Cervical Cancer Defined

The cervix connects the uterus and vagina. The endocervix is the part of the cervix that is closest to the uterus while an ectocervix is nearer to the vagina. Most cases of cervical cancer begin in the cell at the transformation zone. This zone is where the two main types of cells in the cervix (squamous cells and glandular cells) meet.

Cervical cancer starts in the neck of the womb called the cervix. The cervix is a strong muscle and is the opening to the womb from the vagina. Cervical cancer is the third among the most common cancer in women and is the most common cancer type in women under 35 years old.

The cells surrounding the cervix do not suddenly become cancer cells. These cells gradually develop into precancerous cells that will then become cancer cells. These abnormal changes can be seen through a Pap test. Abnormal cells can also be treated to prevent the development of cancer.

Cervical cancer gradually develops in the cells of the cervix. It usually begins as a dysplasia, which is a precancerous condition. Dysplasia is discovered through a Pap smear and can be treated successfully. The treatment for dysplasia on the cervix will depend on the woman’s age, general health, size of the lesion, the changes that have occurred in the cells, and plans of having children in the future.

Dysplasia becomes cervical cancer when the precancerous cells turn into true cancer cells, which spread deeper into the cervix or other organs and tissues.

Although cervical cancer begins as a precancerous condition, not all women develop the disease. It could take several years for the change from precancerous to a cancerous condition to happen, but it could also develop in less than a year. For most women, the pre-cancer cells would either go away on their own even without treatment or would remain unchanged. Unfortunately, in some women, the pre-cancer cells develop into true cancer cells.

There are two main types of cervical cancer, which are named after the type of cell that becomes cancerous. They are squamous cell carcinoma and adenocarcinoma. Other types of cervical cancer are rare.

Squamous cell carcinoma is the most common type of cervical cancer affecting 7 to 8 out of 10 cervical cancer patients (80 to 90 percent). On the other hand, adenocarcinoma is responsible for more than 1 in 10 cervical cancers (10 to 15 percent).

Human Papillomavirus

The human papillomavirus (HPV) is the major cause of cervical cancer. There are over 100 types of HPV and at least 40 are passed on through sexual intercourse. There are 15 types of HPV, which are considered high risk for cervical cancer.

Sexually active women can come in contact with at least one type of human papillomavirus during their lifetime as HPV is common. Most of the time, HPV does not cause any harm and usually goes away on its own. Some types of HPV can cause genital warts. However, these warts do not cause cell changes that could develop into cervical cancer.

Sexual intercourse at an early age, having a partner who has high-risk sexual activities and having various sexual partners can increase the risk of developing cervical cancer. Other risk factors include not getting an HPV vaccine, a weakened immune system, economically disadvantaged, smoking, genetics, and having a mother who took diethylstilbestrol (a synthetic estrogen hormone) to prevent a miscarriage during the early 1960s.

Cervical cancer may spread to other parts of the body such as the bladder, intestines, liver, and lungs.

What are the symptoms of cervical cancer?

Since cervical cancer slowly develops, symptoms are not that apparent and could be asymptomatic – most of the time. The symptoms of cervical cancer are:

• Heavier and longer menstrual periods 
• Vaginal bleeding after sexual intercourse or after menopause
• Abnormal vaginal bleeding in between periods
• A vaginal discharge that does not stop
• A watery, pale, pink, bloody, brown, or foul-smelling vaginal discharge

Advanced Cervical Cancer Symptoms

• Generalized fatigue
• Back pain
• Pelvic pain
• Weight loss
• Urine or feces leakage from the vagina
• Loss of appetite
• Bone pain
• Fractures

Because cervical cancer does not cause noticeable symptoms during the early stages, women are advised to get a Pap test when they turn 21. A routine Pap smear is very important as it helps in detecting abnormal changes of cells in the cervix.

The treatment of cervical cancer requires various techniques depending on the cause and whether cancer has spread beyond the cervix. Cervical cancer is considered the easiest type of cancer in women to prevent. Visit your doctor now and have a routine checkup to prevent or treat the disease early on.

Diagnosing Cervical Cancer

An important aspect of diagnosing cancer is its stage. Staging is the process of determining the extent of the disease to check how far it has spread or progressed. It also serves as a guide to arrive at the appropriate treatment for cancer. Diagnostic tests and examinations are used to determine the tumor size, the invasion of cancer into the tissue, and the spread of cancer cells to nearby lymph nodes and other parts of the body.

There are two systems used for staging cervical cancer. These are the American Joint Committee on Cancer or AJCC, TNM staging system, and the International Federation of Gynecology and Obstetrics (FIGO) system. Based on the AJCC system, cervical cancer is categorized into three factors: the extent of the tumor (T), whether cancer has spread to lymph nodes (N), and whether cancer has spread to distant sites (M). The FIGO system makes use of the same information.

Stage grouping involves the information about the tumor, lymph nodes, and spread of cancer. The stages are classified using the number 0 and Roman numerals I to IV. These stages are then subdivided into letters and numbers. The FIGO stages do not include the lymph nodes until stage III and there is no stage 0 in the FIGO system.

The AJCC system classifies cervical cancer in stages 0 through IV. The clinical findings are the basis of staging, not the surgical findings. The extent of cervical cancer is assessed by the physician’s physical examination and a few diagnostic procedures. When surgery is performed, it might show that the cancer cells have spread more than what the physician thought. This development can then change the treatment plan for cancer but not the stage of cancer.

Survival Rates for Cervical Cancer

The following is the recent statistics of survival rates for cervical cancer based on the data collected by the National Cancer Database:

• Stage 0 - 93%
• Stage IA - 93%
• Stage IB - 80%
• Stage IIA - 63%
• Stage IIB - 58%
• Stage IIIA - 35%
• Stage IIIB - 32%
• Stage IVA - 16%
• Stage IVB - 15%

A malignant tumor in the lower most part of the uterus can be prevented by a Pap smear screening and an HPV vaccine. The treatments for cervical cancer include surgery, radiation, and chemotherapy.