WHAT IS CERVICAL CANCER?
Cancer is a disease in which cells in the body grow in an uncontrolled manner. It is usually named for the part of the body it begins, even if it spreads to other parts later.
When cancer begins in the cervix (the structure that connects the lowest part of a woman’s womb to the vagina), it is termed cervical cancer. It causes cells of the cervix to grow out of control. The excessive growth destroys surrounding organs and may spread to other part of the body if lethal.
All women are at risk of cervical cancer. It occurs most often in women over age 30. It is the fourth most common cancer in women in the world. A leading cause of cancer-related deaths in developing countries.
According to the WHO, Cervical cancer is the second most common cancer in women living in less developed regions with an estimated 570 000 new cases in 2018 (84% of the new cases worldwide). In 2018, approximately 311 000 women died from cervical cancer; more than 85% of these deaths occurring in low- and middle-income countries.
The incidence of cervical cancer has declined steadily in developed countries due to mass screening with Pap tests which allows detection and treatment of early stage of the disease.
TYPES OF CERVICAL CANCER
The cervix has two parts, the endocervix and exocervix.
The endocervix is the opening that leads into the womb and the glandular cells (mucus-producing cells) cover it. The exocervix is the outer part of the cervix and the squamous cells line it.
The different types of cervical cancer are:
- Squamous cell carcinoma: constitute about 90% of cervical cancer cases. It develops from cells in the exocervix.
- Adenocarcinoma: This develops from the mucus-producing cells of the endocervix. Most of the other cervical cancers are adenocarcinoma.
- Mixed carcinoma This has features of the two other types.
WHAT CAUSES CERVICAL CANCER?
The main cause of cervical cancer is Human Papilloma Virus (HPV) which is transmitted from one person to another through sex. HPV infection is common in women who are sexually active. About 90% of HPV infections clear on their own, only 5% of HPV infection results in the development of cervical cancer of which HPV types 16 and 18 are mostly implicated.
RISK FACTORS OF CERVICAL CANCER?
These are factors which increase your chance of contracting cervical cancer::
- Having multiple sexual partners; the more the sexual partners, the more the chances of contracting HPV.
- Early age of sexual intercourse (Coitarche) especially before the age 16.The younger a woman is when she has sexual intercourse for the first time, the higher the risk of HPV infection becomes
- A weakened immune system, the immune system helps the body fight off infections, so conditions that decrease it’s effectiveness unsurprisingly increase the risk of having cervical cancer too. It includes women already living with the Human Immunodeficiency Virus(HIV), diabetes, chemotherapy or underwent organ transplant.
- Sexually transmitted diseases; like HIV, syphilis, chancroid etc. An already existing STD markedly raises the risk, as the predisposing sexual behavior are often similar. Also, some of these diseases cause ulcers (Injuries to the surface of sexual organs) exposing the skin to infections, including HPV.
- Use of oral contraceptives for more than 5 years.
- Smoking: Women who smoke have higher risk of developing cervical cancer than does who do not.
- Family history: if you have a first degree relation like mother or sister already living with cervical cancer, you are twice at risk of contracting cervical cancer.
- Exposure to Diethylstilbesterol; this is a drug women used to take in the 1950s to prevent miscarriage. If your mother took it, then your risk of contracting cancer increases.
WHAT ARE THE SYMPTOMS?
Cervical cancer at its early stage usually produces no symptoms. However in advanced stage, it may present as:
- Pain during sexual intercourse.
- Unusual vaginal bleeding, such as after sex, between periods or after menopause
- Unusual vaginal discharge
After it has spread, the cancer can cause:
- Pain in the pelvis
- Leg swelling
- Kidney failure
- Bone pain
- Weight loss and lack of appetite
- Trouble peeing
HOW IS CERVICAL CANCER DIAGNOSED?
It consists of Pap smear Test. It involves a doctor using a brush-like instrument to collect cell samples from the neck of the womb(where it connects with the vagina). After this, the specimen is sent for laboratory tests which will detect any abnormal cells. These cells may develop into cancers if not discovered and treated appropriately. Regular screening should commence at about age 21 and done every three years till the age of 65.
HOW TO PREVENT CERVICAL CANCER
- HPV Vaccination: the HPV vaccine protects from the type of HPV that cause cervical cancer. The vaccine mostly consist of Cervarix and Gardasil-9, given to girls usually before their first sexual intercourse, that is, before their exposure to the virus.
- Routine screening test: Pap tests may help detect pre-cancerous conditions of the cervix, so they can be treated in order to prevent cervical cancer. Get a Pap test every 3 years once you’re 21 or older.
- Public health awareness: the awareness of cervical cancer is low in developing countries. With increased awareness, most women will present for vaccination and screening for cervical cancer and prevent avoidable deaths.
- Avoid smoking
- Use of condoms during sexual intercourse: condoms may act as a barrier against HPV.
- Delay of first sexual intercourse
- Having fewer sexual partners.
TREATMENT OF CERVICAL CANCER
The treatment options for cervical cancer depend on the type of cervical cancer, how far it has spread, as well as the age and overall state of health of the patient. Treatments include surgery, chemotherapy, and radiation therapy.
- Surgery: Doctors remove cancer tissue in an operation.
- Chemotherapy: Using special medicines to destroy the cancer. The drugs can be pills you take or medicines given in your veins, or sometimes both.
- Radiation: Using high-energy rays (similar to X-rays) to kill the cancer.
Almost all of cervical cancer deaths could be avoided if known effective interventions were available to all women and implemented, including vaccinating adolescent girls against HPV and cervical screening and treatment before the cancer develops.