Definition

     Cervical cancer is cancer that starts in the cervix, the lower part of the uterus (womb) that opens at the top of the vagina.

Causes

• HPV (human papilloma virus) is the major cause of Cervical Cancer and dysplasia.

• High-risk factors:

1. Multiple sexual partners

2. Early onset of sexual activity (less than 18 years of age)

3. Early childbearing (less than 16 years)

4. Sexually transmitted diseases

5. Genital Warts

6. HPV infection, HIV Infection

7. Genital Herpes

8. Smoking

9. DES exposure

10. Weakened immune system

Symptoms  

     Most of the time, early cervical cancer has no symptoms. Symptoms that may occur can include:

• Continuous vaginal discharge, which may be pale, watery, pink, brown, bloody, or foul-smelling

• Abnormal vaginal bleeding between periods, after intercourse, or after menopause

• Periods become heavier and last longer than usual

     Symptoms of advanced cervical cancer may include:

• Loss of appetite

• Weight loss

• Fatigue

• Pelvic pain

• Back pain

• Leg pain

• Single swollen leg

• Heavy bleeding from the vagina

• Leaking of urine or feces from the vagina

• Bone fractures

Screening and Diagnostics

• Pap smear Colposcopy Cervical biopsy

Treatment

• Cervical conization - removing the part of the cervix containing the cancer

• Hysterectomy

• Radiation therapy

• Chemotherapy

Prognosis

     Many factors influence the outcome of cervical cancer. These include: 

• The type of cancer

• The stage of the disease

• The age and general physical condition of the woman

     Pre-cancer conditions are completely curable when followed up and treated properly. The chance of being alive in 5 years (5-year survival rate) for cancer that has spread to the inside of the cervix walls but not outside the cervix area is 92%.

     However, the 5-year survival rate falls steadily as the cancer spreads into other areas.

Complications  

• Some types of cervical cancer do not respond well to treatment.

• The cancer may come back (recur) after treatment.

• Women who have treatment to save the uterus have a high risk of the cancer coming back (recurrence). 

• Surgery and radiation can cause problems with sexual, bowel, and bladder function.

Prevention

• A new vaccine to prevent cervical cancer is now available. In June 2006, the U.S. Food and Drug Administration approve the vaccine called Gardasil, which prevents infection against the two types of HPV responsible for the majority of cervical cancer cases. Studies have shown that the vaccine appears to prevent early-stage cervical cancer and precancerous lesions. Gardasil is the first approved vaccine targeted specifically to preventing any type of cancer.

• Practicing safe sex (using condoms) also reduces your risk of HPV and other sexually-transmitted diseases. HPV infection causes genital warts. These may be barely visible or several inches wide. If a woman sees warts on her partner's genitals, she should avoid intercourse with that person.

• To further reduce the risk of cervical cancer, women should limit their number of sexual partners and avoid partners who participate in high-risk sexual activities.

• Getting regular Pap smears can help detect pre-cancerous changes, which can be treated before they turn into cervical cancer. Pap smears work very well in spotting such changes, but they must be done regularly. Annual pelvic examinations, including a pap smear, should start when a woman becomes sexually active, or by the age of 20 in a non-sexually active woman. If abnormal changes are seen, a colposcopy with biopsy should be performed.

• If you smoke, quit. Cigarette smoking is associated with an increased risk of cervical cancer.