About the Cervix
In the female reproductive system, the cervix is the lowest, thin section of the uterus. During pregnancy, the uterus houses a developing foetus. The cervix connects the lowest section of the uterus to the vagina and creates the birth canal with the vagina.
Cervical cancer develops when healthy cells on the cervix’s surface alter or become infected with the human papillomavirus (HPV) and grow out of control, causing a tumor. Long-term HPV infection of the cervix can progress to cancer, resulting in a lump or tumor on the cervix. A tumor might be malignant or benign. A malignant tumor is one that can spread to other regions of the body. A benign tumor is one that will not spread.
Treatment of a lesion, which is a precancerous area, depends on the following factors:
- The size of the lesion and the type of changes that have occurred in the cells.
- The patient’s desire to have children in the future.
- The patient’s age and general health.
- Preferences of the patient and the doctor.
If the precancerous cells develop into cancer cells and move deeper into the cervix or to other tissues and organs, the illness is known as cervical cancer or invasive cervical cancer.
About cervical cancer :
Cervical cancer can develop from the surface of the cervix visible in the vagina, known as the ectocervix, or from the canal between the vagina and the uterus, known as the endocervix. Cervical cancer is classified into two categories based on the type of cell in which the disease began. Other forms of cervical cancer are uncommon.
Squamous cell carcinoma accounts for around 80% to 90% of all cervical malignancies. These malignancies begin in the cells that cover the cervix’s outer surface.
Adenocarcinoma accounts for 10% to 20% of all cervical cancers. These tumors begin in the glandular cells that border the lower birth canal in the cervix’s interior section.
Risk Factors :
The following factors may raise the risk of developing cervical cancer:
Human papillomavirus (HPV) infection: HPV is the most major risk factor for cervical cancer. HPV is a rather prevalent illness. The majority of infections occur after people become sexually active, and most people recover without incident. There are more than a hundred distinct varieties of HPV. Not all of them are associated with cancer. HPV16 and HPV18 are the most commonly related HPV types or strains with cervical cancer.
Immune system deficiency: People who have a weakened immune system are more likely to get cervical cancer. Immune suppression from corticosteroid medicines, organ donation, therapies for different forms of cancer, or the human immunodeficiency virus (HIV), the virus that causes acquired immune deficiency syndrome, can all induce a weakened immune system (AIDS).
Age: Cervical cancer is uncommon in those under the age of 20. The risk increases between the late teens and the mid-30s.
Socioeconomic factors: Cervical cancer is more frequent in groups of people who are less likely to have access to cervical cancer screening. Black people, Hispanic people, American Indian people, and those from low-income households are more likely to be included in these categories.
Oral contraceptives: Some research findings show that oral contraceptives, or birth control pills, may be linked to an increased risk of cervical cancer and should be avoided.
Exposure to diethylstilbestrol (DES): People whose mothers were given this medicine during pregnancy to prevent miscarriage are more likely to develop a rare kind of cervix or vaginal cancer.
Any of the following could be symptoms or signs of cervical cancer:
- Blood spots or light bleeding between or following periods
- Menstrual bleeding that is longer and heavier than usual
- Bleeding after intercourse, douching, or a pelvic examination
- Increased vaginal discharge
- Pain during sexual intercourse
- Bleeding after menopause
- Unexplained, persistent pelvic and/or back pain.
The common types of treatments used for cervical cancer are described below.
Surgery : During an operation, surgery is the removal of the tumor and some surrounding healthy tissue. These treatments are frequently performed for cancer that has not progressed beyond the cervix:
Conization : The removal of all aberrant tissue using the same process as a cone biopsy (see Diagnosis). It can be used to eradicate microinvasive cervical carcinoma, which can only be seen under a microscope.
Loop electrosurgical excision procedure (LEEP) : The application of an electrical current through a tiny wire hook. The hook is used to extract the tissue. It is capable of removing microinvasive cervical carcinoma.
Hysterectomy : The uterus and cervix are removed. A hysterectomy might be simple or complex. The uterus and cervix are removed during a basic hysterectomy. The uterus, cervix, upper vagina, and tissue around the cervix are all removed during a radical hysterectomy. A radical hysterectomy also entails extensive pelvic lymph node dissection, which involves the removal of lymph nodes.
Bilateral salpingo-oophorectomy : This procedure, if necessary, involves the removal of both fallopian tubes and both ovaries. It is performed concurrently with a hysterectomy.
Radical trachelectomy : A surgical treatment that removes the cervix but leaves the uterus intact. It comprises the dissection of pelvic lymph nodes (see above). Young people who desire to protect their fertility may benefit from this operation. For certain individuals, this treatment has become an acceptable alternative to a hysterectomy.
Exenteration : If cervical cancer has progressed to these organs following radiation therapy, the uterus, vagina, lower intestine, rectum, or bladder may be removed (see below). Exenteration is rarely advised. It is most commonly used when cancer has returned following radiation therapy.
The use of high-energy x-rays or other particles to destroy cancer cells is known as radiation therapy. External-beam radiation therapy, which delivers radiation from a machine outside the body, is the most common type of radiation treatment. Internal radiation therapy, also known as brachytherapy, is the use of implants to deliver radiation therapy.
Therapies using medication
Medication to destroy cancer cells may be part of the treatment plan. Medication can be delivered through the bloodstream to cancer cells all over the body. Systemic therapy refers to the administration of a drug in this manner. Medication can also be administered locally, which means that it is applied directly to the cancer or is kept in a single part of the body.
The types of medications used for cervical cancer include:
- Targeted therapy
Each of these types of therapies is discussed below in more detail.
The targets of all tumours are not the same.
Pembrolizumab (Keytruda), an immune checkpoint inhibitor, is used to treat cervical cancer that has recurred or spread to other parts of the body during or after chemotherapy treatment.
- Cervical cancer can often be avoided by having regular Pap tests and human papillomavirus (HPV) tests to detect and treat precancers. It can also be avoided by getting the HPV vaccine.
- People can also take the following steps to help prevent cervical cancer:
- Delaying first sexual encounter until late adolescence or older
- Putting a limit on the number of sexual partners
- Using condoms and dental dams to practise safer sex
- Avoiding sexual relations with people who have had a lot of partners
- Avoiding sexual contact with people who have genital warts or exhibit other symptoms.
- Quitting smoking