There are two types of cervical cancer: squamous cell carcinoma and adenocarcinoma. They are differentiated based on their appearance under microscopic observation. Squamous cells have a thin, flat exterior while adenocarcinomas have cells that show secretory functions. Squamous cell carcinoma is accounts almost 90% of cervical carcinoma cases.
There are several risk factors for the development of cervical cancer, both genetic and environmental. These include:
Early cervical cancer is asymptomatic, and that is why customary screening by a Pap smear is significant for averting the development of precancerous lesions or noninvasive cancer. As per the US guidelines released in March 2012, an annual Pap smear is recommended for women over 21 years. People having a history of normal Pap smears and a radical hysterectomy may not need to undergo this screening. After every five years, the American Cancer Society suggests screening with Pap smear and HPV DNA testing from the age 30-65 years. Women that have prenatal exposure to diethylstilbestrol (DES), a previous history of cervical cancer or a disease that deteriorate their immune system, should continue with the screening even after 65 years.
If a Pap smear reveals abnormal cells, further diagnostic tests are performed to determine a diagnosis. Irregular cells could indicate:
Human Papillomavirus Infection
Cervical Intraepithelial Neoplasia (CIN): See the next page for details on this pre-cancerous condition.
Further tests are necessary to make a diagnosis. Additional tests that may be performed include:
Biopsy: removal of a small sample of tissue for examination by a pathologist. The procedure is typically done without anesthesia and is associated with minimal pain or bleeding. It is possible to perform the biopsy during a colposcopy.
If the diagnostic tests signify the occurrence of cancer, further imaging (CT, MRI, etc.) may be performed to establish the location and degree of the disease.
Typically, early cervical cancer is asymptomatic. Whitish or foul smelling discharge maybe the first symptom, abnormal vaginal bleeding can occur once the cancer becomes invasive.
Depending on the stage and location of the cancer, several different treatments are used for cervical cancer
Cryosurgery: used for pre-invasive cancer; kills cancer cells by freezing them with a metal probe that has been cooled by liquid nitrogen.
Laser Surgery: used for pre-invasive cancer; laser beams are used to burn off abnormal cells or remove tissue for further study.
Cone Biopsy: used to preserve fertility in women with early stage cancer or to obtain a sample for further study; a cone-shaped section of tissue is taken from the cervix
Simple Hysterectomy: the uterus and cervix are removed either through the vagina or the abdominal wall; results in infertility.
Radical Hysterectomy and Pelvic Lymph Node Dissection: the uterus, upper vagina and lymph nodes are removed through the vagina or the abdominal wall; results in infertility.
Pelvic Externation: for recurrent cancer; radical hysterectomy is accompanied by removal of the bladder, vagina, rectum and part of the colon; results in infertility.
Either internal (also called brachytherapy) or external radiation can treat cervical cancer. Radiation treatments make use of high-energy rays to kill cancer cells. Radiation can be used either alone or in combination with other treatments like chemotherapy to alleviate cancer.
Chemotherapy or chemo means using an assortment of drugs to treat cancer. These drugs kill the dividing cells so that their growth can be controlled. Some of the chemotherapy agents are naturally occurring elements and some are man-made chemicals.
Note:- In Cervical Cancer mostly radiation and chemotherapy are given at the same time. The rationale is that the low levels of chemotherapy given make the cancer cells more sensitive to the radiation. The technique is called chemo radiotherapy or radio sensitization.