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Cervical Cancer
(Cancer of the Cervix)

Definition:
Cervical cancer is a disease in which cancer cells grow in the cervix. The cervix is the lower, narrow part of the uterus (womb) that connects the uterus with the vagina.

Cancer occurs when cells in the body (in this case cervix cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissues and spread to other parts of the body. A benign tumor does not invade or spread.

Causes:
The cause of cervical cancer is multifactorial. Research suggests that some sexually transmitted viruses can cause cells in the cervix to begin the series of changes that can lead to cancer.

Risk Factors:
A risk factor is something that increases your chance of getting a disease or condition. Scientists believe that cervical cancer develops when several risk factors act together.
  • Infection of the cervix with the human papillomavirus (HPV), a sexually transmitted disease (STD) and the primary risk factor for cervical cancer
  • Sex: Female
  • Age: over 25 years old
  • Multiple sexual partners
  • Sexual activity prior to age 18
  • First pregnancy prior to age 20
  • History of not having Pap tests
  • Smoking
  • History of cervical dysplasia (a precancerous condition)
  • Being a woman whose mother took the drug diethylstilbestrol (DES) during pregnancy
  • History of AIDS or infection with HIV
Symptoms:
Symptoms of cervical cancer usually do not appear until the abnormal cells become cancerous and invade nearby tissue. When this happens, the most common symptom is abnormal bleeding, which may include:
  • Bleeding between regular menstrual periods
  • Bleeding after sexual intercourse, douching, or a pelvic exam (most common)
  • Menstrual bleeding that lasts longer and is heavier than usual
  • Bleeding after menopause
  • Increased vaginal discharge that is not blood

Note: These symptoms may also be caused by other, less serious health conditions. A woman experiencing these symptoms should see her doctor.

Diagnosis:
Tests to diagnose cervical cancer include:

Pap Test–detects cervical cancer as well as precancerous tissues in the cervix, called cervical dysplasia. The doctor collects a sample of cells from the cervix to be tested. The performance of an annual Pap smear or test is the single greatest success in the reduction of cancer in developing countries. Cervical cancer is the second leading cause of cancer death in women worldwide.

It is important that a sexually active woman receives an annual Pap test, and she follows up with any abnormal results by getting future tests as described by her physician.

New studies indicate that women over the age of 30 who have had three or more normal annual Pap tests can safely lengthen the Pap screening to once every 3 years.

Colposcopy–examination of the vagina and cervix using a lighted magnifying instrument called a colposcope

Biopsy–removal of a sample of tissue from the cervix to be tested for cancer cells

Treatment:
Once cervical cancer is found, staging tests are performed to find out if the cancer has spread and, if so, to what extent. Treatments for cervical cancer depend on the stage of the cancer.

Treatments include:

Surgery–surgical removal of a cancerous tumor and nearby tissues, and possibly nearby lymph nodes. If the cancer has reached deeper layers of the cervix but has not spread beyond the cervix, the doctor may remove only the tumor. In some cases, a hysterectomy (removal of the entire uterus) is necessary; sometimes the ovaries and fallopian tubes also are removed.

Radiation Therapy (Radiotherapy)–the use of radiation to kill cancer cells and shrink tumors. Radiation may be:

External Radiation Therapy–radiation directed at the tumor from a source outside the body.

Internal Radiation Therapy–radioactive materials placed into the cervix in or near the cancer cells. It is very important that you receive your internal radiation therapy from an experienced radiation oncologist. You should inquire as to how many cases that doctor performs annually, and whether you will receive high dose rate or low dose rate therapy.

Chemotherapy–the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including: pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. Chemotherapy alone is never used to cure cervical cancer. It is used alone only when the cancer can no longer be cured, and then the chemotherapy is used to help control symptoms (pain and bleeding).

Biological Therapy–the use of medications or substances made by the body to increase or restore the body's natural defenses against cancer. Also called biological response modifier (BRM) therapy.

Chemoradiotherapy or Combined Modality Therapy–for most cervical cancers, considered for anything but the earliest staged cancers, chemotherapy and radiation therapy together has been shown to cure more women than radiation therapy alone.

Prevention:
Finding and treating precancerous tissue in the cervix is the most effective way to prevent cervical cancer. Talk with your doctor about an appropriate schedule of check-ups.
 
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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