Cervical Cancer

 

The female reproductive system includes an organ known as the cervix, which plays a vital role in reproduction. This muscular organ is located in the pelvic region, situated between the bladder and the rectum.

During pregnancy, the cervix serves an important role in hosting fertilized eggs and providing a suitable environment for implantation and fetal growth for nine months. It’s worth noting that the uterine muscles are among the strongest muscles in a woman’s body and contract intensely during childbirth.

 

 Various parts of the cervix

 

• The fundus, which refers to the curved upper part of the cervix, is considered the widest part of the cervix and connects to the fallopian tubes.

 

• The fallopian tubes, which are two narrow ducts responsible for transporting eggs from the ovaries.

 

 

• The ovaries, which have an oval structure. Each woman has two ovaries, and their function includes egg production and the production of hormones like estrogen and progesterone.

 

• The body of the uterus, which encompasses the main part of the cervix and starts from the surface of the fallopian tubes and extends downward.

 

 

 

• The isthmus, a part of the cervix situated between the uterine body and the cervix’s canal, where the cervix begins to narrow.

 

• The cervical canal or cervix, which encompasses the narrow, tubular end of the uterus and essentially forms the channel between the uterus and the vagina.

 

 

• The vagina, which is a muscular and membranous canal that functions as the entry, passage of menstrual flow, and exit of the newborn during childbirth.

 

The dimensions of the cervix are approximately 6 to 8 centimeters in length and 3 centimeters in thickness. The cervix consists of three layers, including the endometrium, which forms the innermost layer, the myometrium, which is the thickest layer and consists mainly of muscle, and the serosa, the outermost thin layer covering the cervix.

 

Cervical cancer arises as a result of the rapid and uncontrolled proliferation of pre-existing cells. The cervix comprises glandular and squamous cells.

 

 

Types of Cervical Cancer

• Squamous Cell Carcinoma

This is the most common type of cervical cancer, originating from the outer cervix cells. It accounts for approximately 90% of cervical cancers.

 

• Adenocarcinoma

This cancer starts from glandular cells within the cervical canal.

 

• Adenosquamous Carcinoma

Adenosquamous carcinoma, or mixed carcinoma, exhibits characteristics of both squamous cell carcinoma and adenocarcinoma. It also includes some small glandular cells.

• Mucous tumors

 

• Lymphoma and sarcoma

 

 Causes of Cervical Cancer

• Human Papillomavirus (HPV)

The most significant risk factor for cervical cancer is the human papillomavirus (HPV), capable of infecting skin surface cells covering the genital, anal, oral, and throat areas. Sexual activity, including vaginal, anal, and oral intercourse, can facilitate the spread of HPV through skin-to-skin contact.

HPV is a family of about 150 viruses, some of which are low-risk and typically self-clear from the body’s surface, while others can cause warts.

 

 

However, in cases where the infection does not clear and lingers in the body for months or years, it can become a chronic infection, especially if caused by high-risk types of HPV, ultimately leading to cervical cancer. Currently, there is no known cure for HPV infection, but vaccines are available to prevent infection by high-risk virus strains.

 

• Smoking

When a person smokes, both themselves and those around them are exposed to many carcinogenic chemicals that affect organs outside the lungs. These harmful substances are absorbed through the lungs and spread throughout the body via the bloodstream. Compared to non-smokers, women who smoke are twice as likely to develop cervical cancer.

Researchers have suggested that these substances can damage the DNA of cervical cells, potentially contributing to the onset of cervical cancer. Additionally, smoking weakens the body’s immune system, which is less effective in combating HPV infections.

 

• Weakened Immune System

Individuals with HIV/AIDS or autoimmune conditions, in addition to those who have undergone organ transplantation and are currently on immunosuppressive medications, are more susceptible to HPV infection and the development of cervical cancer due to the compromised immune system.

 

• Long-term Use of Oral Contraceptives

Long-term use of oral contraceptive pills is associated with an increased risk of cervical cancer. However, this risk is potentially reversible after discontinuation of the medication.

 

• Early Age at First Pregnancy

Research findings indicate that one determinant that increases susceptibility to cervical cancer is having a pregnancy before the age of 20. It has been established that women who experience pregnancy at a young age are at a higher risk of developing this type of cancer in their later years.

 

• Genetic and Family History

The genetic background of individuals, especially those with a family history of the disease, can increase susceptibility to cervical cancer.

 

 Symptoms of Cervical Cancer

After cancer cells invade the upper and lower cervical tissues, the initial symptoms of this disease become apparent. These symptoms include:

 

• Abnormal vaginal bleeding (meaning bleeding during menopause or bleeding and spotting outside of the menstrual period).
• Unusual vaginal discharge that may contain some blood.
• Back and pelvic pain.
• Pain during intercourse.
• Feeling tired and loss of appetite.

 

 

 

Methods of Diagnosing Cervical Cancer

The initial stage of diagnosing cervical cancer typically begins with a Pap smear or human papillomavirus (HPV) testing. Subsequent diagnostic evaluations are performed by a medical doctor if there is suspicion of the disease or any other signs. These diagnostic assessments include:

 

• Transvaginal Ultrasound (TVU)

Transvaginal ultrasound is a technique used to capture images of the pelvic area and assess the female reproductive system. This evaluation allows for the examination of changes in the thickness of the cervical covering, which is usually due to the presence of malignant cells.

 

• Biopsy or Sampling

The current method involves obtaining a sample of cellular components of the tissue, which is subsequently sent to a specialized center for further examination. There are various sampling techniques for this purpose.

 

 

• Hysteroscopy

Hysteroscopy is a minimally invasive surgical procedure that allows gynecologists to visualize the lining of the uterus using a hysteroscope, which is a thin, flexible tube with a camera. It can also perform biopsies if necessary. This evaluation is performed with the patient under short-term anesthesia.

 

• Colposcopy

A colposcope, equipped with magnifying lenses, is used for an external examination of the cervix. During this procedure, the patient lies on an examination table while the physician examines cervical cells. After detecting any suspicious abnormalities, a sample is taken and sent to a laboratory for further evaluation.

 

 

• Imaging Tests

If supplementary examinations confirm signs of cervical cancer, doctors may resort to imaging tests to determine the location and spread of cancer cells. A wide range of imaging techniques, including CT scans, chest X-rays, PET scans, and MRI scans, may be used for this purpose.

 

 Stages of Cervical Cancer Progression

Staging cervical cancer and other cancers is essential to determine the most appropriate treatment approach. The stages of cervical cancer progression are as follows:

• Stage 1: In this stage, cancer remains confined to the cervix and does not spread beyond it.
• Stage 2: Cancer in this stage has moved beyond the cervix and reached nearby tissues.
• Stage 3: Similar to stage 2, cancer in stage 3 also spreads beyond the cervix and extends into the pelvic area and abdomen.
• Stage 4: This is the most advanced and challenging stage of cervical cancer. Cancer reaches the bladder and may spread to other distant parts of the body.

 

 

 

 Treatment Methods for Cervical Cancer

Treating precancerous lesions with invasive carcinoma of the cervix is distinct. Various techniques are employed to treat precancerous lesions:

• Cryotherapy

Cryotherapy is a method that uses an extremely cold metal probe. This probe is placed on the cervix and causes the destruction of abnormal cells.

 

• Laser Therapy

In laser therapy, a focused laser beam is introduced through the vagina to target and eliminate all abnormal cells. This procedure exerts relatively high pressure on the body, so it is performed under local anesthesia in a clinic or under general anesthesia in a hospital.

 

• Conization or Cone Biopsy

In this method, a physician removes a cone-shaped piece of tissue from the cervix. The excised tissue encompasses the area where there is a risk of developing precancerous cervical conditions.

This method is not only for sampling and diagnosis but also for treatment because it can sometimes lead to the complete elimination and destruction of abnormal cells. It’s worth noting that this procedure is performed using techniques such as cold knife conization, laser, or loop electrosurgical excision procedure (LEEP).

 

 Treatment methods for invasive cervical cancer

 

• Simple Hysterectomy:

Hysterectomy is a medical procedure that involves the removal of the uterus and cervix while preserving the fallopian tubes, lymph nodes, and ovaries. Various techniques can be used for hysterectomy, including abdominal, vaginal, and laparoscopic approaches.

 

• The abdominal approach entails creating a surgical incision in the front of the abdomen to remove the uterus.
• The vaginal approach involves removing the uterus through the vagina.
• Laparoscopic surgery involves the use of a narrow tube equipped with a camera, which is inserted through small incisions in the abdomen to visualize and extract the uterus.

 

 

• Radical Hysterectomy:

During this specialized procedure, the physician removes the uterus along with adjacent tissues, the cervix, a portion of the vagina, and lymph nodes. Typically, this method is performed through a substantial incision in the abdominal area, otherwise recognized as open surgery.

 

 

 

• Radiation Therapy:

Radiation therapy, also known as radiotherapy, has proven to be an effective treatment for cervical cancer in specific stages of the disease.

This technique utilizes high-energy radiation to damage cancer cells and halts their reproduction. Radiation therapy can be administered through internal (brachytherapy) and external methods.

 

• Chemotherapy:

Chemotherapy involves the administration of potent drugs with the aim of eradicating cancer cells at their roots. It is a treatment method frequently used for cervical cancer, especially in cases where the disease has locally advanced or metastasized to other anatomical regions. Anti-cancer drugs can be administered intravenously or orally and may be prescribed for the management of cervical cancer.

 

 

 

• Immunotherapy:

Immunotherapy focuses on the prescription of drugs designed to enhance the body’s immune system’s capacity to detect and combat cancer cells more effectively. In specific cases, immunotherapy may be employed as a treatment method for cervical cancer.

 

The Last Word

Discovering comprehensive information about cervical cancer is crucial for early detection and effective management. If you or someone you know is seeking guidance on this topic, consider a consultation with Dr. Maadico. With a deep understanding of cervical cancer, Dr. Maadico offers personalized insights and professional advice tailored to your unique situation.

Whether you have concerns about symptoms, prevention, or treatment options, a consultation provides an opportunity to discuss your individual needs and receive expert recommendations.

Get a Free Consultation

 

Frequently Asked Questions

 

1. What are the methods for preventing cervical cancer?

 

• Given that the most significant factor in the development of cervical cancer is the HPV virus, the administration of the HPV vaccine is considered the most effective method for preventing cervical cancer.

 

• Additionally, engaging in safe sexual practices and limiting sexual partners can reduce the risk of HPV infection and, consequently, lower the risk of cervical cancer.

 

 

• Performing annual screening tests, including Pap smears, is instrumental in the early detection of precancerous lesions and in preventing cervical cancer.

 

2. Is cervical cancer hereditary?

If a mother and sister in a family have a history of cervical cancer, the likelihood of risk and susceptibility to cervical cancer increases in other family members.

 

3. How many days is the hospital stay during cervical cancer surgery?

The duration of hospitalization varies depending on the surgical method and the overall health of different patients. However, typically, the hospital stay for vaginal and laparoscopic hysterectomy surgeries is 2 to 3 days, while for abdominal hysterectomy surgery (open surgery), it is 4 to 5 days.