Cervical Cancer

Cervical cancer will be diagnosed in more than 11,000 women in the U.S. in 2008 and more than 3,000 women will die of the disease this year.

Worldwide it is third leading cause of cancer death in women.

What is the cervix?

The cervix is the lower portion of the uterus. It connects the uterus to the birth canal (vagina) and is the area of the uterus where a fetus will grow and develop.

There are two types of cervical cancer:

• squamous cell carcinoma
• adenocarcinoma
  

Per the American Cancer Society, 80 to 90 percent of all diagnosed cases of cervical cancer are squamous cell carcinoma.
A diagnosis of cervical ‘pre-cancerous tissue’ is treated the same as cancer, though these abnormal cells do not always become cancerous. This is because often the symptoms of cervical cancer are silent until the cancer is at advanced stages.

The HPV and Cervical Cancer Connection:

Human Pappillomavirus is connected to 90% of all diagnosed cervical cancer cases. Many people have this common virus which is passed to another person during sex. A healthy immune system generally protects the HPV virus from doing any harm. However in some women it can cause pre-cancerous cellular changes that may continue to slowly change the cells to cancerous tissue.

The HPV vaccine will protect women from 4 types of human papillomavirus. Per the CDC: “If you are 11–26 years old, you can help prevent cervical cancer by getting the HPV vaccine. It protects against the types of HPV that most often cause cervical, vaginal, and vulvar cancers, and is given in a series of three shots.”

For detailed information on the HPV virus see the Mayo Clinic site.

Risk Factors:

• HPV infection (early sex, unprotected sex)
• Smoking
• Multiple full-term pregnancies
• Immune suppression diseases
• Birth control pills
• Other sexually transmitted diseases
• Family history
• Diets low in fruits and vegetables
• Socio-economic (no access to health care and regular PAP screenings)
• Age-most often occurs in women over the age of 40

These risk factors are discussed in more detail at the American Cancer Institute site.

Symptoms:

Cervical cancer begins on the cellular level which causes silent symptoms. Symptoms such as pelvic pain, bloody discharge or pain during intercourse may not appear until the cancer is no longer in the early stages.

Prevention:

• Reduce risk factors as appropriate
• Ask your physician if the HPV vaccine is right for you
• Schedule regular PAP tests

What is a PAP test?

The name PAP comes from one of the inventors George Papanikolaou.

A PAP test is done during your routine gynecological pelvic exam. Cell scrapings of the cervix are put on slides which are then examined for cellular changes or abnormalities.

Detailed information on PAP screenings can be found in the National Cancer Institute fact sheet.

Diagnosis and Treatment:

Diagnosis begins with a physical exam and history. The level of diagnostic testing will be determined by the stage of your disease. 78% of all cervical cancer cases are diagnosed in the early stage.

If it is suspected that the cancer is not in the early stage, your physician may order detailed testing to check the lymph nodes, urinary system, rectal and vaginal areas for spread of the disease. Detailed testing information can be found at the The M.D. Anderson Cancer Center site.

Treatment may include, surgery, chemotherapy and radiation. Per The M.D. Anderson Cancer Center, treatment options also include the following:

• The stage of the cancer
• The size of the tumor
• The patient’s desire to have children
• The patient’s overall health and age

Terminology for diagnosis and/or treatment:

Cone biopsy: a surgical procedure where a cone shaped piece of tissue is removed from the cervix.

Cryosurgery: a surgical procedure that uses an instrument to freeze and destroy precancerous tissue.

LEEP : Loop Electrical Excision Procedure- treatment done under local anesthesia, an electrical current passed through a thin wire hook to remove abnormal tissue.

Laser surgery: a surgical procedure that uses a laser beam to remove surface lesions.

Resources:

For more detailed information on cervical cancer, the CDC (Center for Disease Control) offers a downloadable pdf fact sheet and a cervical cancer podcast.

Eyes on the Prize.org offers support and information for gynecological cancer.

Women’s Health Cancer Centres (Canada) is a huge network of resources.

Battling Books:

100 Questions & Answers About Cervical Cancer by Don S., M.D. Dizon (2008).

Women at risk: The HPV epidemic and Your Cervical Health by Gregory Henderson M.D. Ph.D and Batya Swift Yasgur (2002).