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Cervical cancer
Cervical cancer occurs in the cells of the cervix, which is the bottom section of the uterus that attaches to the vagina. It is typically caused by a chronic infection with specific kinds of human papillomavirus (HPV), which is transferred sexually.
Causes:
Persistent infection with certain strains of human papillomavirus (HPV), a sexually transmitted infection, is the leading cause of cervical cancer. HPV is a virus family, and some strains are considered high-risk because they can cause cervical cancer. HPV-16 and HPV-18 are the two most common high-risk strains, accounting for over 70% of cervical cancer cases. It should be noted that not all HPV infections result in cervical cancer.
In fact, the vast majority of HPV infections recover on their own without producing any severe health issues. In some circumstances, however, the infection can remain and create alterations in the cervix's cells, eventually leading to the formation of cervical cancer.
Other factors that may increase the risk of developing cervical cancer include:
Tobacco use raises the risk of cervical cancer and makes it more difficult for the body to fight against HPV infection.
Weak immune system: Having a weaker immune system as a result of illnesses such as HIV/AIDS or taking immunosuppressive medicines can increase the risk of getting cervical cancer.
Long-term use of oral contraceptives: Some studies have showed that long-term usage of certain forms of oral contraceptives (five years or more) may marginally raise the risk of cervical cancer. However, after these contraceptives are stopped, the risk returns to normal.
several sexual partners: Having several sexual partners raises the likelihood of HPV infection and, as a result, the risk of getting cervical cancer.
Early sexual activity: Sexual activity at a young age raises the risk of HPV exposure before the immune system has fully grown.
Symptoms:
In the early stages, cervical cancer may not cause any noticeable symptoms, which is why regular cervical cancer screening is crucial for early detection.
Abnormal vaginal bleeding can occur between menstrual periods, during sexual encounters, or after menopause. Light bleeding, spotting, or more menstrual-like bleeding may occur.
Pelvic pain or discomfort: Advanced cervical cancer may cause persistent pain or a dull aching in the pelvic region or lower abdomen. It might be either intermittent or continuous.
Pain during or after sexual intercourse: Pain during or after sexual intercourse might develop due to the presence of cervical cancer. This pain may manifest as profound pelvic pain or discomfort.
Unusual vaginal discharge: Changes in vaginal discharge might be caused by cervical cancer. The volume of discharge may increase, and it may have an odd odour or appear watery, red, or thick.
Urinary issues: Advanced cervical cancer can affect the bladder, causing urinary issues such as frequent urination, blood in the pee (hematuria), or urinary incontinence.
Screening and Diagnosis:
Screening and timely diagnosis play a crucial role in detecting cervical cancer at an early stage or identifying precancerous changes in the cervix. Here are some common screening and diagnostic methods used for cervical cancer:
The Pap test (Pap smear) is a common screening test for cervical cancer. A healthcare provider removes cells from the cervix and examines them under a microscope to discover any abnormal alterations during this procedure. It can detect precancerous cells or cancer in its early stages. The Pap test is typically advised every three years for women aged 21 to 65, though the frequency may vary according on individual risk factors and national norms.
HPV test: Another screening option is the HPV test, which can be used as a primary screening test or in conjunction with a Pap test. It identifies the presence of high-risk HPV types in cervical cells. The test is advised for women over the age of 30, and it can be administered in conjunction with a Pap test or as a standalone test every five years.
A colposcopy may be performed if abnormalities are discovered following a Pap or HPV test. It entails utilising a colposcope, a specific magnifying equipment, to inspect the cervix more closely. The healthcare provider may take biopsies (small tissue samples) from any worrisome locations throughout the process for future study.
Biopsy: A biopsy is the only sure way to diagnose cervical cancer. A tiny sample of cervical tissue is removed for laboratory analysis. Depending on the location of the cervix that needs to be collected, numerous types of biopsies are available, such as punch biopsy, cone biopsy, or endocervical curettage (ECC).
Imaging testing: If cancer is thought to have progressed beyond the cervix, imaging tests such as ultrasound, CT scan, or MRI may be done to identify the extent of the cancer. These tests aid in the stage of cancer and the planning of appropriate treatment.
Stages and Treatment:
Cervical cancer is staged based on the severity of the disease, which aids in determining the best treatment options. The International Federation of Gynaecology and Obstetrics (FIGO) staging method is the most often used for cervical cancer.
Stage 0 (Carcinoma in situ): At this stage, abnormal cells are restricted to the cervix's surface and have not spread to deeper tissues. Among the treatment options available are:
Cone biopsy: A cone-shaped portion of tissue with abnormal cells is removed. LEEP (Loop Electrosurgical Excision Procedure): A small wire loop heated by an electrical current is used to remove aberrant cervical tissue. Laser surgery is the use of a laser beam to eliminate cancerous cells.
Stage I: The cancer has spread to the cervix.
Cancer in stage IA is tiny and can only be noticed under a microscope. Among the treatment options available are:
Surgery: Radical hysterectomy (removal of the uterus and cervix) with or without lymph node removal. External beam radiation or brachytherapy (internal radiation therapy) are two types of radiation therapy.
Chemoradiotherapy is a treatment that combines radiation therapy and chemotherapy.
Stage IB: Cancer is evident and restricted to the cervix, or the tumour is tiny and bigger in size. Treatment options may include a mix of the treatments listed above.
Cancer has gone beyond the cervix but has not reached the pelvic sidewall or the bottom portion of the vagina.
Among the treatment options available are:
Surgery: Radical hysterectomy with lymph node removal. External beam radiation mixed with brachytherapy or concurrent chemoradiotherapy is referred to as radiation therapy.
Cancer has spread to the bottom third of the vagina, the pelvic sidewall, or is causing renal difficulties in stage III.
Among the treatment options available are:
External beam radiation mixed with brachytherapy or concurrent chemoradiotherapy is referred to as radiation therapy.
Chemotherapy is frequently used in conjunction with radiation therapy.
Cancer has spread to nearby organs or distant places at this stage.
Among the treatment options available are:
Chemotherapy can be used alone or in tandem with radiation therapy. Palliative care focuses on symptom alleviation and enhancing quality of life.
The precise treatment plan will be determined by a number of factors, including the stage of cancer, the individual's overall health, and personal preferences. Surgery, radiation therapy, chemotherapy, or targeted therapy may all be used in the treatment. The healthcare team, which may include gynecologic oncologists, radiation oncologists, medical oncologists, and other specialists, will collaborate to design the best treatment plan for each patient.
Prevention:
Prevention plays a crucial role in reducing the incidence of cervical cancer.
HPV vaccine is a highly efficient prophylactic measure against the most common high-risk strains of human papillomavirus (HPV). HPV vaccines provide protection against HPV types 16 and 18, which cause the majority of cervical cancer cases. Both males and females should be vaccinated before becoming sexually active. The immunisation is normally administered in a six-month course of doses. It is vital to note that immunisation is most effective when given before to HPV exposure.
Regular cervical cancer screening can detect precancerous changes in the cervix as well as early-stage cervical cancer. The Pap test (Pap smear) and the HPV test are the two basic screening procedures. The suggested screening frequency varies according to age, risk factors, and regional guidelines. It is critical to adhere to the prescribed screening schedule and consult with your healthcare physician about the optimal screening strategy for you.
Safe sexual practises, such as using condoms consistently and correctly, can minimise the chance of HPV infection. Condoms cannot completely protect against HPV, although they can help minimise the chance of transmission.
Limiting the number of sexual partners: Reducing the number of sexual partners and being in a mutually monogamous relationship can lower the risk of HPV infection.
Avoid smoking: Cigarette smoking has been related to an increased risk of cervical cancer. Quitting smoking or avoiding smoking entirely can reduce the risk.
Maintaining general excellent health and a strong immune system can help lower the chance of cervical cancer. This involves eating a good diet, getting enough restful sleep, and engaging in frequent physical activity.
Educating and increasing awareness: It is critical to spread knowledge about cervical cancer, its causes, prevention techniques, and the necessity of vaccination and screening. Early detection and treatment can be aided by educating oneself and others.
Importance of HPV Vaccination:
HPV vaccination is a crucial preventive measure against cervical cancer and other HPV-related diseases.
Cervical cancer prevention: HPV infection is the leading cause of cervical cancer. Vaccination against the most common high-risk HPV strains, such as HPV-16 and HPV-18, lowers the chance of developing cervical cancer considerably. According to studies, HPV vaccination can prevent up to 90% of cervical cancer incidences.
Protection against other HPV-related malignancies: In addition to cervical cancer, HPV infection has been associated to anal, vaginal, vulvar, penile, and oropharyngeal (throat and mouth) cancers. HPV vaccination can also help prevent certain tumours.
Genital wart prevention: Certain HPV varieties, such as HPV-6 and HPV-11, are responsible for genital warts. HPV vaccination protects against various HPV strains, lowering the risk of genital warts.
HPV vaccination is most effective when taken before being exposed to the virus. Adolescents (including men and females) who are vaccinated before becoming sexually active have the highest advantage since they are less likely to have been exposed to HPV. The age at which HPV vaccination is suggested varies by country, however it is generally recommended for boys and girls between the ages of 9 and 14.
Herd immunity: Widespread HPV vaccination can result in herd immunity, which means that when a considerable section of the population is vaccinated, it protects unprotected individuals by reducing overall viral transmission. This is especially crucial for those who are unable to take the vaccine owing to medical or other reasons.
Long-term protection: HPV vaccines offer long-term protection against the specific HPV types. According to studies, the immunisations provide protection for at least ten years, and ongoing research suggests that it may last even longer.
Safety and efficacy: HPV vaccines have undergone extensive testing and have been found to be safe and highly effective. They have been approved by regulatory authorities worldwide and endorsed by major health organizations, including the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC).
Follow-up and Prognosis:
After the initial treatment for cervical cancer, regular follow-up care is essential to monitor for any recurrence or potential complications.
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Follow-up visits: After treatment, your healthcare team will schedule regular follow-up visits to monitor your progress and assess your overall health. The frequency of these visits may vary depending on individual factors, such as the stage of cancer, the specific treatment received, and any other underlying health conditions.
Physical examination: During follow-up visits, your healthcare provider will conduct a physical examination, including a pelvic examination, to check for any signs of recurrence or other abnormalities.
Imaging tests: Depending on the stage and treatment of cervical cancer, your healthcare provider may order imaging tests such as CT scans, MRIs, or PET scans to monitor the response to treatment and detect any potential recurrence or metastasis (spread to other parts of the body).
Blood tests: Blood tests, such as tumor marker tests or complete blood counts, may be done periodically to assess your overall health and monitor for any potential signs of recurrence.
Pap tests and HPV tests: Regular cervical cancer screening, such as Pap tests or HPV tests, may continue as part of the follow-up care to monitor for any changes in the cervix.
Management of side effects and late effects: If you experience any side effects or late effects from treatment, such as fertility issues, sexual dysfunction, or urinary problems, your healthcare team will provide appropriate management and support.
Prognosis: The prognosis for cervical cancer depends on various factors, including the stage of cancer at diagnosis, the specific characteristics of the tumor, the effectiveness of treatment, and individual factors like age and overall health. Early detection and treatment generally result in a better prognosis. It's important to discuss your specific prognosis and long-term outlook with your healthcare provider, as they can p
Disclaimer: This article is meant for informational purposes only and must not be considered a substitute for advice provided by qualified medical professionals.