Cervical cancer | Meaning , Causes , symptoms , Stage , Screening and vaccination

Cervical cancer

Cervical cancer is the 4th most occurring cancer in female worldwide. Approximately 56% of which turn out deadly. The occurrence of cervical cancer is more observed in middle to low income countries. But vaccine against the virus responsible for the cervical cancer is available. This makes the cervical cancer preventable.

Let’s dissect and understand cervical cancer point by point. This blog will enhance your knowledge as well as give you better understanding for cancer and cervical cancer.

What is this ‘C’ word?

Cancer, We all hear this word day in and day out, in newspapers and on social media, at home and at office. The moment we hear cancer, a certain fear creeps in. But do we know what is cancer?.This is a silent disease we can say. Normally our cells divide and this is how growth and rejuvenation happens in our body every second. The cells have intelligence to know when to start and when to stop. But because of certain internal or external factors, this intelligence gets hijacked. And these hijacked cells start to grow, but their button to switch off doesn’t work. Uncontrollable growth of cells is the common definition of cancer. The growing cancer cells make tumor at the origin site. In medical terms it is called as ‘malignant tumor’.

Cancer word derives from word crab. But have you ever wondered why this word was chosen by Hippocrates? Well cancer is also a constellation, which was named so because of it’s imaginary similarity with shape of crab. There are many theories why this disease was named after crab(cancer). One says that when you examine a malignant tumor, it feels like a rock or the back of the crab, so the name cancer. Another theory is more interesting. It suggests that Hippocrates understood the cancer and its pain so well that he compared pain of a malignant tumor to the bite of a crab. Hence he called it Cancer.

The common name of cancer generally contains name of the organ involved e.g. skin cancer, pancreatic cancer, cervical cancer etc. But they are classified into types according to the type of tissues/cells involved e.g. carcinoma, melanoma, sarcoma etc.

What is Cervix?

Before understanding what is cervical cancer, it is important to understand the organ affected by this type of cancer. Knowing the anatomy of female reproductive system and cervix will help understanding the concept better.

Female reproductive system comprises of 2 ovaries, 2 fallopian tubes, uterus, vagina and cervix. Vagina is the outer organ of the system where as uterus lies inside the body. Cervix connects the body of uterus with the vagina.

Cervix has two parts ‘endocervix’ and ‘exocervix’, both of them have different types of cells. Endocervix is the inner part of cervix that opens up to the lower part of uterus, whereas endocervix is the outer part of cervix that can be seen by doctor during pelvic examination. Both of this part meets at a junction called as ‘transformation zone'. Position of this zone changes with age and after giving birth. The cells of this zone are prone to cervical cancer.

What causes cervical cancer?

There are many factors that can induce the chances of development of cervical cancer. But the known cause of cervical cancer is a virus called as 'Human papilloma virus’ (HPV). Not all variants of this virus cause cancer. But mainly 2 of them are found culprit for this.

HPV spreads through sexual contact. This does not require penetrative sex but direct contact of genitals can also transmit the virus. Majorly HPV infection can be healed itself without any medications after sometime. But the infection of oncogenic HPV might ignite cervical cells to turn cancerous after 15-20 years of infection.

Symptoms of cervical Cancer

HPV infection causes the normal cell of cervix to turn into pre-cancerous cells which if left untreated, leads to cervical cancer. Women with pre cancer or early cancer don’t generally show any symptoms. Signs and symptoms of cervical Cancer are usually visible only after cancer has advanced.

Symptoms of cervical Cancer are not very specific, they can be seen in other different diseases also. Consultation is advisable with the onset of any of these symptoms.

• Irregular menstruation

• Unusual bleeding in between periods or after vaginal intercourse or after menopause

• Pain during sex

• Abnormal odor and discharge, discomfort in vagina

• Fatigue, weight loss

Stages of cervical cancer

• Stage 0: cancer is not invasive at this stage. Cancerous cells are only present in the outer lining of the cervix, the tumor is called as carcinoma in situ. Deeper tissues are not affected here.

• Stage I: Cancer is found in uterus as well as deeper tissues of cervix. Lymph nodes are not invaded.

• Stage II: Cancer has spread out, but is still inside the pelvic region i.e. tissues surrounding cervix and vagina.

• Stage III: Cancer has spread out of the pelvic area. But other parts of body or lymph nodes are not involved in cancer spread.

• Stage IV: Organs nearby and other parts of body are invaded by cancerous cells at this stage.

Screening of cervical Cancer

Diagnosis of cervical cancer is very crucial in treatment if done in the early cancer stage. Lesions of pre cancerous stage and early cancer can be detected through certain screening procedure. For screening of cancerous test mostly swabs are taken by your practitioner from the cervix. In laboratory one of these or both tests can be done.

• Pap test - This is conventional way to check if any abnormal cells are present in a histological sample.

• HPV test – This tests screens if high-risk Human papilloma virus is present in the abnormal cells.

• Liquid based cytology – This is automated cytology test done for screening of abnormal cell presence.

• Visual inspection with acetic acid – A dilute acetic acid solution is applied on the suspected area of cervix. Cancerous cells turn white, further biopsy is done for the confirmation.

WHO suggests that screening for cervical cancer should be done once in a while by women with age between 30 to 49.

Patients with immunodeficiency or compromised immunity should be advised to go for screening more frequently as they are at higher risk for the infection and cancer development.

Vaccination for cervical cancer

Vaccination for cervical cancer is available worldwide. WHO and Center of Disease Control (CDC) highly promote women to get cervical cancer vaccine. It is also known as HPV as it protects against Human papilloma virus. There are various types of HPV are available in market. They protect against cancer causing viral strains as well as they also protect against warts because of HPV.

WHO recommends women to take the vaccine before age of 15 and before they become sexually active. But cervical cancer vaccine can be taken by any woman at the age as early as 9 up to 49 of age.

Doses of vaccine are age dependent. Children under age of 15, should be prescribed two doses of vaccine. These doses should be taken 6 to 12 months apart. Patients who are taking vaccine at age of 15 or old should take 3 doses. These doses should be taken within span of 6 months.

Who should not take cervical cancer vaccine?

• Pregnant women

• Women with ongoing HPV infection

• Mildly or severely ill women

We hope after reading this whole blog, you’ve gained more knowledge about cervical cancer. We recommend women to visit their gynecologist and enquire about cervical cancer vaccine. Prevention is much better than treatment, especially in case of deadly disease like cancer.

Stay healthy and happy.

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URVI BHANUSHALI

M.Sc,Microbiology