Cervical cancer, also known as cancer of the cervix or cervical cancer of the uterus, is a serious disease that affects women worldwide. Although the incidence has decreased in countries with effective screening programs, it remains a major public health concern.
Cervical cancer occurs when cells in the cervix grow abnormally and invade other tissues and organs in the body. This uncontrolled growth is usually slow and begins with a precancerous lesion called cervical intraepithelial neoplasia (CIN). Although cervical cancer primarily affects sexually active women, it is important to note that not all sexually active women will develop the disease.
Early detection of cervical cancer is essential to increase the chances of successful treatment.
Symptoms of cervical cancer
The symptoms of cervical cancer can vary depending on the stage of the disease. In the early stages, there are often no noticeable symptoms, which highlights the importance of regular screening tests. However, as the cancer progresses, the following symptoms may appear:
Early symptoms:
a more common early symptom is abnormal vaginal bleeding. This can include bleeding between periods, after sex, or after menopause. There may also be unusual vaginal discharge, which may be watery, bloody, or have an unpleasant odor.
Late symptoms:
as the cancer progresses, the symptoms may become more severe. These may include persistent pelvic pain, pain during sexual intercourse, heavy vaginal bleeding, unexplained weight loss, and persistent fatigue.
It is crucial to remember that these symptoms can be caused by other benign conditions. If you experience any of these symptoms, it is essential to consult a doctor for an accurate diagnosis.
Classification of cervical cancer
Cervical cancer is classified in two main ways: depending on the type of cell where it originates and the extent of the tumor. Understanding both classification systems is essential for determining the best course of treatment.
According to the cell type:
Squamous cell carcinoma: it is the most common type of cervical cancer, representing approximately 80-90% of cases. It originates in the squamous cells, which are thin, flat cells that line the outer surface of the cervix.
Adenocarcinoma: it originates in the glandular cells that produce mucus in the cervical canal. It accounts for approximately 10–20% of cervical cancer cases.
Other types: there are other less common types of cervical cancer, such as adenosquamous carcinoma, small cell carcinoma, and sarcoma.
According to the extent of the tumor (staging):
The most common staging system for cervical cancer is the TNM system, which assesses tumor size (T), lymph node involvement (N), and the presence of metastasis (M). The staging ranges from stage 0 (carcinoma in situ) to stage IV (cancer that has spread to distant organs). Staging is crucial for determining the prognosis and treatment plan.
Causes of cervical cancer
The main cause of cervical cancer is persistent infection with high-risk human papillomavirus (HPV). HPV is a common virus that is transmitted through sexual contact. There are many types of HPV, and some of them, known as high-risk HPV, are associated with an increased risk of cervical cancer. Although most HPV infections resolve on their own, persistent infections with high-risk HPV can cause cellular changes that, over time, can lead to cancer.
In addition to HPV infection, there are other factors that can increase the risk of developing cervical cancer:
Early initiation of sexual activity increases the likelihood of HPV exposure.
Having multiple sexual partners increases the risk of contracting HPV.
Smoking weakens the immune system and increases vulnerability to HPV infections.
A weakened immune system makes it harder to fight HPV infections.
Prolonged use of oral contraceptives may slightly increase the risk of cervical cancer.
Having a family history of cervical cancer may indicate a genetic predisposition.
HIV infection weakens the immune system and increases the risk of persistent HPV infections.
Having other sexually transmitted infections can increase susceptibility to HPV.
Complications of cervical cancer
Cervical cancer, if left untreated, can lead to a range of complications that affect health and quality of life:
Metastasis: cancer can spread to other organs, such as the lymph nodes, lungs, liver, or bones.
Ureteral obstruction: the growth of the tumor can obstruct the ureters, the tubes that carry urine from the kidneys to the bladder, which can cause kidney problems.
Chronic pain: cervical cancer can cause chronic pain in the pelvis, back, or legs. The pain can be mild or severe and can interfere with daily activities.
Severe vaginal bleeding: heavy vaginal bleeding can cause anemia, a condition in which the blood does not have enough healthy red blood cells. Anemia can cause fatigue, weakness, and shortness of breath.
Kidney problems: obstruction of the ureters can cause kidney damage and kidney failure. Kidney failure may require dialysis or a kidney transplant.
Fistulas: in advanced cases, fistulas, abnormal connections between organs such as the bladder and vagina, may form. Fistulas can cause infections and other health problems.
Infertility: some treatments for cervical cancer, such as hysterectomy (removal of the uterus) or radical trachelectomy, can cause infertility. Radiotherapy can also affect fertility. It is important to talk to your doctor about the possible implications for fertility before starting treatment.
It is crucial to seek medical attention if the disease is suspected. Early detection and timely treatment are essential to improve the prognosis.
Diagnosis of cervical cancer
The diagnosis of cervical cancer involves a series of tests and procedures that allow doctors to assess the presence and extent of the disease:
Vaginal cytology (Pap test or Pap smear): this test involves collecting cells from the cervix to examine them under a microscope for abnormal cells. At HM Hospitales, advanced liquid cytology techniques are used, which offer greater accuracy in the detection of abnormal cells.
HPV test: this test detects the presence of the human papillomavirus (HPV) in the cells of the cervix. It is especially useful for identifying high-risk HPV infections, which are associated with an increased risk of cervical cancer.
Colposcopy: it is a visual examination of the cervix with a magnifying instrument called a colposcope. It allows the doctor to see abnormal areas in the cervix in greater detail. During the colposcopy, a biopsy can be performed if suspicious areas are observed. HM Hospitales has state-of-the-art colposcopy equipment for accurate diagnosis.
Biopsy: it consists of extracting a small sample of tissue from the cervix for examination under a microscope. It is the only way to confirm the diagnosis of cervical cancer. There are different types of biopsies, such as needle biopsy, punch biopsy, and cone biopsy (conization).
Conization: it is a surgical procedure to remove a conical portion of tissue from the cervix. It can be diagnostic (to obtain a larger tissue sample for biopsy) or therapeutic (to remove abnormal tissue).
Imaging studies (Magnetic resonance imaging – MRI, Computed tomography – CT, Positron emission tomography – PET): these imaging studies are used to determine the extent of the cancer and whether it has spread to the lymph nodes or other organs. HM Hospitales offers high-quality diagnostic imaging services, including MRI, CT and PET, for accurate assessment of the extent of the cancer.
Treatments for cervical cancer
Treatment for cervical cancer is individualized based on the stage of the cancer, the patient’s overall health, and her preferences. Treatment options include:
Surgery: it may involve the removal of a portion of the cervix (conization), the removal of the uterus (hysterectomy), or the removal of the cervix and upper part of the vagina (trachelectomy). The choice of surgical procedure depends on the stage of the cancer and the patient’s desire to preserve her fertility. HM Hospitales has expert surgeons in gynecological surgery, including robotic surgery, which offers greater precision and a shorter recovery time.
Radiotherapy: it uses high-energy radiation to destroy cancer cells. It can be administered externally, using a device that directs radiation to the tumor, or internally, by placing small radioactive implants near the tumor (brachytherapy). Radiotherapy can be used alone or in combination with chemotherapy.
Chemotherapy: it uses medications to destroy cancer cells. It is often administered in combination with radiotherapy to improve the effectiveness of the treatment. Chemotherapy drugs can be administered intravenously or orally.
Targeted therapy: it uses drugs that target specific characteristics of cancer cells, blocking their growth and spread. These medications are more specific than traditional chemotherapy and may have fewer side effects.
Immunotherapy: it helps the body’s immune system fight cancer. It can be used in combination with other treatments to improve outcomes. Immunotherapy is constantly evolving, and new medications and approaches are being developed.
The treatment of cervical cancer often involves a multidisciplinary approach, involving gynecologists, oncologists, radiation therapists, and other specialists. This approach ensures that the patient receives a comprehensive and personalized treatment plan.
Remember that this article is for informational purposes only and does not replace professional medical advice. If you suspect you have cervical cancer, consult a specialist to obtain an accurate diagnosis and a treatment plan tailored to your needs.
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