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Cancer of the cervix

AGE  Most common between the ages of 45 and 65GENDER  
LIFESTYLE  Unprotected sex at an early age, unprotected sex with multiple partners, and smoking are risk factorsGENETICS  Not a significant factor

A cancerous growth occurring in the lower end of the cervix... with over 3,000 new cases of cervical cancer each year in the UK.

Cancer of the cervix
© Jupiter

Cancer of the cervix is one of the most common cancers affecting women. However, it is one of the few cancers that can be prevented by regular screening before symptoms appear. Cancer of the cervix usually develops slowly. In the precancerous stage, cervical cells gradually change from being mildly to extremely abnormal, a condition known as cervical intraepithelial neoplasia. These changes in the cervical cells can be detected using a cervical smear test, allowing treatment to be carried out before cancer develops.

What are the causes of cervical cancer?

The cause of cancer of the cervix is not clear, but there is evidence that changes in cells in the cervix are associated with some types of human papillomavirus (HPV). The virus is transmitted through unprotected sexual intercourse, and the risk of cervical cancer is increased if you have unprotected sex from an early age or with many partners. Smoking is also a risk factor for cervical cancer. Women who have reduced immunity or who are taking immunosuppressant drugs are at increased risk of developing cancer of the cervix.

What are the symptoms of cervical cancer?

Cancer of the cervix does not always cause symptoms. However, in some women, there may be some abnormal vaginal bleeding, especially after sexual intercourse. As the cancer progresses, further symptoms may include:

  • A watery, bloodstained, and offensive-smelling vaginal discharge.
  • Pelvic pain.

Left untreated, cancer of the cervix may spread to the uterus and then to the lymph glands in the pelvis. Eventually, cancer may spread to other parts of the body, such as the liver and lungs.

How is cervical cancer diagnosed?

If your doctor suspects that you have cancer of the cervix from your symptoms, he or she may perform a smear test and may also arrange for you to have a colposcopy, in which the cervix is viewed through a magnifying instrument and checked for abnormal areas. A sample of tissue will probably be taken from the cervix during the procedure and later examined under a microscope for evidence of cancerous cells.

If cancer of the cervix is diagnosed, you may have further tests to see if the condition has spread to other parts of the body. These tests may include a chest X-ray or MRI of the chest to look at the lungs and blood tests and CT scanning of the abdomen to assess liver function.

What is the treatment?

The treatment for cancer of the cervix depends on the stage of the disease and your individual circumstances.

If the cancer is confined to the cervix and you plan to have children, it may be possible to remove only the affected area of the cervix. More often, a hysterectomy to remove the cervix and the uterus will be performed. If the disease has spread to the uterus, it may be necessary to remove the uterus as well as the fallopian tubes, the ovaries, the top of the vagina, and the nearby lymph nodes. In women who are premenopausal, the ovaries are left if possible because they produce sex hormones and removing them causes premature menopause. If the cancer has spread to other organs in the body, radiotherapy, and sometimes chemotherapy, may be needed.

What is the prognosis?

If cancer of the cervix is diagnosed and treated early, almost all women recover completely. However, if the disease has spread beyond the cervix, the disease is fatal in 2 out of 5 women. Routine cervical smear tests and the early diagnosis and treatment of abnormal cervical cells have greatly reduced the incidence of cancer of the cervix in the developed world. In addition to having regular cervical smear tests, it is advisable to try to reduce the risks of developing cervical cancer by not smoking and by using barrier methods of contraception.

TREATMENT: Treating CIN

Mild CIN may not require treatment but more severe CIN or persistent mild CIN may need treatment to destroy or remove the area of abnormal tissue (the transformation zone). The main methods are LLETZ (large loop excision of the transformation zone) and cone biopsy. All treatments are carried out through the vagina, and it is usual to have slight bleeding or a discharge for a few days afterwards.

Posted 30.06.2010

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