Cancer of the cervix (cervical cancer) is a type of cancer that occurs in the cells of the cervix i.e., the lower part of the uterus that connects to the vagina. When the cells in this part of the body begin to grow out of proportion and control, it leads to cancer of the cervix.

What are the Signs and Symptoms of Cervical Cancer?

The most common symptoms of cervical cancer are:

• Abnormal Vaginal Bleeding: This is the most common cervical cancer symptom especially when the cancer may have spread to nearby tissues. Examples of such abnormal vaginal bleeding are: bleeding between menstrual periods, heavier or longer menstrual periods, bleeding after sexual intercourse, and after menopause.
• Vaginal Discharge and Foul Smelling: An infected cervix can create a foul-smelling vaginal discharge, which serves as another sign of cervical cancer. This continuous discharge may be pale, watery, brown, or mixed with blood.
• Pain During Sexual Intercourse: Women with advanced cervical cancer may experience pain during sexual intercourse because of tumor growth throughout tissues and reproductive organs.
• Low Back, Pelvic, or Appendix Pain: Low back pain or pelvic pain can be linked to problems with reproductive organs, such as the cervix. A sign of cervical cancer is pelvic pain, especially continuous pain.
• Loss of Appetite or Unexplained Weight Loss: As with many other cancers, a sign of cervical cancer is unexplained weight loss or loss of appetite.

What Causes Cervical Cancer?

Most cases of cervical cancer are usually caused by the sexually transmitted Human Papillomavirus (HPV). Though being affected by HPV does not mean a woman can get cervical cancer, but can if left untreated. In developed countries, HPV is not common among women. This is because early vaccination at ages 6 years and above is recommended. The vaccine against HPV helps create antibodies that reject and fight against the virus once contracted.

Other factors include:

Having a family History of Cervical Cancer: Once there is a family history of cervical cancer especially if the mother or sister had cervical cancer, the chances of developing the disease are higher than people with no family history of the disease.

Sexual History: Several factors related to a woman’s sexual history can increase the risk of cervical cancer. The risk is most likely affected by increasing the chances of exposure to HPV.

• Becoming sexually active at a young age (especially younger than 18 years old)
• Having many sexual partners
• Having one partner who is considered high-risk (someone with HPV infection or who has many sexual partners)

Having a Weakened Immune System: Human immunodeficiency virus (HIV), the virus that causes AIDS, weakens the immune system and puts people at higher risk for HPV infections. Also, unvaccinated pregnant women who continue to engage in sexual activities are at risk of contracting HPV due to their weak immune systems.

How Can Women Prevent Cervical Cancer?

Cancer of the cervix is one of the vaccine-preventable cancers.

Primary Form of Prevention

HPV Vaccination

The primary form of prevention is getting immunized against the human papillomavirus (HPV) infection, and this can be through the HPV Vaccine. This vaccine should be routinely given to children (either male or female) who are below the age of 12 years (pre-teen) before their exposure to HPV. This vaccine creates antibodies that protect them from contracting the virus when they grow up to have partners who are unvaccinated and have the HPV infection and become sexually active. Also, the vaccine does not protect individuals who are already infected with HPV because they cannot receive the vaccine after getting infected.

Getting the HPV vaccine while pregnant does not have any harmful effects on the pregnancy. People who are HPV-negative after getting screened, and are unvaccinated, should be given the HPV vaccine to protect them from the virus.

Secondary Form of Prevention

The secondary form of prevention includes the use of screening methods for early detection and treatment of pre-cancerous lesions. Screening tests such as HPV and Pap tests are the most used for cancer of the cervix.

• HPV Test:This test is done on a sample of cells removed from the woman’s cervix. The sample is tested for the strains of HPV most commonly linked to cervical cancer. HPV testing may be done by itself or combined with a Pap test. Those who are HPV-negative should be vaccinated.
• Pap Test:Also called a Pap smear, it is the most common test used to check for early changes in the cervix. A Pap test involves gathering a sample of cells from the cervix. It is often done at the same time as a bimanual pelvic exam as part of a gynecologic checkup. A Pap test may be combined with an HPV test.
• Visual Inspection with Acetic Acid (VIA):VIA is a screening test that can be done with a few tools and the naked eye. During VIA, a dilution of white vinegar is applied to the cervix to check for abnormalities on the cervix, which will turn white when exposed to vinegar. This screening test is very useful in places where access to medical care is limited.

When a pap test is positive and a cone biopsy of the cervix shows early changes in a grown woman who has had all her children, it is advisable to carry out a total hysterectomy to prevent the onset of full-blown cancer of the cervix.

Diagnosing Cervical Cancer

Cancer of the cervix can be detected using these methods:

Screening

These are tests that help to detect cancer of the cervix and its precancerous cells that may likely develop into the disease. It has been suggested that screening for cancer of the cervix is best at the age of 21 years. Screening tests include:

• HPV Test
• Pap Test
• Visual Inspection with Acetic Acid (VIA)

Biopsy: This is the removal of small samples of tissue in the cervix for laboratory testing.

• Punch biopsy, which involves using a sharp tool to pinch off small samples of cervical tissue.
• Endocervical curettage, which uses a small, spoon-shaped instrument (curet) or a thin brush to scrape a tissue sample from the cervix.
• Electrical wire loop, which uses a thin, low-voltage electrified wire to obtain a small tissue sample. Generally, this is done under local anesthesia in the office.
• Cone biopsy (conization), which is a procedure that allows the doctor to obtain deeper layers of cervical cells for laboratory testing. A cone biopsy may be done in a hospital under general anesthesia.

What Treatment Options Are Available for Cervical Cancer?

Surgery: This is a common treatment method when the cancer has not spread from the cervix. It is the removal of the tumor and some surrounding healthy tissue during an operation. A total hysterectomy (removal of the whole womb) can be done to prevent the cancer from spreading.

Radiation Therapy: This is the use of high-energy X-rays or other particles to destroy cancer cells in the cervix

Chemotherapy: It is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells. For cervical cancer, it is often given in combination with radiation therapy

Targeted Therapy: This treatment targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.

Immunotherapy: Also called biological therapy, is designed to boost the body's natural defenses to fight cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function.