Cervical Cancer Everything You Need To Know
Cervical Cancer Overview
Most cervical cancer is caused by a virus called human papillomavirus, or HPV. You can get HPV by having sexual contact with someone who has it. There are many types of the HPV virus. Not all types of HPV cause cervical cancer. Some of them cause genital warts, but other types may not cause any symptoms.
Most adults have been infected with HPV at some time. An infection may go away on its own. But sometimes it can cause genital warts or lead to cervical cancer. That's why it's important for women to have regular Pap tests. A Pap test can find changes in cervical cells before they turn into cancer. If you treat these cell changes, you may prevent cervical cancer.
Cervical cancer is cancer that starts in the neck of the womb. The neck of the womb is called the cervix. The womb and cervix are part of a woman's reproductive system, which is made up of the
- Womb, including the cervix
The diagram shows the position of these organs in the body.
Where cervical cancer starts
The cervix is covered with a layer of skin like cells on its outer surface, called the ectocervix. There are glandular cells lining the inside of the cervix (the endocervix). The glandular cells produce mucus. The skin-like cells of the ectocervix can become cancerous, leading to a squamous cell cervical cancer. Or the glandular cells of the endocervix can become cancerous, leading to an adenocarcinoma of the cervix.
The area where cervical cells are most likely to become cancerous is called the transformation zone. It is the area just around the opening of the cervix that leads on to the endocervical canal. The endocervical canal is the narrow passageway that runs up from the cervix into the womb. The transformation zone is the area that your doctor or nurse will check during cervical screening.
The vagina is the tube from the outside of the body to the entrance to the womb. The skin-like cells that cover the cervix join with the skin covering the inside of the vagina. So even if you have had your womb and cervix removed, you can still have screening samples taken from the top of the vagina.
Like all other areas of the body, there are lymph nodes around the womb and cervix. The nearest large groups of lymph nodes are in the groin. Lymph nodes or lymph glands are part of the lymphatic system. The lymphatic system has 2 important roles.
- 1. It helps to protect the body against infection.
- 2. It filters, drains and circulates the tissue fluid that bathes all body cells and tissues.
Lymph nodes are important in cancer care. Tissue fluid that bathes the area containing cancer will drain to the nearest lymph nodes. So if any cancer cells break away from a tumour, the first place they will end up is in the nearest lymph nodes. When you have surgery for cancer, your surgeon will usually take out some lymph nodes and send them to the lab to be checked for cancer cells.
Signs & Symptoms To Look For
Abnormal cervical cell changes rarely cause symptoms. But you may have symptoms if those cell changes grow into cervical cancer. Symptoms of cervical cancer may include:
- 1. Bleeding from the vagina that is not normal, such as bleeding between menstrual periods, after sex, or after menopause.
- 2. Pain in the lower belly or pelvis.
- 3. Pain during sex.
- 4. Vaginal discharge that isn't normal.
As part of a pelvic exam, you should have a Pap test. During a Pap test, the doctor scrapes a small sample of cells from the surface of the cervix to look for cell changes. If a Pap test shows abnormal cell changes, your doctor may do other tests to look for precancerous or cancer cells on your cervix.
Your doctor may also do a Pap test and take a sample of tissue (biopsy) if you have symptoms of cervical cancer, such as bleeding after sex.
Facts About Cervical Cancer
Cervical cancer survival gradually continues to fall beyond five years after diagnosis. 63% of women are predicted to survive their disease for ten years or more, as shown by age-standardised net survival for patients diagnosed with cervical cancer during 2010-2011 in England and Wales. Out of 20 common cancers in England and Wales, ten-year survival for cervical cancer ranks 8th highest overall (and 6th highest for females only). These high survival rates can be attributed in large part to cervical screening. Screening can detect cervical cancers at an early stage when treatment is most likely to be successful.
There were 3,224 new cases of cervical cancer in 2014 this was less than 1% of all cancers. The peak age for cervical cancer is between 25-29 and the trend for cervical cancer has gone down 44% since the 1970'sMortality rates for cervical cancer were 890 in the UK in 2014 that is less than 1% of all female cancer deaths and the peak age to die of cervical cancer from these figures is 85-89 years old.
Female mortality rates in cervical cancer have dropped a whopping 72% since the 1970's
Treatment For Most Cervical Cancers
The treatment for most stages of cervical cancer includes:
- Surgery, such as a hysterectomy and removal of pelvic lymph nodes with or without removal of both ovaries and fallopian tubes.
- Chemotherapy and or Radiation therapy.
Depending on how much the cancer has grown, you may have one or more treatments. And you may have a combination of treatments. If you have a hysterectomy, you won't be able to have children. But a hysterectomy isn't always needed, especially when cancer is found very early.
Finding out that you have cancer can change your life. You may feel like your world has turned upside down and you have lost all control. Talking with family, friends, or a counsellor can really help. Ask your doctor about support groups or visit www.cancer.org.
The Pap test is the best way to find cervical cell changes that can lead to cervical cancer. Regular Pap tests almost always show these cell changes before they turn into cancer. It's important to follow up with your doctor after an abnormal Pap test result so you can treat abnormal cell changes. This may help prevent cervical cancer.
If you are age 26 or younger, you can get the HPV vaccine, which protects against types of HPV that cause most cases of cervical cancer.
The virus that causes cervical cancer is spread through sexual contact. The best way to avoid getting a sexually transmitted infection is to not have sex. If you do have sex, practice safer sex, such as using condoms and limiting the number of sex partners you have.
Cervical Cancer Prevention
Have regular Pap test screening
The recommended Pap test schedule is based on your age and things that increase your risk. Talk to your doctor about how often to have this test.
Women who smoke cigarettes or who breathe in secondhand smoke have a higher risk for cervical cell changes that can lead to cervical cancer.2Quitting smoking may decrease this risk.
For information about quitting, see the topic Quitting Smoking.
Get the HPV vaccine
If you are age 26 or younger, you can get the HPV shot. The vaccines Cervarix, Gardasil, and Gardasil 9 protect against the types of human papillomavirus (HPV) that cause cervical cancer. It is recommended for children age 11 or 12 but can be given as early as age 9. For girls who have not already gotten the vaccine, it is recommended up to age 26. For boys who have not already gotten the shot, the vaccine is recommended up to age 21.
The staging, given as a number from one to four, indicates how far cancer has spread.
The chances of living for at least five years after being diagnosed with cervical cancer are:
- stage 1 – 80-99%
- stage 2 – 60-90%
- stage 3 – 30-50%
- stage 4 – 20%
Stages Of Cervical Cancer
The staging for cervical cancer is as follows:
- stage 0 (pre-cancer) – there are no cancerous cells in the cervix, but there are biological changes that could trigger cancer in the future; this is called cervical intraepithelial neoplasia (CIN) or carcinoma in situ (CIS)
- stage 1 – the cancer is still contained inside the cervix
- stage 2 – the cancer has spread outside of the cervix into the surrounding tissue but hasn't reached the tissues lining the pelvis (pelvic wall) or the lower part of the vagina
- stage 3 – the cancer has spread into the lower section of the vagina and/or into the pelvic wall
- stage 4 – the cancer has spread into the bowel, bladder or other organs, such as the lungs
Diagnosis Of Cervical Cancer
Diagnosing cervical cancer
If cervical cancer is suspected, you'll be referred to a gynaecologist (a specialist in treating conditions of the female reproductive system).
A referral will be recommended if the results of your cervical screening test suggest that there are abnormalities in the cells of your cervix. However, in most cases, the abnormalities don't mean you have cervical cancer.
You may also be referred to a gynaecologist if you have abnormal vaginal bleeding, or if your GP has noticed a growth inside your cervix during an examination.
The sexually transmitted infection (STI) chlamydia is one of the most common reasons why women experience unusual vaginal bleeding. Your GP may recommend that you're tested for it first before being referred. Testing for chlamydia involves taking a small tissue sample from your cervix or carrying out a urine test.
If you've had an abnormal cervical screening test result, or your symptoms suggest that you may have cervical cancer, your gynaecologist will usually carry out a colposcopy. This is an examination to look for abnormalities in your cervix.
During a colposcopy, a small microscope with a light source at the end (colposcope) is used. As well as examining your cervix, your gynaecologist may remove a small tissue sample (biopsy) so that it can be checked under a microscope for cancerous cells.
In some cases, a minor operation called a cone biopsy may also be carried out. The operation is carried out in hospital, usually under a local anaesthetic.
During a cone biopsy, a small, cone-shaped section of your cervix will be removed so that it can be examined under a microscope for cancerous cells. You may experience vaginal bleeding for up to four weeks after the procedure. You may also have period-like pains.
If the results of the biopsy suggest you have cervical cancer and there's a risk that cancer may have spread, you'll probably need to have some further tests to assess how widespread the cancer is. These tests may include:
1. A pelvic examination carried out under general anaesthetic – your womb, vagina, rectum and bladder will be checked for cancer
- 2. Blood tests – these can be used to help assess the state of your liver, kidneys and bone marrow
- 3. Computerised tomography (CT) scan – scans are taken of the inside of your body and a computer is used to assemble them into a detailed three-dimensional image; the CT scan can help to identify cancerous tumours and show whether cancerous cells have spread
- 4. Magnetic resonance imaging (MRI) scan – this type of scan uses strong magnetic fields and radio waves to produce detailed pictures of the inside of your body; it can also be used to check whether cancer has spread
- 5. Chest X-ray – this will indicate whether cancer has spread to your lungs
- 6. Positive emission tomography (PET) scan – a specialised scan, where a mildly radioactive substance is injected into your veins so the cancerous tissue shows up more clearly; it's often combined with a CT scan and is used to see if cancer has spread, or to check how well a person is responding to treatment
Reducing The Risk Of STI's
Preventing an STI, including HPV, is easier than treating an infection after it occurs. HPV infection usually doesn't cause symptoms, so you or your partner may not know that you are infected.
To reduce your risk:
- Talk with your partner about STIs before beginning a sexual relationship. Find out if he or she is at risk for an STI. Remember that it's possible to be infected with an STI without knowing it. Some STIs, such as HIV, can take up to 6 months before they are detected in the blood.
- Avoid sexual contact if you have symptoms of an STI or are being treated for an STI.
- Avoid all intimate sexual contact with anyone who has symptoms of an STI or who may have been exposed to an STI.
- The fewer sex partners you have in your lifetime, the better it is for your health. Your risk for an STI increases if you have several sex partners or if your sex partner has more than one partner.
- Use male or female condoms to reduce the risk of getting an STI. Using male condoms when you have sex has been shown to reduce your risk of getting HPV.3 Female condoms may help also, although there has been less study of this type of protection.
Not having sexual contact is the only certain way to prevent exposure to STIs. Sexually transmitted infections such as human papillomavirus (HPV) can be spread to or from the genitals, anus, mouth, or throat during sexual activities.
What Is A Biopsy
A biopsy is a sample of tissue taken from the body in order to examine it more closely. A doctor should recommend a biopsy when an initial test suggests an area of tissue in the body isn't normal.
Doctors may call an area of abnormal tissue a lesion, a tumour, or a mass. These are general words used to emphasise the unknown nature of the tissue. The suspicious area may be noticed during a physical examination or internally on an imaging test.
Why Are Biopsies Done?
Biopsies are most often done to look for cancer. But biopsies can help identify many other conditions.
A biopsy might be recommended whenever there is an important medical question the biopsy could help answer. Here are just a few examples:
- A mammogram shows a lump or mass, indicating the possibility of breast cancer.
- A mole on the skin has changed shape recently and melanoma is possible.
- A person has chronic hepatitis and it's important to know if cirrhosis is present.
In some cases, a biopsy of normal-appearing tissue may be done. This can help check for cancer spread or rejection of a transplanted organ.
In most cases, a biopsy is done to diagnose a problem or to help determine the best therapy option.
Types of Biopsies
There are many different kinds of biopsies. Nearly all of them involve using a sharp tool to remove a small amount of tissue. If the biopsy will be on the skin or other sensitive areas, numbing medicine is applied first.
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