CERVICAL CANCER
The Indian Union government announced free HPV vaccines for children between 9-14 years of age to prevent the emergence of cervical cancer. Cervical cancer is a disease that torments a lot of women around the world. It is the third most reported cancer in India and the second most reported cancer amongst women. According to a research paper published in PubMed Central, a lack of awareness and poor to moderate living standards are responsible for the prevalence of cervical cancer. Another study based on The GLOBOCAN 2020, which came out in 2022, reported that India has the highest number of cervical cancer cases in Asia.
Keep reading to learn about this deadly disease and how it can be managed effectively.
<span data-metadata=""><span data-buffer="">What Is Cervical Cancer?
Cervical cancer is a serious condition where malignant tumours develop in the tissues of the cervix, a muscular organ located below the uterus that connects it to the vagina. Often referred to as the “neck of the uterus,” the cervix serves as a crucial gateway for various biological processes. It forms a canal that allows menstrual blood to exit the body and provides the pathway through which sperm enters the uterine region during sexual intercourse. During childbirth, the cervix plays a pivotal role by dilating up to 10 centimetres to enable the baby to pass from the uterus through the vagina.
The development of cervical cancer typically begins with pre-cancerous changes in the cervical cells, notably cervical intraepithelial neoplasm (CIN). If left untreated, cervical cancer can spread to other parts of the body, leading to severe health complications. Timely medical intervention, including surgery, radiation, and chemotherapy, can significantly improve outcomes for those affected by this disease.
<span data-metadata=""><span data-buffer="">Where does cervical cancer start?
Cervical cancer begins in the cervix, a structure composed of robust fibromuscular tissue lined with two distinct types of cells.
– The glandular cells, which line the innermost part of the cervix known as the endocervical canal, are responsible for secreting mucus and other fluids essential for reproductive functions.
– On the outermost part of the cervix, called the ectocervix, squamous cells create a protective barrier.
The transformation zone, where these two cell types meet, is particularly vulnerable to abnormal changes and is the most common site where cervical cancer starts.
Abnormal cells can develop in either the glandular or squamous tissues, leading to pre-cancerous conditions. These cells can proliferate uncontrollably, eventually forming malignant tumors if not detected and treated early.
<span data-metadata=""><span data-buffer="">What are the signs and symptoms of cervical cancer?
Cervical cancer often presents a range of signs and symptoms, but one of its most nerve-racking aspects is that many women remain asymptomatic until the disease has advanced to a later stage.
Common signs include;
– Unusual vaginal bleeding: This can happen in three notable ways: excess bleeding or prolonged bleeding during the menstrual cycle, bleeding during sexual intercourse, bleeding in between two-period cycles, and bleeding after menopause.
– Watery vaginal discharge: This occurs with a strong odour.
– Pain during sexual intercourse: This is the most significant symptom that can also reveal first or second-stage cancer if the cancerous cells are facing the vulva. Women who experience severe or shooting pain or bleeding during sexual intercourse should consult a doctor.
Additional symptoms may emerge in the form of persistent back pain, swelling in the legs due to lymphatic obstruction, and general fatigue or weakness. Blood in the urine and difficulty in bowel movements are also possible indicators of the disease’s advancement or metastasis.
The silent progression of cervical cancer underscores the critical importance of regular screening.
<span data-metadata=""><span data-buffer="">Experiencing unusual pain during sex? Click here to book a Pap smear test.
<span data-metadata=""><span data-buffer="">What are the different types of cervical cancer?
Cancer is generally named after it’s place of origin. There are two types of cervical cancers;
- Squamous cell carcinoma: It develops from the cells of the ectocervix.
- Adenocarcinoma: Cancer develops in the glandular cells of the endocervix. Sometimes, women develop a rare type of adenocarcinoma called clear cell carcinoma or mesonephroma.
- Mixed carcinoma: It is a combination of both squamous cell carcinoma and adenocarcinoma.
<span data-metadata=""><span data-buffer="">Are you having unusual pelvic pain? Tiredness or a loss of appetite?
Don’t be concerned! Early testing and screening provide the necessary answers. But, even if you face these difficulties, CancerMitr is here to help you navigate the path from disease discovery to recovery. To learn more about our services, please visit our website.
<span data-metadata=""><span data-buffer="">What are the different stages of cervical cancer?
Cancer staging helps determine the chances of survival and the best course of treatment. Cancer staging focuses on where the cancer is located, if it has spread, to what extent it has spread, and whether it is affecting other body parts. The cervical cancer staging process was developed by the International Federation of Obstetrics and Gynecology or FIGO (which is named after the Federation Internationale de Gynecologie et d’Obstetrique).
Based on the FIGO system, the different stages of cervical cancer are as follows;
- Stage I: Tumour has spread deeper into the tissue from the cervix lining, but it has not spread to other body parts.
- Stage II: The cancer is confined to the pelvic area, but it has not spread to other parts like the uterus, vagina or tissue near the cervix.
- Stage III: The tumour has spread to the lower one-third of the vagina and probably spread to the pelvic wall and nearby lymph nodes but not to distant sites.
- Stage IV – Stage 4 generally alludes to metastasis.
<span data-metadata=""><span data-buffer="">What are the different grades of cervical cancer?
The grading of cancer is determined by how closely the cancer cells resemble normal cells, and it provides information regarding the rate of growth and metastasis. Cancer grades are divided into three;
- Grade 1 or low grade: Cancer tissues have more normal-looking cells.
- Grade 2 or intermediate grade: Cancer tissue looks somewhat like normal cells.
- Grade 3 or high grade: Cancer tissue looks completely different from normal cells.
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<span data-metadata=""><span data-buffer="">How is cervical cancer diagnosed?
Certain blood tests and imaging tests help in diagnosing the disease in its early stages. Some of the diagnostic methods are as follows:
Pap smear test or a pap test is a procedure used to check for the presence of abnormal cells in a woman’s cervix. It is the most important diagnostic method for cervical cancer. During this test, the medical expert uses a tool to remove cells from the surface of a cervix. It is then checked in a lab for the presence of abnormal cells, including cancer. It aids in detecting the disease at an early stage. It also helps detect precancerous cells, which can develop into cervical cancer later.
VIA of the cervix is a screening method used to detect precancerous lesions and cervical cancer. During the procedure, a healthcare provider applies a diluted solution of acetic acid (vinegar) to the cervix. This solution causes abnormal cells to turn white, which can then be seen with the naked eye under adequate lighting. VIA is a simple, cost-effective, and immediate diagnostic tool that does not require complex equipment, making it particularly useful in low-resource settings. It allows for the identification of areas that may require further investigation or treatment, playing a critical role in early detection and prevention of cervical cancer.
Medical experts use colposcopy to check for the presence of cervical cancer. It is a process that involves a colposcope which magnifies the cells of the cervix and vagina.
It confirms whether the abnormal tissue is either benign or malignant. A biopsy is a process where a small amount of tissue is taken from the body and then checked in lab condition. Types of biopsies are as follows;
- Endocervical curettage or ECC: It is a medical procedure where the doctor uses a small, spoon-shaped instrument called a curette to scrape off some tissues from the cervical opening.
- Loop electrosurgical excision procedure or LEEP: It involves a thin wire hook through which electricity is passed to remove tissues for lab examination.
- Conization or cone biopsy: It involves a process where cone-shaped tissue is removed from the cervix. Conization is also used for treating early-stage cervical cancer or precancerous tumour.
Medical expert checks for the spread of cancer through various imaging tests like X-ray, CT scan, PET scan, MRI, or PET scan.
<span data-metadata=""><span data-buffer="">What are the various cervical cancer treatment methods?
Surgery
Surgery is the most important form of cervical cancer treatment. It is a process that involves the removal of the tumour or tumour-affected tissues or organs. Various surgical methods used to treat cervical cancer are as follows;
- Conization: It is a procedure where the tumours are removed in the form of a cone. It is a reliable method to treat precancerous cells or early stages of cervical cancer.
- Loop electrosurgical excision procedure or LEEP: Microinvasive cervical cancer is removed with a thin wire hook through which an electrical current is passed.
- Hysterectomy: It is the surgical removal of the cervix and the uterus to prevent the further spread of the disease. Depending upon the spread of the disease, the uterus, cervix and some tissue around it, and upper vagina are removed, a process called radical hysterectomy.
- Bilateral salpingo-oophorectomy: They are also removed if the tumours have spread to the ovaries or fallopian.
- Radical trachelectomy: It is a procedure to ensure a woman’s fertility by removing the cervix and leaving the uterus intact.
- Exenteration: It is a procedure where the uterus, vagina, lower colon, rectum, or bladder are removed, depending on the tumour’s spreading. This procedure is recommended only if cancer recurs after other treatment methods like radiation therapy.
Other treatment methods
- Radiation therapy: It is a process that involves the use of high-energy X-rays or other particles to target and destroy cancer cells. It is done before surgery to shrink the tumour, or it may be given alone.
- Chemotherapy: It is the process of administering powerful drugs in the human body to kill cancer cells. Chemotherapy is done to reduce the tumour’s size before surgery and kill the cancer cells that have spread in the human body after surgery.
- Target therapy: It is a treatment that involves the targeting of cancer’s specific genes, proteins, or the tissue environment (that contributes to it’s growth and spreading). The advantage of this process is that, unlike chemotherapy, it limits the damage done to normal tissues.
- Immunotherapy: It is a process where the human body’s immune system is triggered with the help of certain medications to respond to cancer cells.
What are the various side effects of cervical cancer treatment?
Cervical cancer treatments can significantly impact a woman’s health and quality of life, bringing about a range of side effects. Sexual health problems, including decreased libido, are common as the cervix is integral to the female reproductive system. Treatments such as hysterectomy can lead to infertility, preventing women from conceiving, which can be emotionally devastating.
Additionally, the aggressive nature of cancer treatments often results in;
- Hair loss
- Persistent nausea and vomiting
- Loss of appetite
- Fatigue
- Mouth or lips sores
- Frequent infections
- Anaemia
- Numbness in the hands and feet
- Pain
- Heightened sensitivity to temperature changes
- Burning or tingling sensations
Comprehensive care is essential to manage these varied and challenging side effects.
<span data-metadata=""><span data-buffer="">What are the supportive therapies for cervical cancer patients?
- Physiotherapy and pelvic exercises: To help deal with bladder and bowel issues caused by chemotherapy and radiation therapy.
- Diet and nutrition: Chemotherapy leads to severe nausea and vomiting. A personalised nutrition plan may be needed to reduce the severity of the side effects.
- Ozone therapy or HBOT: Ozone therapy or hyperbaric oxygen therapy helps in reducing side effects and enhancing healing.
- Medications: Patients who suffer from severe side effects like pain, nausea, sores, etc., can contact medical experts for medications.
- Mental health support: The news related to a cancer diagnosis is upsetting. At the same time, patients undergoing treatment that physically changes them find coping difficult. Mental health counsellors can provide the required support to the patient.
- Supportive care: To cope with side effects of other cancer treatments like chemotherapy, immunotherapy, and radiation therapy, cancer patients can opt for supportive methods like Flower bach, Mistletoe therapy, Tibetan therapy, Homeopathy and Ayurveda.
What lifestyle changes and follow-up care steps are people with cervical cancer expected to make?
These lifestyle changes and follow-up care steps can help manage the effects of cervical cancer, improve your quality of life, and enhance overall health outcomes. Always consult with your healthcare provider to tailor these recommendations to your specific needs.
- Balanced Diet: Emphasize a diet rich in fruits, vegetables, whole grains, and lean proteins to support overall health and immune function.
- Hydration: Ensure you drink plenty of water to stay well-hydrated, especially during treatment.
- Avoid Alcohol and Tobacco: Quit smoking and limit alcohol consumption to reduce the risk of complications and recurrence.
- Regular Exercise: Engage in moderate physical activity, such as walking, swimming, or yoga, to boost energy levels, reduce fatigue, and enhance mood.
- Rest and Recovery: Balance physical activity with adequate rest to help your body recover from treatment.
- Stress Management: Practice mindfulness, meditation, and deep breathing exercises to manage stress and anxiety. Joining support groups can also provide emotional support.
- Sexual Health: Discuss any changes or concerns regarding sexual health with your partner and healthcare provider. Counseling or therapy may be beneficial in addressing these issues.
- Scheduled Appointments: Attend all follow-up appointments with your healthcare providers to monitor your health and catch any potential issues early.
- Surveillance Tests: Undergo periodic imaging tests, blood tests, and pelvic exams as recommended to monitor for any signs of cancer recurrence.
- Symptom Monitoring: Keep track of any new or worsening symptoms and report them to your healthcare provider promptly.
- Medication Adherence: Take all prescribed medications as directed to manage symptoms and prevent complications.
- Counselling Services: Consider professional counselling to address any mental health concerns such as anxiety, depression, or fear of recurrence.
- Support Networks: Utilize social support from family, friends, and cancer support organizations to help cope with the emotional and psychological challenges.
- Healthy Weight: Maintain a healthy weight through a balanced diet and regular exercise.
- Vaccinations: Stay up-to-date with recommended vaccinations, including the HPV vaccine, to protect against future infections.
- Stay Informed: Educate yourself about cervical cancer, treatment options, and advances in care to make informed decisions about your health.
- Advocacy and Involvement: Participate in awareness programs and advocacy for cervical cancer to help others and stay engaged in your care community.
In conclusion,
Navigating life after a cervical cancer diagnosis involves a multifaceted approach encompassing lifestyle changes and diligent follow-up care. Embracing a balanced diet, staying hydrated, and avoiding harmful substances like tobacco and alcohol are crucial steps in supporting overall health and recovery. Regular exercise and adequate rest help maintain energy levels and reduce fatigue, while mindfulness practices and support groups offer essential emotional support. It’s vital to engage in open communication about sexual health concerns and seek professional counseling if needed. Consistently attending follow-up appointments, adhering to prescribed medications, and staying vigilant about new symptoms are key to early detection of any recurrence. By staying informed about advancements in treatment and participating in advocacy efforts, patients can not only improve their own outcomes but also contribute to broader awareness and support for cervical cancer. Together, these efforts create a comprehensive plan to manage the journey through and beyond cervical cancer, fostering resilience and hope for a healthier future.