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Cervical Cancer: Types, symptoms, causes and treatments

Team AckoAug 26, 2022

Cervical Cancer has caused several deaths worldwide, and many of these fatal cases have been from developing countries. In fact, as per a World Health Organization report on Cervical Cancer in India, it was estimated that around 41,91,000 Indian women died of the disease in 2019. Thus, it is important to be aware of Cervical Cancer and its types, symptoms, causes and treatments. In this article, we elaborate on all these aspects.

Cervical Cancer

What is Cervical Cancer?

Cervical Cancer is cancer that develops in the cervix. The cervix is an opening that is located towards the bottom of the uterus (womb) and is attached to the vagina or birth canal. It acts as a pathway between the uterus and vagina. Cancer is the uncontrolled growth of cells, and it generally develops in the cervix due to mutations in the cells caused by various stimulants.

Parts of the cervix

The cervix primarily consists of the following two parts.

  • Endocervix: It is the connecting opening between the cervix and the uterus. It consists mostly of glandular cells.

  • Exocervix: This is the outer part of the cervix and is usually visible to a doctor during a speculum exam. It consists mostly of squamous cells.

What is the transformation zone?

The transformation zone is the place where the glandular cells of the endocervix and the squamous cells of the exocervix meet. The location of the transformation zone tends to change with age and during childbirth. Usually, cancerous cells begin to develop in this region.

Cervical pre-cancers

The cells of the cervix that become cancerous, do not turn cancerous immediately after entering the transformation zone. Rather, they tend to develop abnormal changes referred to as pre-cancers. Some ways doctors describe these abnormal pre-cancerous cells include dysplasia, squamous intraepithelial lesion (SIL), and cervical intraepithelial neoplasia (CIN).

After an examination of the abnormal cells in the lab, they are graded from one to three based on the extent of the abnormality.

  • CIN 1: This type of pre-cancer is the least severe, and the abnormality in the appearance of the tissue at this stage is usually mild. It is also referred to as low-grade SIL or mild dysplasia.

  • CIN 2 or CIN 3: In these two types of pre-cancer stages, the abnormality in the appearance of the tissue is more apparent. High-grade SIL is considered to be the most dangerous type of pre-cancer.

What are the types of Cervical Cancers?

Cervical Cancer types are distinguished by their unique appearances when examined under a microscope. The following are some of the most common types.

  • Squamous cell carcinomas: These are the most common type of cancerous cells and usually develop in the cells of the exocervix, in the transformation zone.

  • Adenocarcinomas: This type of Cervical Cancer develops from the gland cells in the exocervix that are responsible for producing mucus.

  • Adenosquamous or mixed carcinomas: These cancer cells are generally rare and show features of both adenocarcinomas and squamous cell carcinomas.

Different stages of Cervical Cancer

The different Cervical Cancer stages help doctors to diagnose the extent of the cancer’s spread. It also helps doctors to determine the most effective form of treatments to prescribe.

  • Stage 0: Pre-cancerous cells have developed.

  • Stage 1: Cancer cells have spread from the top to deeper parts of the cervix tissues. It is possible that at this stage, the cancer has spread to nearby lymph nodes and the uterus.

  • Stage 2: Cancer has spread out of the cervix and uterus but has not yet reached the pelvic walls or the vagina’s lower part. In this stage, cancer may or may not invade the nearby lymph nodes.

  • Stage 3: At this stage,cancer has developed in the pelvic walls or the vagina’s lower part. 

Signs and symptoms of Cervical Cancer

The typical Cervical Cancer symptoms include the following.

  • Pain in the pelvis

  • Bleeding even after menopause

  • Bleeding after engaging in sexual intercourse

  • Bleeding in between periods

  • Discharge from the vagina that is tinged with blood

  • Discharge from the vagina accompanied by a strong odour

Causes of Cervical Cancer

Currently, substantial evidence is not available to conclude the exact causes of the various types of cancers. Nonetheless, based on numerous case studies, the following are the speculated Cervical Cancer causes.

  • Human Papillomavirus Infection (HPV): HPV is a sexually transmitted disease (STD) that is known to cause Cervical Cancer in women. There are around 100 variants of the virus, but only 13 of them are associated with developing this form of cancer.

  • Becoming sexually active early on in life: It has been found that there is a link between early sexual activity in women and the development of Cervical Cancer.

  • Having multiple sexual partners: Women having multiple sexual partners are more likely to develop Cervical Cancer. This is probably because of the transmission of STDs like HPV that are cancer-causing.

  • Birth control medication: The consumption of birth control pills slightly increases the risk of developing Cervical Cancer in women.

  • Smoking: Smoking is a risk factor not only for Cervical Cancer but for other types of cancer as well.

  • Having a weak immune system: People who suffer from Human Immunodeficiency Virus Infection (HIV) or Acquired Immune Deficiency Syndrome (AIDS) are more susceptible to developing Cervical Cancer.

How to diagnose Cervical Cancer

Cervical Cancer is generally diagnosed using the following tests.

  • Pap test: In this test, a few tissue samples are taken from the cervix and examined in the lab for abnormalities. Lab tests can detect the presence of abnormal cells, cancerous cells and abnormal cells that may lead to the development of cancer.

  • HPV DNA test: In this test, an HPV virus sample collected from the cervix is checked for the likelihood of it causing Cervical Cancer.

Procedures to extract tissue samples

The following are some commonly employed methods medical professionals use to extract tissue samples from the cervix.

  • Endocervical curettage: This procedure involves the use of a spoon-like tool to scrape cervix tissue samples.

  • Punch biopsy: In this procedure, a sharp tool is used to pinch off tissue samples from the cervix.

  • Cone biopsy: This procedure is used to obtain deeper cervical tissue for lab testing and is usually carried out after administering general anaesthesia.

  • Electrical wire loop: In this procedure, a low voltage electrified wire is used to obtain tissue samples and is generally done under the influence of general anaesthesia.

Procedures to find out the stage

Doctors prescribe one of the following tests to determine the stage of cancer. Based on the results, necessary treatments are prescribed.

  • Visual inspection: In visual inspection, scopes are used to examine the bladder and rectum to determine the extent of the cancerous spread.

  • Imaging tests: Scans like MRI, CT, X-ray and Positron Emission Tomography (PET) are used by doctors to find out if the cancer has spread beyond the cervix.

Treatment procedures for Cervical Cancer

The following are the common Cervical Cancer treatment methods.

  • Surgery: Surgeries are either done to remove the cancerous regions or the cervix as a whole. Fortunately, both these procedures may not affect the ability to have children. However, if you undergo a hysterectomy wherein your cervix and uterus are removed completely, you may not be able to bear children again.

  • Chemotherapy: In this treatment, a drug is used to kill cancer cells. It is administered either orally in pill form or intravenously. In some cases, both methods are used. Higher doses of chemotherapy are typically prescribed to help control the symptoms of very severe forms of Cervical Cancer.

  • Targeted drug therapy: This treatment is usually administered parallelly with chemotherapy and is generally prescribed when Cervical Cancer has escalated to its advanced stages.

  • Radiation therapy: In this procedure, the cancer cells are killed using high-powered protons and x-rays. This treatment may be used after surgery to prevent the recurrence of the cancer. It is usually administered either externally, internally or both ways. Also, radiation therapy is known to cause menopause. 

  • Immunotherapy: It is a drug treatment that strengthens your body’s immune system to fight cancer cells. Usually, cancer cells produce proteins that make them undetectable. Immunotherapy thwarts that process and makes these cells relatively easier to detect. This form of treatment is usually advised by doctors only after other treatment methods have failed.

  • Palliative care: This is a supportive treatment that is administered in tandem with other forms of treatment. It aims to address the pain and symptoms of cervix cancer. It also aims to support the family members of the affected. Individuals having this kind of support, in addition to their other treatments, are known to live longer.

Prevention of Cervical Cancer

Here are some tips for Cervical Cancer prevention.

  • Get screened regularly to detect abnormalities in cells that may lead to cancer.

  • Get an HPV vaccine. This will reduce the risk of HPV causing Cervical Cancer.

  • Quit smoking. People who smoke are at a higher risk of developing this and other forms of cancer.

  • Practice safe sex to prevent getting STDs like HPV that may cause cancer in the cervix.

  • Having fewer sex partners may also reduce the risk of developing this disease.

Frequently asked questions

The following are some of the common questions and answers regarding Cervical Cancer.

Which is the most common cause of Cervical Cancer?

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Cervical cancer is most commonly caused by HPV, which spreads from the skin-to-skin contact of the genital region.

Is Cervical Cancer curable?

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Yes, Cervical Cancer can be cured. However, there is no guarantee that it will not recur.

How fast does it take for Cervical Cancer to develop?

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Cervical Cancer generally takes years or decades to develop. However, it progresses faster in individuals who have a weak or compromised immune system. On average, it would take a minimum of five years for Cervical Cancer to develop.

At what age does Cervical Cancer develop?

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Cervical cancer can develop at any age. However, it usually develops in women between the ages of 35 and 44.

References:

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet. As this content piece is not vetted by a medical professional, please consult a doctor before making any health-related decisions.

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