Cervical cancer is a significant health concern influencing women globally, posing a threat to their reproductive health and overall well-being. This type of cancer originates in the cervix, the bottom part of the uterus that links to the vagina. While cervical cancer is preventable and, if detected early, highly treatable, it remains a leading cause of cancer-related deaths among women.
To comprehend cervical cancer, it is crucial to understand the complex anatomy of the female reproductive system. The cervix plays a pivotal role in facilitating the passage of sperm into the uterus and allowing the flow of menstrual blood out. Unfortunately, the very characteristics that make the cervix dynamic also make it susceptible to the development of cancerous cells.
The treatment of cervical cancer is multifaceted and depends on factors like the stage of the cancer, the patient’s overall health, & their reproductive goals. Common treatment modalities include surgery, radiation therapy, and chemotherapy. In some cases, a combination of these approaches is employed to ensure a comprehensive and effective response to the disease.
Preventing cervical cancer is possible through lifestyle modifications and vaccination against high-risk HPV strains. Regular screenings, practicing safe sex, and adopting a healthy lifestyle contribute to reducing the risk of developing cervical cancer. Additionally, the availability of vaccines targeting HPV has been a significant breakthrough in preventing cervical cancer, especially in younger populations.
In this blog, we delve into the various aspects of cervical cancer, from understanding its origins and risk factors to exploring symptoms, diagnostic procedures, and treatment options. Empowering individuals with knowledge about cervical cancer is fundamental in fostering early detection, promoting preventive measures, and ultimately saving lives.
Read More: Warning Signs Of Cancer In Women
Table of Contents
Cervical Cancer Symptoms
In the premature stages, cervical cancer may not cause noticeable symptoms, which is why regular screenings, such as Pap smears & HPV tests, are crucial for early diagnosis. As the cancer progresses, the following signs & symptoms may occur:
1. Abnormal Vaginal Bleeding:
– Unusual bleeding between menstrual periods
– Bleeding after sexual intercourse
– Postmenopausal bleeding (bleeding after menopause)
2. Pelvic Pain or Discomfort:
– Persistent pelvic pain not related to menstruation or other known causes
3. Pain During Sexual Intercourse:
– Pain or discomfort during sexual activity, particularly deep penetration
4. Unusual Vaginal Discharge:
– Increased or changes in vaginal discharge, which may be watery or have a foul odor
5. Pelvic Pain and Back Pain:
– Pain in the pelvis or lower back that may be persistent.
It’s vital to remember that these symptoms can also be caused by medical conditions other than cervical cancer, and having these symptoms doesn’t necessarily mean you have cancer. However, if you experience any of these symptoms, especially if they are persistent or unusual for you, it’s crucial to consult with a medical professional for a thorough examination and appropriate testing.
What Is Cervical Cancer?
What Is Cervical Cancer? Cervical cancer is a kind of cancer that harms the lower part of the uterus (womb) that connects to the vagina. It develops when the cells of the cervix grow abnormally & invade the nearby tissues or spread to other parts of the body. Cervical cancer is one of the most common cancers among women worldwide, and it can be prevented & cured if detected early & treated properly. According to the WHO, India had an estimated 123,907 new cases and 77,348 deaths from cervical cancer in 2021, accounting for about 20% of the global burden.
Cervical Cancer Causes
Cervical cancer is predominantly caused by continual infection with certain kinds of human papillomavirus (HPV), a sexually transmitted virus. HPV is a set of over 200 related viruses, & about 40 types can harm the genital area. However, not all HPV infections lead to cervical cancer, and most infections resolve on their own without causing any symptoms.
Here are the key factors and details about the causes of cervical cancer-
1. Human Papillomavirus (HPV) Infection:
– High-Risk HPV Types: Persistent infection with high-risk types of HPV, especially HPV 16 and HPV 18, is the primary cause of cervical cancer. These viruses can infect the cells of the cervix, leading to changes in the cells that may eventually become cancerous.
– Transmission: HPV is generally transmitted through sexual contact, including vaginal, anal, & oral sex. It can be spread even when an infected person has no symptoms.
2. Risk Factors for HPV Persistence:
– Early Sexual Activity: Engrossing in sexual activity at an early age increases the risk of HPV exposure.
– Multiple Sexual Partners: Having numerous sexual partners or having sexual partners with multiple partners increases the likelihood of exposure to HPV.
– Weakened Immune System: A weakened immune system, either due to conditions like HIV or immunosuppressive medications, can decrease the body’s ability to clear the HPV infection.
3. Smoking:
– Smoking tobacco is viewed as a major risk factor for cervical cancer. It is believed that the harmful substances in tobacco smoke may make it easier for HPV to persist and lead to cervical cancer.
4. Long-Term Use of Oral Contraceptives:
– Women who have used oral contraceptives for an extended period, typically five years or more, may have a slightly higher risk of getting cervical cancer.
5. Multiple Pregnancies:
– Women who have had three or more full-term pregnancies may have an increased risk of cervical cancer.
6. Lack of Regular Pap Smear Screenings:
– Regular screenings, such as Pap smears or Pap tests, can find changes in the cervix early on, allowing for intervention before cancer develops. Lack of regular screenings increases the risk of undetected abnormalities progressing to cervical cancer.
It’s important to note that while these factors increase the risk of getting cervical cancer, they do not guarantee its development. Many women with one or more risk factors never develop the disease, and some without apparent risk factors may still develop cervical cancer. Vaccination against HPV, particularly in adolescence, and regular cancer screenings are necessary for early diagnosis & prevention.
Cervical Cancer Treatment
The type of treatment for cervical cancer depends on various factors, like the stage of cancer, the size & location of the tumor, the patient’s age and general health, and the patient’s preferences. Some of the common types of treatments for cervical cancer are:
– Surgery: This involves removing the tumor & some surrounding healthy tissues to prevent cancer from spreading. Depending on the extent of the surgery, it may include removing part or all of the cervix (cone biopsy or hysterectomy), part or all of the uterus (hysterectomy), part or all of the ovaries and fallopian tubes (salpingo-oophorectomy), or part or all of the pelvic lymph nodes (pelvic lymph node dissection). Surgery is usually done for early-stage cervical cancer or as a part of other treatments for advanced-stage cervical cancer.
A cone biopsy may cost around INR 30,000 (USD 387), while a radical hysterectomy may cost around INR 1,50,000 (USD 1935).
– Chemotherapy: This involves using drugs to kill or stop the growth of cancer cells. Chemotherapy can be given before or after surgery, or along with radiation therapy, to shrink the tumor or prevent it from coming back. Chemotherapy can also be utilized as a palliative treatment to alleviate symptoms & improve the quality of life for patients with advanced-stage cervical cancer.
A single cycle of chemotherapy may cost around INR 20,000 (USD 258), while a full course of chemotherapy may cost around INR 1,00,000 (USD 1290).
– Radiation therapy: This involves using high-energy rays or particles to destroy or damage cancer cells. This therapy can be given externally (external beam radiation therapy) or internally (brachytherapy). External beam radiation therapy utilizes a machine that executes radiation beams at the cancer tumor from outside the body. Brachytherapy uses radioactive sources that are placed inside or near the tumor. Radiation therapy can be utilized alone or in a mixture with surgery or chemotherapy to treat cervical cancer.
External beam radiation therapy may cost around INR 1,00,000 (USD 1290), while brachytherapy may cost around INR 50,000 (USD 645).
– Immunotherapy: This involves using substances that stimulate the body’s immune system to fight cancer cells. Immunotherapy can be given as injections, pills, or infusions. It can be used alone or in combination with other treatments to treat cervical cancer that has spread to other parts of the body or that has come back after previous treatments.
A single dose of immunotherapy may cost around INR 1,00,000 (USD 1290), while a full course of immunotherapy may cost around INR 5,00,000 (USD 6450).
– Hormone therapy: This involves using drugs that block or interfere with hormones that help cancer cells grow. Hormone therapy can be used to treat a cervical tumor that has spread to other parts of the body or that has come back after previous treatments.
A single dose of hormone therapy may cost around INR 10,000 (USD 129), while a full course of hormone therapy may cost around INR 50,000 (USD 645).
Cervical Cancer Treatment Cost In India
The price of cervical cancer treatment in India varies depending on the type of treatment, procedure, involved tests, and chosen hospital. Typically, cervical cancer treatment costs in India may range from INR 82,000 (USD 1057) to INR 2,06,000 (USD 2656). However, this is only an approximate estimate, and the final cost may vary depending on various factors such as:
– The city where you choose to get treated
– The hospital where you choose to get treated
– The doctor who performs the treatment
– The stage and type of cervical cancer
– The number and type of tests required
– The number and type of sessions required
– The type and duration of hospital stay
– The type and amount of medications needed
– The type and extent of follow-up care required
Cervical Cancer Risk Factors
Understanding these risk factors is essential for preventive measures, early detection, and effective management. Here are some key risk factors:
1. Human Papillomavirus (HPV) Infection:
– Primary Cause: Persistent infection with high-risk types of HPV, particularly HPV 16 and 18, is the primary cause of cervical cancer. HPV is a sexually transmitted infection.
– Transmission: It spreads through sexual contact, including vaginal, anal, or oral sex.
2. Smoking:
– Link to Cervical Cancer: Smoking is associated with an increased risk of cervical cancer. The chemicals in tobacco may affect the cervix and make it more susceptible to HPV infection.
3. Weakened Immune System:
– Immunosuppressive Conditions: Conditions or medications that weaken the immune system, such as HIV/AIDS or immunosuppressive drugs after organ transplantation, can increase the risk of cancer.
4. Oral Contraceptives (Birth Control Pills):
– Long-Term Use: Prolonged use of oral contraceptives, especially for more than five years, has been linked to a slightly increased risk of cervical cancer.
5. Early Age at First Sexual Intercourse:
– Increased Exposure: Engaging in sexual activity at an early age may increase the likelihood of exposure to HPV.
6. Multiple Sexual Partners:
– Higher Risk of HPV Exposure: Having many sexual partners increases the possibility of being exposed to HPV, which is a significant risk factor for this type of cancer.
7. History of Sexually Transmitted Infections (STIs):
– Increased Vulnerability: Infections such as chlamydia or gonorrhea can damage the cervix, making it more susceptible to HPV infection.
8. Family History:
– Genetic Predisposition: While most cases of cervical cancer are not directly inherited, having a family history of cervical cancer or certain genetic factors may contribute to an increased risk.
9. Socioeconomic Factors:
– Access to Healthcare: Limited access to healthcare, including routine Pap smears and HPV vaccinations, may contribute to a higher risk of cervical cancer.
10. Poor Socioeconomic Status:
– Limited Resources: Women with lower socioeconomic status may face challenges in accessing preventive healthcare measures & may have a higher risk of cervical cancer.
11. Inadequate Screening:
– Missed Detection: Irregular or lack of cancer screening, like Pap smears or HPV testing, can result in missed opportunities for early detection & intervention.
Types Of Cervical Cancer
There are several kinds of cervical cancer, and they are classified based on the type of cells involved. The 2 main types are squamous cell carcinoma & adenocarcinoma.
Here’s a brief overview:
1. Squamous Cell Carcinoma:
– Most common type (70-90%).
– Develops in squamous cells lining the cervix.
– Associated with persistent HPV infection, smoking, and other factors.
2. Adenocarcinoma:
– Second most common (10-25%).
– Originates in epithelial cells of the cervix.
– Linked to HPV infection, exposure to DES, and genetic factors.
3. Adenosquamous Carcinoma:
– Less common, with features of both squamous and glandular cells.
4. Small Cell Carcinoma:
– Rare and aggressive.
– Develops from small neuroendocrine cells.
5. Clear Cell Carcinoma:
– Rare, linked to DES exposure.
– Arises from glandular cells with clear cytoplasm.
Stages Of Cervical Cancer
The stage of cervical cancer describes how far the cancer has spread from the cervix to other body parts. The stage is determined by tests and procedures such as physical exam, Pap smear, biopsy, imaging tests, and surgery. Knowing the stage of cervical cancer is important for choosing the best treatment and predicting the outcome.
Stage I
Stage I cervical cancer means that the cancer has formed and is found in the cervix only. It has not metastasized to nearby lymph nodes or distant organs. Stage I cancer usually does not cause any symptoms and is often detected by an abnormal Pap smear.
Stage I has a high chance of cure with appropriate treatment. The 5-year relative survival rate at this stage is around 92%. The treatment options depend on the size & depth of the tumor, the desire to preserve fertility and other factors.
Stage I is further divided into two sub-stages:
– Stage IA: The cancer is very small and can only be seen under a microscope. It is less than 5 millimeters (mm) deep and 7 mm wide.
– Stage IA1: The cancer is not more than 3 mm deep and 7 mm wide.
– Stage IA2: The cancer is over 3 mm but not over 5 mm deep & 7 mm wide.
– Stage IB: The cancer can be seen without a microscope or is larger than stage IA. It is more than 5 mm deep or 7 mm wide.
– Stage IB1: The cancer is not larger than 2 centimeters (cm).
– Stage IB2: The cancer is bigger than 2 cm but not larger than 4 cm.
– Stage IB3: The cancer is bigger than 4 cm.
Stage II
Stage II cervical cancer means that cancer has metastasized beyond the cervix to the upper two-thirds of the vagina or the tissue near the uterus (parametria). It has not developed in nearby lymph nodes or distant organs. Stage II may cause symptoms such as abnormal vaginal bleeding, discharge, or pain.
Stage II has a lower chance of cure than stage I, but still has a good prognosis with appropriate treatment. The 5-year relative survival rate at this stage is around 63%. The treatment options are similar to stage I but more aggressive.
Stage II is further divided into two sub-stages:
– Stage IIA: The cancer has spread to the upper two-thirds of the vagina but not to the parametria.
– Stage IIA1: The tumor is not larger than 4 cm.
– Stage IIA2: The tumor is bigger than 4 cm.
– Stage IIB: The cancer has spread to the parametria but not beyond.
Stage III
Stage III of cervical cancer means that the cancer has extended to the lower third of the vagina, the pelvic wall, or the ureters (the tubes that links the kidneys to the bladder). It may or may not have metastasized to nearby lymph nodes but has not moved to distant body parts. Stage III may cause symptoms such as leg swelling, kidney problems, or bowel problems.
Stage III has a lower chance of cure than stage II but still has a possibility of cure with appropriate treatment. The 5-year relative survival rate at this stage is around 35%. The treatment options are similar to stage II but more aggressive.
Stage III is further divided into two sub-stages:
– Stage IIIA: The cancer has expanded to the lower third of the vagina & not to the pelvic wall or the ureters.
– Stage IIIB: The cancer has spread to the pelvic wall or has caused swelling or blockage of one or both ureters.
Stage IV
Stage IV cervical cancer means that the cancer has disseminated beyond the pelvis to other parts of the body, such as the bladder, rectum, liver, lungs, bones, or brain. It may or may not have spread to close lymph nodes. Stage IV cervical cancer is also called metastatic cervical cancer. Stage IV may cause symptoms such as weight loss, fatigue, abdominal pain, bone pain, or neurological problems.
Stage IV cervical cancer is usually not curable but still treatable. The 5-year relative survival rate at this stage is around 16%. The treatment options aim to control the growth & spread of cancer, relieve symptoms, & improve quality of life.
Stage IV is further divided into two sub-stages:
– Stage IVA: The cancer has moved to nearby organs such as the bladder or rectum.
– Stage IVB: The cancer tumor has metastasized to distant body parts like the liver, lungs, bones, or brain.
Cervical Cancer Diagnosis
Cervical cancer can be diagnosed by different tests, such as
Pap test: This procedure collects cells from the cervix and examines them for abnormal changes. It is advised for women aged 21 to 65 every three to five years.
– HPV test: A procedure that checks for the presence of HPV infection in the cervical cells. This test can be done along with the Pap test or separately for women aged 30 and older.
– Colposcopy: A procedure that uses a magnifying instrument to look at the cervix and identify any abnormal areas. It is usually done if the Pap test or HPV test shows abnormal results.
– Biopsy: A procedure that takes a small amount of tissue from the cervix & sends it to a laboratory for analysis. This test can confirm the diagnosis and determine its type and stage.
Conclusion
Cervical cancer, driven primarily by HPV infection, poses a global health challenge for women. Early detection through recognizing symptoms and regular screenings is crucial. Treatment options, including surgery and chemotherapy, show promise, but outcomes depend on the cancer’s stage at diagnosis. Public awareness and preventive measures, such as vaccination, are vital in addressing this issue, emphasizing the need for collaborative efforts from medical professionals, policymakers, & communities to reduce the impact of cervical cancer in India and worldwide.
Cervical cancer treatment often involves surgery, radiation therapy, and chemotherapy, with costs that can be overwhelming for many families. Crowdfunding provides a platform where individuals can reach out to a global community for financial support, making treatment accessible to those who cannot afford it otherwise.
