Cervical Cancer: Causes, Symptoms, Treatment & Prevention
Cervical cancer is one of the most common cancers in Southern Africa. It’s caused by the Human Papillomavirus, something which is easily preventable and treatable if diagnosed early.
Unfortunately, low-income and poor areas in Namibia don’t have access to vaccines that aid in reducing its occurrence or the medicines necessary to treat it.
In this article, we cover what cervical cancer is, who is most at risk of developing it, what signs and symptoms to look out for, and how to treat and prevent it.
We cover the following topics in this article
- What is cervical cancer?
- What causes cervical cancer?
- What are the symptoms of cervical cancer?
- The stages/types of cervical cancer
- Who is most at risk of developing cervical cancer?
- How to prevent cervical cancer?
- Screening for cervical cancer
- 4 ways of treating cervical cancer
- Book a consultation
What is cervical cancer?
Cervical cancer is cancer of the cervix, an area that connects the upper region of the uterus to the vagina or birth canal. It is the fourth most commonly occurring cancer in women across the globe.
What causes cervical cancer?
Cancer occurs when healthy cells within the body begin to change (or mutate) and multiply uncontrollably.
A healthy cell typically has a life cycle where it multiplies and eventually dies. Cancerous cells, on the other hand, multiply at a far more rapid pace, but they do not die. These cells mass together until they form a tumour that can break away and spread to other parts of the body.
According to the World Health Organization, 95% of cervical cancers are caused by the human papillomavirus (HPV). It is a sexually transmitted infection.
You can get HPV by having vaginal, anal or oral intercourse with someone who already has the virus. Though they may not have any indications that they are a carrier.
HPV can cause genital warts, skin disorders and cervical cancer. You only need to have sexual intercourse with one person who has the virus to become infected with it. That could be your first partner.
Speak to your doctor about getting vaccinated against HPV, and arrange regular screenings with your gynaecologist.
What are the symptoms of cervical cancer?
In the early stages of cervical cancer, there are very few warning signs that you may be ill. But knowing your body and your cycle can help you pick up any changes and act on them.
Here are a few symptoms of early cervical cancer and pre-cancer:
- Heavier bleeding for longer during menstruation
- Bleeding after intercourse
- Pain in the pelvic region during intercourse
- Bleeding after menopause
- An increase in vaginal discharge, which may contain light spotting
Other signs to watch for include:
- An itchy vaginal area or burning sensation
- Bloating
- Frequent urination
- Abdominal and lower back pain
- Extreme fatigue
The stages/types of cervical cancer
There are two main types of cervical cancer (main types because there are some apart from the two):
- Adenocarcinoma – This is the less common type of cervical cancer. It begins in the glandular cells which line the cervical canal.
- Squamous cell carcinoma – This is the most common type of cervical cancer. It occurs in 90% of cases and begins in the squamous cells, which line the outer area of the cervix.
They do sometimes occur together, but this is rare.
Who is most at risk of developing cervical cancer?
You are at a higher risk of developing cervical cancer if;
- You have an infection as a result of the Human Papillomavirus (HPV).
- You have previously been diagnosed with a sexually transmitted disease (STD) such as chlamydia, syphilis, gonorrhoea, and HIV/Aids.
- You have multiple sexual partners without taking precautions, or you became sexually active at a very young age. This can increase your risk of contracting HPV.
- You are a smoker, as this increases your risk of developing squamous cell cancer.
- You suffer from a weakened immune system.
How to prevent cervical cancer?
There are five ways you can reduce your chance of developing cervical cancer.
- Get vaccinated. The best way to avoid becoming infected with the human papillomavirus is to get the HPV vaccine. Boys and girls between the ages of 9 and 14 should have the HPV vaccine. If your HPV screening test is negative, you can get the vaccine regardless of your age.
- Do not engage in sexual intercourse until you have had the HPV vaccine and you are old enough.
- Limit the number of sexual partners you have and practice safe sex. Cervical cancer develops as a result of the human papillomavirus (HPV). HPV is a sexually transmitted disease.
- Avoid smoking, as this is associated with squamous cell carcinoma.
- Arrange for a regular pap smear (every second year) and HPV typing every 3-5 years.
- Take extra precautions if you have a compromised immune system, as you are more susceptible to contracting HPV. For women with a weakened immune system, cervical cancer can develop within 5 to 10 years. In healthy women, it can take up to 20 years.
Screening for cervical cancer
Pap smear
Doctors can use a pap smear when diagnosing cervical cancer. Routine pap smear tests can pick up precancerous cells in the cervix. During the test, your gynaecologist will take a sample of your cells from your cervix by scraping it with a small, spoon-shaped curet.
This is then sent to a lab to be viewed under a microscope. The lab technician is checking for anomalies. A biopsy will be performed if the technician suspects cancer.
HPV type testing
This is a test that can be used to detect the presence of HPV. There are high-risk and low-risk types of HPV.
- Low-risks include types 6, 11, 42, 43, and 44.
- High-risk HPV types 16 and 18 increase your risk of developing cervical cancer.
Your doctor will recommend an HPV test if your pap smear is abnormal or you are over the age of 30. A positive HPV diagnosis allows your doctor to formulate a treatment plan as HPV can cause cervical cancer.
In many cases, HPV resolves on its own within 2 years of infection. During this time, your doctor will monitor the infection to see if it is clearing on its own.
Please note that HPV typing before age 30 is not recommended.
Colposcopy
If your pap smear shows signs of pre-cancer cells, your doctor will perform a colposcopy. A harmless dye is applied to stain your cervix. It will highlight any unusual cells. Your doctor then uses a colposcope to magnify your cervix up to 15x to identify cells that need to be biopsied.
Electrical wire loop
If the colposcopy and biopsy are inconclusive, your doctor may recommend an electrosurgical excision procedure using a loop. It will take a small tissue sample from your cervix for further testing. Colposcopy and electrosurgical excisions are conducted for diagnosis and treatment.
Conisation
Lastly, your doctor can perform a conisation, which allows them to obtain deep tissue cells from within your cervix. This can be performed in an operating room or your gynaecologist’s office.
To determine the stage of cancer, your doctor may recommend.
- Imaging tests using either a CT scan, MRI or X-ray. This can help us see if the cancer has spread and to which organs.
- A visual examination of your rectum and bladder.
4 ways of treating cervical cancer
Your treatment plan will depend on what stage of cervical cancer you have. Doctors typically recommend a combination treatment plan—surgery, radiation, and chemotherapy.
1. Surgery:
We usually treat early-stage cervical cancer by surgically removing the cancerous cells. If the disease is contained in a small area, we can surgically remove that section.
But if the disease has spread to the surrounding tissue, we may need to remove the cervix entirely. This is known as a trachelectomy procedure. In both instances, it is still possible to fall pregnant as the uterus has been untouched.
In some cases, doctors may recommend removing the cervix and the uterus. This is known as a hysterectomy and can prevent the cancer from spreading. Should you have a hysterectomy, you won’t be able to fall pregnant.
2. Radiation:
Radiation therapy is used in combination with chemotherapy. It uses high-powered energy beams which damage cancerous cells and stop further growth. It can be given internally or externally. If external, a radiation beam will be directed to the cancerous area. If internal, a device with radioactive material will be placed within your vagina for a few minutes.
3. Chemotherapy:
Chemotherapy is a chemical treatment that kills off cancerous cells. It is given in pill format or through a vein. Chemotherapy is known to enhance the effects of radiation treatment, so they are often used together.
4. Immunotherapy:
Immunotherapy or biological therapy is used to fight cancerous cells that may go undetected. Immune therapy targets certain markers in your immune cells that can be turned on to set off an immune response. This type of therapy is considered in the advanced stages of cervical cancer.
Book a consultation
If you know that you haven’t had the HPV vaccine and you’re sexually active, you could be at risk for cervical cancer. Speak to your doctor about screening options, such as a simple pap smear and HPV typing. This will show whether further tests are needed.
Remember, you have a greater chance of making a full recovery if you catch the disease early rather than in the later stage.
Contact Welwitschia by calling +264 64 218 911 or emailing hello@welwitschiahospital.com to book an appointment. You can also find a local gynacologist in Walvis Bay here.
Sources:
- Header Image by Freepik
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