapy combined have been
shown to cure more women than radiation
therapy alone.
Prevention
Finding and
treating precancerous tissue in the cervix
is the most effective way to prevent
cervical cancer. Talk to your doctor about
an appropriate schedule of check-ups. You
should, therefore, continue to receive
regular Pap smears. In addition, since
cervical dysplasia and cancer are so closely
linked to HPV infection, another effective
approach is to reduce your risk of exposure
to this virus. There are currently two
methods to accomplish this:
- Safe sexual
practice—Limit the number of sexual
partners and always use condoms, unless
you’re in a longstanding monogamous
relationship
-
HPV vaccination —In preliminary
research this vaccine was 100% effective
in preventing the HPV infection, though
it remains to be seen whether vaccinated
women will actually see a decrease in
their risk of cervical cancer and
precancer. If you are at risk for HPV,
talk to your doctor about receiving this
new vaccine.
RESOURCES:
American Cancer Society
www.cancer.org
National Cervical Cancer Coalition
www.nccc-online.org
CANADIAN RESOURCES:
Canadian Cancer Society
www.cancer.ca
Women's Health Matters
www.womenshealthmatters.ca/index.cfm
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