Cervix is a part of the female reproductive system, to be precise, it is the lower portion of the uterus (or the womb). It is also known as the uterine cervix.The unborn baby or the fetus grows in the upper part or the body of the uterus. It is the cervix that connects the main body of the uterus to the vagina lower down. There are two parts of the cervix. The portion of the cervix which is closest to the body of the uterus is the inner cervix or the endocervix. That part of the cervix next to the vagina is the outer cervix or the exocervix (or ectocervix). The cells covering the endocervix are glandular cells and the cells covering the ectocervix are the squamous cells. Both these lining cell types meet up at a zone known as the transformation zone.
What are cervical cancers ?
Cervical Cancers are basically tumours of the UTERINE CERVIX.
How is a cervical cancer caused ?
As in many lower-tract gynaecological tumours, Human Papilloma Virus (HPV) infection plays a role in the aetiology of cancer of the cervix. HPV can be spread from one person to another through either skin-to-skin contact or through unprotected sex. Having multiple sexually transmitted diseases (like Chlamydia) can contribute to the pathogenesis, as well.Women smokers are double likely to get cervical cancer as women non-smokers. Tobacco by-products have been detected in the cervical mucus of women smokers.Being immunocompromised (such as having AIDS or HIV infection) also can predispose to HPV infection and thus, cervical cancer.
What are the types of cervical cancer ?
There are several types of cancer that can initiate in the cervix. However, the chief types of cervical cancers include squamous cell carcinomas and adenocarcinomas.
- Squamous cell carcinoma: A majority of the cervical cancers are mostly squamous cell carcinomas. Squamous cell carcinomas arise from cells in the exocervix, that is from the squamous cells. They mostly start in the transformation zone (that is the zone in which the exocervix and endocervix join). The changes in the squamous cells are first precancerous. The precancerous lesions can be referred to as cervical intraepithelial neoplasia (CIN), or as squamous intraepithelial lesion (SIL), or even dysplasia. Then the precancerous lesions may progress to become squamous cell carcinomas or invasive cancers.
- Adenocarcinoma: Most of the other cervical cancers, apart from squamous cell carcinomas are adenocarcinomas. Adenocarcinomas are cancers that arise from glandular cells, that is from the mucus-producing cells of the endocervix. These are also invasive.
Other types of cancer are also known to develop in the cervix. These other types of cancers, such as melanoma, sarcoma, and lymphoma are quite rare.
What are the clinical features of cervical cancers ?
Symptoms of early cervical cancers include vaginal bleeding or foul smelling, yellowish discharge. Pain during sex or spotting after sex can also be noted. In the later stages of cervical cancers, back pain, lethargy, or nausea/vomiting can be noted.
How are cervical cancers diagnosed ?
- A complete physical examination of the body is mandatory.
- Pap Smear Test : The gynaecologist will examine your cervix and take smears from the surface of the cervix for a microscopic cellular examination. A suspicious Pap smear shows the need for a biopsy, i.e. the surgical resection of part or whole of a tissue containing all the cervix layers. This allows visualisation not only of individual cells, as in a smear, but of the whole tissue structure.
- Colposcopy: In case of abnormal or atypical results, of the Pap smear, colposcopy will be performed in the clinical examination. Colposcopy is a practice in which the patient lies down on the examination table and a speculum is put in the vagina to help good visualization of cervix. The doctor then utilizes a colposcope to thoroughly examine the cervix. The colposcope is an instrument endowed with magnifying lenses that can be compared to binoculars. An acetic acid wash can also be utilized to assess the cervix clearly.
- Biopsy: Removed tissue examined under a microscope by a pathologist is the only sure-shot way to make a cervical cancer diagnosis.
- Imaging Tests: To determine the exact extent of disease, additional tests may need to be performed so doctors can view, assess and judge the cancer. These imaging tests include the following such as X- rays, CT Scan, MRI Scan or PET Scans.
How are cervical cancers staged ?
The stage is the exact spread of the disease in the human body. Staging is used to assess the risks and prognosis associated with the cancer extent to determine the appropriate treatment. The less advanced the stage, the better the prognosis.
Stage 0- This is the stage of pre-cancerous disease, that is small lesions confined to the superficial layer (only epithelium) of the cervix. Such lesions are also called Carcinoma in situ or otherwise Cervical Intraepithelial Neoplasia (CIN).
- Stage I: After stage 0, in stage I, the cancer has grown into (invaded) the cervix, but it is not yet spread outside the uterus.
- Stage II: The cancer has now grown well beyond the cervix and uterus also, but hasn’t yet spread to the pelvic walls or the lower vagina.
- Stage III: The cancer has finally spread to the lower vagina or the pelvic walls.
- Stage IV: The cancer has made its way to nearby organs or other body parts.
How are cervical cancers treated ?
The standard treatment is basically surgical. A surgical intervention has to be done on the uterus and the removal of lymph nodes, as well within the pelvis.Young patients, who wish to get pregnant ahead in life, may opt for uterus-preserving surgery. In these cases, a significant cone of the cervix can be cut out by conization or optionally, the whole cervix can only be removed by a procedure known as trachelectomy.If needed, other patients can have a simple surgical removal of the uterus called simple hysterectomy or the surgical removal of the ovaries and the upper vagina as well as the uterus called radical hysterectomy.For more advanced stages, radiotherapy and chemotherapy should be given together. In this external radiotherapy, radiation is produced by an external source and targeted to the tumour as well as lymph nodes & vessels. The chemotherapy has an arsenal drugs to kill the remnant cancer cells in the body.
What is the care to be taken after the removal of a cervical cancer ?
Metastatic diagnostic workup and monitoring post-treatment has to include imaging and scanning of the limbs, thorax, chest, retroperitoneum, and abdomen with radiography, MRI or CT scans. Adjuvant chemotherapy or radiotherapy may be required in cases wherein excision cannot be done completely.
Are cervical cancers preventable ?
Either we can prevent the pre-cancer from occurring or we can prevent the progression of pre-cancer into full blown cancers.Avoiding exposure to the Human Papilloma Virus (HPV) by practising safe sex and getting the HPV vaccine help in preventing cervical cancer.The best way to find cervical cancer early on is to have routine & regular screening with a smear test called the PAP test (which can be combined with a test for human papilloma virus or HPV).
How to find and reach cancer specialists for cervical cancer treatment ?
Now you can find and reach cancer specialists from different cancer hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple cancer specialists, cost estimates for cervical cancer treatment from different cancer hospitals, compare things and then choose a cancer specialist or a cancer hospital for cervical cancer treatment.
Find, reach and choose a cancer specialist for cervical cancer treatment on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
