Cervical cancer is characterized by the appearance of atypical cells, which multiply uncontrollably in the cervix (cervix, the first part of the uterus that opens into the vagina).
Fortunately, if it is discovered at an early stage, cervical cancer is curable in most cases. The most effective way to prevent cervical cancer is to have a regular Pap test, which can detect abnormal cervical cells before tumor cells appear, the stage at which treatment is most effective.
There are two types of cervical cancer:
- cervical cancer with foam cells (epidermoid)
- cervical adenocarcinoma
Cellular changes in the cervix are usually asymptomatic, at this early stage the diagnosis is made based on the results of the Pap test. With the development of the cancer process, symptoms appear, which include:
- abnormal vaginal bleeding or significant changes in the menstrual cycle (menometrorrhagia);
- bleeding of the cervix during sexual intercourse or at the time of insertion of the diaphragm;
- pain during sexual intercourse (dyspareunia);
- Abnormal vaginal discharge, present in large quantities and sometimes mixed with fine strands of blood.
Advanced (complicated) cervical cancer has the following symptoms:
- anemia due to abnormal blood loss;
- pelvic pain (lower abdomen), lower limb pain or low back pain (back);
- vaginal fistula (abnormal communication between vagina and rectum, respectively bladder, so that feces and urine are eliminated through the vagina). Fistula occurs due to the extension of the cancerous process to the surrounding tissues).
- weight loss (several kilograms in a few weeks, months).
Cervical cancer is caused by cellular abnormalities in the cervix. Most precancerous cells occur in the cervix, an area that constantly undergoes cyclical changes (depending on the menstrual cycle).
During this physiological process, the cervical cells may undergo various mutations, favoring the appearance of abnormal cells, especially in the case of infection with human papilloma virus (sexually transmitted virus that causes lesions in the cervix and thus is an increased risk for cervical cancer).
Other risk factors for cervical cancer are:
- smoking, especially women with a long history of cigarette use;
- compromised immune system, especially women with HIV (human immunodeficiency virus that causes AIDS);
- use of oral contraceptives for more than 5 years, probably in connection with HPV (human papillomavirus) infection.
Regular Pap smears are the safest method to identify early cellular changes before the actual cancerous process occurs.
Cervical cancer diagnosed at an early stage can be completely treated. The types of treatment used in cervical cancer are:
- surgical therapy, which removes the tumor
- radiotherapy, used in the treatment of other organs affected by the tumor
- chemotherapy, used in the treatment of metastases
The choice of treatment has a major impact on quality of life. Therefore, it is important for the patient to discuss with the treating physician all treatment options and treatment recommendations.
The prognosis of cervical cancer depends on its type and stage. In order to choose the right treatment, the age, the general state of health, the quality of life, as well as the desire to have children in the future are also taken into account.
Cervical cancer treatment may be unique or it may be a combination of several methods, such as:
- therapeutic condition, for tumor removal (in case of small tumors)
- simple, partial hysterectomy, which removes the uterus and cervix
- total hysterectomy (removal of the uterus and appendages), as well as removal of the lymph nodes affected by the tumor process
- radiotherapy, which uses fractional doses of high-intensity X-rays, or the introduction of intravaginal implants (radioisotopes) capable of destroying malignant cells
- chemotherapy, which uses certain substances capable of destroying tumor cells
- chemotherapy can be given at the same time as radiotherapy (chemoradiotherapy), this method improving the survival rate in stages IIB, IIIA, IIIB and IVA, without significant side effects.
Chemoradiation may also improve the survival rate in stages IB and IIA in patients with large tumors.
Microinvasive squamous cell carcinoma (stage IA 1), with minimal invasion of the deep layers of the cervix, is the tumor type with the highest success rate. At this stage, treatment with the technique of conization or resection with diathermic loop is recommended and subtotal (partial) hysterectomy can also be performed. The 5-year survival rate in this case is 100%.
Most treatments for cervical cancer have different side effects. These differ from patient to patient depending on the type of treatment used, age and general health. The doctor can provide the patient with all the necessary information about possible side effects.