Cervical cancer is the cancer of the neck of the womb. It can affect women of all ages, but is more common in women between 30 and 45; it rarely occurs in women under 25. Almost all cervical cancers (95%) are caused by different types of human papillomavirus (HPV). HPV is virus and is found often in sexually active men and women.
Cervical cancer occurs due to a genetic mutation that causes normal cells to turn into cancer cells. Healthy cells grow and multiply at a standard rate and eventually die within a specified time (apoptosis). Cancer cells grow and multiply continuously and do not die, but form a mass, and then they gradually invade nearby tissues and can spread to other parts of the body (metastasis).
Risk factors for cervical cancer
- Multiple sexual partners. The more sexual partners the woman has, the greater the chance of becoming infected with the HPV virus. Ø Early sexual activity. Sexual activity before the age of 18 increases the risk of HPV infection.
- Other sexually transmitted diseases. If you have other sexually transmitted diseases – such as chlamydia, gonorrhea, syphilis and HIV / AIDS, then you are more likely to increase your risk of HPV infection.
- Immunosuppression: Most women who are infected with HPV do not develop cervical cancer. However, if they have HPV infection and their immune system is weakened, they are more likely to develop cervical cancer. The immune system prevents the HPV virus from multiplying after the exposure to it, however in a small group of women, HPV survives for years, contributing to the process that causes cervical cells to transform into cancer cells.
- Smoking: the risk of cervical cancer doubles in women who smoke. Smoking can weaken the immune system around the cells of the cervix, making it more difficult for the body to prevent and eliminate high-risk HPV infections. which could cause the growth of abnormal cells.
Symptoms
Cervical cancer may be asymptomatic, especially in the early stages, however as the disease progresses, the following symptoms may occur:
- Vaginal bleeding after sexual intercourse, between menstrual cycles or after menopause.
- Watery, bloody vaginal discharge with an unpleasant odor.
- Pain during sexual intercourse
HPV Screening and Vaccination Cervical screening with Pap test can prevent cervical cancer and save thousands of lives every year. Cervical smear test helps to identify and if necessary, to provide treatment in cases which abnormal cervical cells are found. Nowadays, HPV testing can be performed at the same time of the cervical smear test. In the United Kingdom, as well as in other European countries, the HPV vaccine is available to girls between the ages of 12 and 13. The vaccine can prevent cervical cancer by significantly reducing the risk of infection from some types of HPV. However, it does not protect against all types of cervical cancer, so it remains important for all women to have regular screening (including those who have been vaccinated). The fact that HPV infection is very common, but cervical cancer is less common shows us that only a very small percentage of women are vulnerable to the effects of HPV infection. Risk factors that affect the risk of cervical cancer also play a fundamental role. If you have been vaccinated against the HPV virus, you are protected against at least 70% of cervical cancer that caused by HPV infections, but you are not completely protected. Regular cervical smear screening is just as important as whether or not you have been vaccinated, as it will detect abnormalities caused by other HPV types. Finally, the mortality rate of cervical cancer is reduced due, to a large extent, to the detection of precancerous cells with the smear test. The protective effects of the HPV vaccine will be clear in the coming years, helping to reduce the number of deaths from cervical cancer.
Treatment
The 70% of cervical cancers are squamous cell carcinoma and the incidence of adenocarcinoma is about 20%. The management of both types of cancer is essentially the same, as well as their survival rates. The treatment options that may be considered for cases of cervical cancer include surgery, radiotherapy and chemotherapy. The factors that affect the treatment are: the stage of the disease, the patient’s age and the coexisting medical problems. The final decision on treatment should be made following a multidisciplinary team meeting, which includes gynaecological oncologist, clinical oncologists, radiologists and histopathologists. As with all cancer treatments, the goal can be either therapeutic or palliative. In women with stage IIA or lower stage tumors, surgery or radical chemotherapy may be given with therapeutic intent and have equivalent treatment rates. In such cases, the goal is to use a unique method of treatment whenever possible, as morbidity is greatly increased when radiotherapy is given in addition to surgery. Specifically, there is an increased rate of lymphedema in patients requiring postoperative radiotherapy following lymphadenectomy. In more advanced disease, chemoradiotherapy is the main treatment option, although surgery may play a role in symptom relief.
