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Writer's pictureDr Zaharuddin KL Gynaecologist

Cancer of Cervix - infographic

Cancer of the cervix (neck of the womb) is a type of cancer that occurs in the cells of the cervix - the lower part of the uterus that connects to the vagina.



Chronic infection with the human papillomavirus (HPV) causes most cases of cervical cancer.

When an HPV infection occurs, the immune system of women usually eliminate the infection and prevent the virus from causing harm.


When an HPV infection occurs, the immune system of women usually eliminate the infection and prevent the virus from causing harm.

However, in a small group of women,this viral infection last for many years, 

contributing to the process that causes some of the cells on the surface of the cervix to become cancerous cells.

Risk of cervical cancer can be reduced by regular pap smear and receive the vaccine that protects against HPV infection.


Symptoms of cervical cancer are as follows:

  • Vaginal bleeding after intercourse, between periods or after menopause

  • Watery, bloody vaginal discharge and a foul odor

  • Pelvic pain or pain during sex

  • sometime, patients have no symptom - early disease diagnosed after abnormal pap smear

The risk factors

These factors can increase the risk of cervical cancer:




Multiple Sexual Partners.

  • greater number of sexual partners, the greater the risk of HPV infection and increase the risk of cervical cancer


  • start sexual activity at early age. Having sex at a young age increases the risk of HPV.


  • Sexually transmitted infections (STDs).

  • If you have other STDs - such as chlamydia, gonorrhea, syphilis or HIV / AIDS - you have a higher risk of getting HPV.


  • A weak immune system.Most women who are infected with HPV never develop cervical cancer.

  • However, if you have HPV infection and your immune system is weakened by other health conditions, you may be more likely to get cervical cancer.


Smoking. 

  • Smoking causes the immune system is weakened, persistent HPV infection and cannot be removed. 

  • Chronic HPV infection causes cervical cancer.


Screening for cervical cancer (cervical) included. :

Pap smear.

  • During a Pap smear, - the doctor will wipe the cervix with a special tool and sent samples to a lab to be examined for abnormalities.

  • Pap smear can detect cells in cervical abnormalities, including cancer cells and cells that show changes (dysplasia) that increase the risk of cervical cancer.


HPV DNA testing.

  • If you are aged 30 or more, your doctor may also use a laboratory test called the HPV DNA test to determine whether you have been infected with any of the HPV types most likely to cause cervical cancer. 

  • Like the Pap test, the HPV DNA test involves collecting cells from the cervix for testing.


Diagnosis


  • Checking your cervix (colposcopy)

  • This examination called a colposcopy. 

  • The gynaeoncocologist  uses a special telescope (colposcope) to examine the cervix. 

  • If the gynaeoncocologist  identifies  abnormalities in the cervix, he can take a small sample from the cervix for analysis (biopsy).


  • Taking a sample of cervical cells.

  • During the biopsy procedure, the gynaeoncocologist  removes abnormal cells from the cervix using a special biopsy device.


Cone biopsy of the cervix.

  • A cone biopsy (conization or LLETZ) 

  • so called because it involves taking a cone-shaped sample of the cervix 

  • allows the gynaeoncologist  to get a layer of cervical cells for laboratory testing. 

  • The gynaeoncologist  can use a scalpel, laser or heated-wire loop to remove the abnormal tissue.


Cancer stage (Staging)

  • If the patient has been diagnosed with cervical cancer, the patient will undergo further tests to determine the extent (stage) of cancer. 

  • Stage of cancer is a major factor in making decisions about the treatment.


Imaging tests.

  • Tests such as X-rays, computerized tomography scan (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) 

  • to assist the gynaeoncologist determines whether the cancer has spread beyond the cervix.


Stage / Level of cervical cancer (cervical) include:










Treatments and drugs

  • Treatment for cervical cancer depends on several factors, such as stage of cancer, other health problems and patient’s wish about treatment.


Treatment options may include:


Surgery.


  • Surgery to remove the uterus (hysterectomy) is typically used to treat early stage cervical cancer.

  • Radical hysterectomy - removal of the cervix, uterus, part of the vagina and the lymph nodes in the pelvis - is the standard surgical treatment. 

  • Hysterectomy can cure early stage cervical cancer and prevent cancer from coming back.


Radiation


  • Radiation therapy uses high-powered energy to kill cancer cells. 

  • This therapy can be given externally using external radiation (external beam) or internally (brachytherapy) by placing devices filled with radioactive material near the cervix.

  • Both methods can be combined as chemo-radiation therapy.

  • Radiation therapy may be used alone, with chemotherapy before surgery to shrink a tumor or after surgery to kill cancer cells remaining.

  • Premenopausal women may stop menstruating as a result of radiation therapy and into menopause.


Chemotherapy


  • Chemotherapy uses drugs to kill cancer cells. 

  • Chemotherapy drugs, which can be used in combination with a type or two types of medication, usually injected into a vein.

  • Low-dose chemotherapy often combined with radiation therapy, because chemotherapy can enhance the effects of radiation.

  • Higher doses of chemotherapy are used to control high levels of cervical cancer may not be cured.

  • Certain chemotherapy drugs can cause infertility and early menopause in premenopausal women.


Prevention


  • Use a condom every time having sex

  • delay sex at a more mature age

  • have fewer sexual partners and limited

  • not smoking

  • receive HPV vaccine

  • undergo regular Pap tests (routine)


REF.:

Mayo clinic

ACOG

NHS(UK)

Patient's info UK


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