Cervical cancer happens when cells change in the cervix, the part of the body that connects the uterus and vagina. This cancer can affect the deeper tissues of the cervix and could spread to other parts of the body (or metastasize), often affecting the lungs, liver, bladder, vagina, and rectum. Most cases of cervical cancer are caused by infection with the human papillomavirus (HPV), which is preventable with a vaccine.
Cervical cancer grows slowly, so there’s usually time to find and treat it before it causes serious problems. Thanks to improved screening through Pap tests and the cervical cancer vaccine, it kills fewer and fewer women each year. Women aged 35 to 44 are most likely to get it. More than 15% of new cases are in women over the age of 65, and especially those who haven’t been getting regular screenings.
What Is a Cervix?
The cervix is the lowermost part of the uterus. It forms a canal between the uterus and vagina, and is almost cylindrical in shape and measures about 2.5cm in length and diameter. It is divided into supravaginal part – the part lying above the vagina – and the vaginal part that lies within the vagina, with each measuring 1.25cm.
The cervix is made of two parts and is covered with two different types of cells. The endocervix is the opening of the cervix that leads into the uterus and is covered with glandular cells. The exocervix (or ectocervix) is the outer part of the cervix that can be seen by the doctor during a speculum exam. It is covered in squamous cells.
The place where these two cell types meet in the cervix is called the transformation zone. The exact location of the transformation zone changes as you get older and if you give birth. Most cervical cancers begin in the cells in the transformation zone.
What Are the Risk Factors of Cervical Cancer?
Almost all cervical cancers are caused by the human papillomavirus (HPV), a common virus that can be passed from one person to another during sex. There are many types of HPV. Some can cause changes on a woman’s cervix that can lead to cervical cancer over time, while other types can cause genital or skin warts.
HPV is so common that most people get it at some point in their lives, and it usually causes no symptoms, so you can’t even tell that you have it. For most women, HPV will go away on its own. However, if it does not, there is a chance that it may cause cervical cancer over time. Other things that can increase your risk of cervical cancer include:
- Having HIV (the virus that causes AIDS) or another condition that makes it hard for your body to fight off health problems
- Using birth control pills for a long time (five or more years)
- Having given birth to three or more children
- Having several sexual partners
What Are the Symptoms of Cervical Cancer?
The biggest symptom of cervical cancer is that there are no symptoms The symptoms that do show often occur late and include:
- Intermenstrual bleeding
- Post-coital bleeding (vaginal bleeding that occurs within 24 hours after sexual intercourse)
- Bleeding between periods
- Bleeding after sexual intercourse
- Bleeding in post-menopausal women
- Discomfort during sexual intercourse
- Vaginal discharge with a strong odour
- Vaginal discharge tinged with blood
- Pelvic pain
What Should I Know About the PAP Test?
The Pap test and the HPV test can help prevent cervical cancer or find it early. The Pap test (or Pap smear) looks for pre-cancers or cell changes on the cervix that might become cervical cancer if they’re not treated appropriately. The HPV test looks for the virus (human papillomavirus) that can cause these cell changes.
Both tests can be done in a doctor’s office or clinic. During the Pap test, the doctor will use a plastic or metal instrument called a speculum to widen your vagina. This helps the doctor examine the vagina and the cervix, and collect a few cells and mucus from the cervix and the area around it, which are then sent to a laboratory. If you’re getting a Pap test, the cells will be checked to see if they look normal. And if you’re getting an HPV test, the cells will be tested for HPV.
How Is Cervical Cancer Treated?
Cervical cancer is treated in several ways, and it depends on the kind of cervical cancer and how far it has spread. Treatments include surgery such as a hysterectomy or cryosurgery, and chemotherapy or radiation therapy.
This treatment kills the cancer cells by freezing them. It may be used to treat pre-cancers or abnormal cells that can turn into cancer if not treated.
A hysterectomy takes out the uterus and cervix. It’s the most common way to treat cervical cancer and there are many ways to do this surgery. Sometimes, the ovaries are taken out at the same time. Nearby lymph nodes may also be taken out to see if they have cancer cells. Each type has its own risks.
This method uses special medicines to shrink or kill the cancer. The drugs can be pills you take, medicines given through your veins, or sometimes both.
Radiation uses high-energy rays (similar to X-rays) to kill the cancer. Radiation can be aimed at the cervix from a machine outside the body. This method is called External Beam Radiation. A radioactive source can also be put into the vagina near the cervix. This is called Brachytherapy.
What Is HPV?
Human papillomavirus (HPV) is a distinct group of viruses that spread through sexual contact. HPV is the main cause of cervical cancer and can also contribute to the development of vulvar, vaginal, anal, and oropharyngeal cancers. HPV vaccines help control the spread of the virus. This vaccine for cervical cancer, along with regular screening, can help us win over the cancer as well as protect us from many other infections.
How Is HPV Spread?
You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. It also spreads through close skin-to-skin touching during sex. A person with HPV can pass the infection to someone even when they have no signs or symptoms. If you are sexually active, you can get HPV, even if you have had sex with only one person. You also can develop symptoms years after having sex with someone who has the infection. This makes it hard to know when you first got it.
How Do I Know if I Have HPV?
There are HPV tests that can screen for cervical cancer. Healthcare providers only use these tests for screening women aged 30 years and older. HPV tests are not recommended to screen men, adolescents, or women under the age of 30. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they’ve developed more serious problems from HPV, such as cancers.
Which Vaccine Should You Take?
This vaccine stimulates an immune response that protects against nine strains of HPV.
This vaccine is a non-infectious vaccine that protects against four strains of HPV.
Who Needs the HPV Vaccination, and When ?
Across the world, HPV vaccination is recommended at ages 11 or 12, even though it can be given at the relatively young age of nine. The vaccination is highly recommended for all women up to the age of 26 – especially if they were not properly vaccinated against HPV earlier. Experts feel that it is extremely effective when administered before the first sexual intercourse.
What Is the Recommended Timing of HPV Shots?
The vaccine is given in a two- or three-dose schedule, depending on the age of the patient. For ages 9- 14, two doses at zero month and six months is recommended. For ages 15 to 45, three doses at zero month, one month, and six months are advised.
What Are the Side Effects of the HPV Vaccination?
Common side effects include:
- bruising or itching at the site of the injection
- a high temperature or feeling hot and shivery
- pain in the arms, hands, fingers, legs, feet, or toes