Managing cancer of the cervix can take different approaches depending on the stage of the disease, the patient’s age, and the overall well-being of the patient. After a woman is diagnosed with cancer of the cervix, the doctor needs to advise her on the best way to manage the disease.

Early Detection and Secondary Prevention

The best way to find cervical cancer early is to have regular screening tests. The common tests for cervical cancer screening are the HPV test and the Pap test. These tests can be done alone or at the same time. Regular screening has been shown to prevent cervical cancers and save lives. The most important thing to remember is to get screened regularly, no matter which test one gets. Those with negative pap smears and positive HPV tests can get vaccinated. Those with an early intracellular abnormality of the cervix may have hysterectomy i.e., removal of the uterus.

Signs and Symptoms of Cancer of the Cervix

Early detection of cervical cancer does greatly improve the chances of successful treatment of the disease. Awareness of the various signs and symptoms of cervical cancer can also help.

In the early stages of cervical cancer, a person may experience no symptoms at all. As a result of this, women must have regular cervical smear tests or Pap tests.

The most common symptoms are:

Abnormal Vaginal Bleeding

The most common cervical cancer symptom is abnormal vaginal bleeding, which typically occurs after the cancer has spread to nearby tissue. Although women often think bleeding is normal spotting, it's important to see a doctor if you experience:

• Bleeding between menstrual periods
• Heavier menstrual periods
• Longer menstrual periods
• Bleeding after sexual intercourse
• Bleeding after menopause
• Bleeding after a pelvic exam
• Bleeding resulting in anemia-causing fatigue, dizziness

Vaginal Discharge, Foul Smelling

If cervical cancer lacks oxygen, some cells may die off, infecting the tumor. The infection creates 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. Pelvic pain near the appendix doesn't usually occur unless the cancer is in advanced stages. There will usually be other cervical cancer red flags before pelvic pain occurs.

Advanced Cancer

In women with advanced and metastatic cancers, the symptoms may be more severe depending on the tissues and organs to which the disease has spread. The cause of a symptom may be a different medical condition that is not cancer, which is why women need to seek medical care if they have a new symptom that does not go away.

As the cancer grows and becomes more advanced, it may start to press against nerves in the pelvic wall, resulting in leg pain and sometimes swelling. While swelling could be a symptom of several medical problems, if accompanied by leg pain, this could be a warning sign of cervical cancer.

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. Sometimes, regardless of how much food is consumed, weight loss continues to be a problem for women with cervical cancer.

These signs and symptoms can also be caused by conditions other than cervical cancer. For example, an infection can cause pain or bleeding. Still, if any of these symptoms continue, it is advisable to see a medical practitioner (doctor). Ignoring symptoms may allow the cancer to grow to a more advanced stage and lower your chance of effective treatment.

Diagnosing Cancer of the Cervix

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)

If cancer of the cervix is suspected, doctors are likely to start with a thorough examination of the cervix. A special magnifying instrument (colposcope) is used to check for abnormal cells. During the colposcope examination, the doctor is likely to take a sample of cervical cells (biopsy) for laboratory testing. To obtain tissue, the doctor may use:

• 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.

Staging

Once the doctor determines that one has cervical cancer, she would have further tests to determine the extent (stage) of the cancer. Cancer of the cervix stages is a key factor in deciding on one’s treatment. Staging exams include:

• Imaging Tests.Tests such as X-rays, CTs, MRIs, and positron emission tomography (PET) help the doctor determine whether the cancer has spread beyond the cervix.
• Visual Examination of The Bladder and Rectum.The doctor may use special scopes to see inside the bladder and rectum.

Stages

• Stage I: Cancer is found only in the cervix. It hasn't spread and is small.
• Stage II: Cancer has spread beyond the cervix and uterus but hasn't yet spread to the pelvic wall (the tissues that line the part of the body between the hips) or the vagina.
• Stage III: Cancer has spread to the lower part of the vagina and may have spread to the pelvic wall, ureters (tubes that carry urine), and nearby lymph nodes.
• Stage IV: Cancer has spread to the bladder, rectum, or other parts of the body like the bones or lungs.

What Treatment Options Are Available for Cancer of the Cervix?

Deciding on the kind of treatment depends on several factors, such as the stage of cancer, as well as age, and overall state of health. Treatment for early-stage cancer of the cancer when the cancer remains within the cervix, has a success rate. The further a cancer spreads from its original area, the lower the success rate tends to be.

There are different types of treatment for patients with cervical cancer, and we have five types of standard treatment that are used. They include:

• Surgery
• Radiation therapy
• Chemotherapy
• Targeted therapy
• Immunotherapy

Although these treatments for cervical cancer may cause side effects, follow-up tests may be needed.

Surgery

Surgery 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. Total hysterectomy (removal of the whole womb) is usually done at Stage I which will prevent the cancer from spreading.

Radiation Therapy

Radiation therapy is the use of high-energy X-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. Radiation therapy may be given alone, before surgery, or instead of surgery to shrink the tumor.

The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period that combines external and internal radiation treatments. This combined approach is the most effective to reduce the chances the cancer will come back, called a recurrence.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells.

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period. A patient may receive 1 drug at a time or a combination of different drugs given at the same time. For women with cervical cancer, chemotherapy is often given in combination with radiation therapy

Targeted Therapy

Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or 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.

Not all tumors have the same targets. To find the most effective treatment, a doctor may run tests to identify the genes, proteins, and other factors in your tumor. This helps to better match each patient with the most effective treatment whenever possible.

Immunotherapy

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.

Different types of immunotherapies can cause different side effects. Common side effects include skin reactions, flu-like symptoms, diarrhea, and weight changes.

Conclusion

Cervical cancer is a very difficult cancer to treat if it has established itself. The best approach is primary prevention by vaccination or secondary prevention through total hysterectomy in Stage I.