Cervical Cancer

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First the good news. Death from cervical cancer is down 90% since the invention of the Pap smear in 1941. Cervical tumors tend to have a slow growth rate so early detection increases the likelihood of a cure. If you are diligent about having an annual Pap smear, and abnormal cells are detected, this is likely to be a cancer you will survive. The bad news is that you must have an annual Pap smear, a procedure few women look forward to.

Causes

There are many factors that contribute to cancer, and in some cases, no matter how healthy your lifestyle and how meticulous you are about your health care, you might get cancer anyway. Some people have what doctors call a genetic predisposition which is why your doctor will always ask about your family health history. Viruses can cause genetic changes in cells that increase the likelihood they will become cancerous. For cervical cancer it is important to be tested for *HPV (Human Papillomarvirus), a genital wart virus that is mainly transmitted through sexual contact.  This falls under the lifestyle risk factor category as you have a measure of control in preventing the contraction of a sexually transmitted disease by taking precautions such as requiring that your partner use a condom. Other lifestyle risk factors that increase the odds of developing cervical cancer include smoking, and taking an oral contraceptive (the pill) for longer than five years.

Symptoms

Cervical cancer is quiet. Like many other types of cancer, there are no signs or symptoms until it has advanced to a life-threatening stage. You might experience abnormal bleeding which is any bleeding that occurs other than that from menstruation You also might experience an abnormal discharge, or pain, but these signs tend to occur in the late stages of cancer.

Early Detection

Surviving cervical cancer could depend on a simple test that should be performed yearly on women who are sexually active. The Pap smear, named after its inventor, George Papanicolaou (thank you, George) can detect a range of abnormalities including minor tissue inflammation, papilloma infection, abnormal cells, cervical cancer and in some cases uterine cancer. The test is a painless procedure that involves retrieving cells from the cervix that will be analyzed in a lab. In some cases, if the results are irregular, a second test is done in a few weeks which can often be normal as there are factors other than cancer that can show abnormalities.

If the Pap smear shows an abnormality the doctor may then perform a colposcopy.  For this procedure, a dye is applied to the cervix and the cervix is then examined using a lighted microscope. The dye helps highlight abnormal tissue. If  the colposcopy shows abnormal tissue you will likely have a biopsy which involves removing the abnormal tissue for further testing. Your doctor will discuss the kind of biopsy that is the best one for you. In some cases, a biopsy is all that is needed if the abnormal tissue is completely removed during the procedure, and further treatment is not necessary.

Advanced Stages

Most cervical cancers can be removed by surgery and have a very high rate of cure. Even after successful removal, patients are still monitored closely for some time after to ensure that the cancer has not returned.

The size of the tumor determines how radical a surgery is necessary.  If cancer has advanced into the wall of the cervix, a hysterectomy will most likely be required. If it has spread to the lymph nodes, affected nodes would be removed as well.

With very advanced tumors, radiation therapy will most likely be recommended to kill remaining cancer cells. There are side effects to radiation. It can cause stenosis which is closing and dryness of the vagina. A special device called a dilator is used to help prevent stenosis. This can be done at home. In some cases, cervical cancer can be cured by just using radiation therapy, even when the tumor has spread.

In a very few cases in which the cancer cells have invaded the surrounding area of the pelvis, such as the bladder and rectum, but has yet to reach major organs such as the kidneys and lungs, radiation is usually tried first. If that fails, a surgical procedure called exenteration might be successful. In this case, all pelvic organs are removed. They are then replaced using grafts made of the individual’s own tissue, and artificial devices. The cure rate for this is about 50%.

Just One Simple Test

The Pap smear is your strongest ally against cervical cancer. It is a simple test and takes just minutes but it could mean life or death. Don’t let embarrassment, procrastination or the excuse that you are too busy, prevent you from having one annually.

*In 2006, the world’s first HPV vaccination was approved in the U.S. and Canada. This vaccine has proven effective against 4 types of HPV and is currently available for females aged 9 to 26. This vaccine is a preventative, not a cure. Females that are not yet sexually active are the best candidates for the vaccine as they will not have been exposed to HPV but women who are sexually active can still benefit if they have not yet contracted HPV. See your family doctor or gynaecologist to see if you or someone you know is a good candidate for this vaccine.

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