Cervical Cancer - Symptoms, Vaccine and Treatment

Cervical Cancer is a disease in which the cells of the cervix become abnormal and start to grow uncontrollably, forming tumors. Cervical cancer is one of the most common cancers affecting women. Cervical cancer is usually preceded by dysplasia, precancerous changes in the cells on the surface of the cervix. These abnormal cells can progress to invasive cancer. Once the cancer appears, it can progress through four stages. The stages are defined by the extent of spread of the cancer. The more widely the cancer has spread, the more extensive the treatment is likely to be.

Causes

Although the cause is unknown, several predisposing factors have been associated with cervical cancer: frequent intercourse at a young age (under 16), multiple sexual partners. multiple pregnancies, human papillomavirus (HPV), and other bacterial or viral venereal infections.

Signs and Symptoms

Most often, cervical cancer in its earliest and most treatable stages does not cause any symptoms. When there are symptoms, the most common are:

• Persistent vaginal discharge, which may be pale, watery, pink, brown, blood streaked, or dark and foul-smelling
• Abnormal vaginal bleeding, especially between menstrual periods, after intercourse or douching, and after menopause, which gradually becomes heavier and longer

Symptoms of advanced cervical cancer may include:

• Loss of appetite, weight loss, fatigue
• Pelvic, back, or leg pain
• Leaking of urine or feces from the vagina
• Bone fracture

Diagnostic tests 

A Papanicolaou (Pap) test identifies abnormal cells, and colposcopy determines the source of the abnormal cells seen on the Pap test.

Cone biopsy is performed if endocervical curettage is positive.

The Vira pap test, currently under investigation, permits examination of the specimen's deoxyribonucleic acid (DNA) structure to detect HPV.

Treatment

Accurate clinical staging will determine the type of treatment. Preinvasive lesions may be treated with total excisional biopsy, cryosurgery, laser destruction, conization (followed by frequent Pap test follow-ups) or, rarely, hysterectomy. Therapy for invasive squamous cell carcinoma may include radical hysterectomy and radiation therapy (internal, external. or both). Rarely, pelvic exenteration may be performed for recurrent cervical cancer.

Complications of surgery include bladder dysfunction, formation of lymphocytes or seromas after lymphadenectomy, and pulmonary embolism. Complications of radiation therapy include diarrhea, abdominal cramping, dysuria, and leukopenia. Combined surgery and irradiation in the abdomen and pelvis may lead to small bowel obstruction, stricture and fibrosis of the intestine or rectosigmoid, and rectovaginal or vesicovaginal fistula.

Can cervical cancer be prevented?

Early detection of cervical problems is the best way to prevent cervical cancer. Routine, annual pelvic examinations and Pap tests can detect precancerous conditions that often can be treated before cancer develops. Invasive cancer that does occur would likely be found at an earlier stage. Pelvic examinations and Pap tests are the methods used to determine if there are cervical problems. Women who are or have been sexually active, or are age 18 or older, should have regular checkups, including a pelvic exam and Pap test.