Cervical cancer guide

30/07/2022

Icon editWhat is cervical cancer?

Cervical cancer is a malignant tumour that develops in the cervix (the entrance to the uterus from the vagina). The cervix is ​​the female reproductive system's lower part of the uterus. It connects the lower part of the uterus to the vagina and forms the birth canal.What is cervical cancer?

There are two main types of cervical cancer:

  • squamous cell carcinoma - is a type of cancer that forms in cells on the upper surface covering the cervix. It accounts for about 90% of all diagnosed cases of cervical cancer.
  • adenocarcinoma - is a type of cancer that begins in cells that produce mucus.

Most cervical cancers are caused by human papillomavirus (HPV) infection, which a vaccine can prevent. Cervical cancer grows slowly, so there is usually time to diagnose and treat it before it causes serious problems. Most often suffer from women from 35 to 44 years. However, more than 15% of new cases occur in women over 65, especially those who have not received regular examinations.

Icon microscopeDiagnostic tests

The early stages of cervical cancer are usually asymptomatic and difficult to detect. The first signs often appear after a few years. Finding abnormal cells during cervical screening is best to avoid this cancer.

An essential point for prompt diagnosis is screening - also known as smear analysis. Screening identifies pre-cancer changes or early cancer before signs and symptoms appear. The general goals of cancer screening are as follows:

  • reduce the number of people dying from cancer or eliminate cancer deaths;
  • reduce the number of people who develop cancer.

Symptoms of cervical cancer may include:

  • pain during sex;
  • unusual vaginal bleeding, such as after sex, between periods, after menopause, or after a pelvic exam;
  • unusual vaginal discharge.

Women may not feel the pain in the early stages of the disease. However, as cancer progresses and spreads to nearby tissues and organs, women may experience pelvic pain or urinary problems. In addition, some feel a general malaise, tiredness, or decreased appetite. These signs are not necessarily a symptom of cervical cancer, but it is essential to check for them.

  • Bimanual examination of the pelvic organs and speculum examination - any changes in the cervix, uterus, vagina, ovaries and other nearby organs are examined. Also, the Papanicolaou test is performed (cells are taken to be checked under a microscope). This examination usually takes a few minutes and is done in an examination room in the doctor's office.
  • The biopsy - is one of the most accurate methods during which a tiny part of the problematic tissue is removed for examination under a microscope. The pathologist examines the tissue for the presence of malignant cells.
  • CT (computed tomography scan) - using x-rays, photos of the internal organs are taken in different projections. The computer combines these images, and the doctor receives a three-dimensional image, which shows any abnormalities or formations.
  • MRI (magnetic resonance imaging scan) - uses magnetic fields generated by an MRI machine to obtain detailed body images. It is possible to get the size of the tumour.
  • PET (positron emission tomography) - creating organs and tissue images inside the body. A doctor injects a small amount of radioactive sugar substance into the patient's body. After that, the cells that use the most energy take up this sugar. Since cancer uses energy more actively, it absorbs more radioactive material. However, the amount of radiation in the substance is too small to pose a risk to the patient. The scanner then detects this substance and reproduces it inside of the body.
  • Biomarker testing of tumour - laboratory tests help identify specific genes, proteins, and other factors unique to a tumour. It can also be called molecular testing of the tumour. All these tests help determine and choose specific treatment options for the disease.

Icon doctorTreatment methods

The recommended treatment for cervical cancer depends on many factors, including the stage of the disease, age, and the desire to have children in the future. Treatment options may include the following methods:

  • Systemic chemotherapy - uses anti-cancer (cytotoxic) drugs to kill cancer cells. The scheme and schedule of chemotherapy treatment usually consist of a certain number of cycles carried out over a set period. In addition, a method is used to prevent the division and the formation of new cancer cells.
  • Immunotherapy - uses the body's natural defences to fight cancer. With the help of medicines, the ability of the body's immune system to destroy cancer cells improves.
  • Targeted therapy - is directed at certain parts of cancer cells, namely specific genes or proteins that help the growth and survival of cancer. This type of treatment blocks the growth and spread of cancer cells and does not affect or damage healthy cells.
  • Radiation therapy - the use of high-energy x-rays or other particles to kill cancer cells, which are sent to the affected area with special equipment. The goal is to destroy cancer cells with minimal impact on surrounding tissues.
  • Surgical treatment - includes the following options:
    • cryosurgery - liquid nitrogen is used to freeze cancer cells. Used in the early stages.
    • laser surgery - a laser beam is used to burn cancer cells and is also used in the initial stage on an outpatient basis.
    • conization - using a surgical or laser knife, a cone-shaped piece of cervical tissue is removed.
    • hysterectomy - removal of the cervix and uterus. The operation can be performed through an incision in the lower abdomen, through the vagina or laparoscopically.
    • radical hysterectomy - removal of the cervix, the uterus and tissues around it, and part of the vagina. Some lymph nodes may also be removed.
    • trachelectomy - removal of the cervix and part of the vagina without removing the uterus. An essential method for patients who want to have children later.
    • pelvic exenteration - removal of the cervix, uterus, surrounding organs and tissues, and nearby lymph nodes. The method is recommended if there is a recurrence of the disease.

Early detection of cervical cancer allows more treatment options. When drawing up a treatment plan, the doctors will consider and advise the patient on how the disease and treatment methods will affect sexual function and the ability to have children and other aspects.

Icon plusNew treatment options

Researchers worldwide actively seek more effective methods of preventing and treating cervical cancer. Some of the promising new developments include the following:

  • Transarterial chemoembolization (TACE) - is a minimally-invasive procedure used for cervical cancer metastases and consists of introducing a chemotherapy drug directly into the affected area locally (through the vessels). A blockage (embolization) of the blood arteries that feed cancer cuts off the blood supply and keep chemotherapy inside the tumour.
  • Transarterial chemoperfusion (TACP) - is also applicable for metastatic cancer. During the procedure, tiny beads of the chemotherapy drug are implanted through a catheter into the blood vessels that feed the tumour. The beads block the vessel, preventing blood from reaching the tumour. At the same time, the balls secrete chemotherapy drugs that reduce the tumour.
  • Brachytherapy (internal radiotherapy) - is a type of internal radiation therapy in which microscopic beads containing a radiation source are injected directly into the tissue of the cervix. It allows acting specifically on the focus of cancer.
  • Proton therapy - is a type of radiotherapy in which a beam of radiation (protons) with a given amount of radiation is directed precisely to the affected cervix area while bypassing and not damaging nearby tissues.
  • High-Intensity Focused Ultrasound (HIFU) - beams of ultrasonic energy are focused using special equipment. Ablation (thermal destruction of tissue) occurs at the point of convergence of the rays, making it possible to treat the tumour without surgical intervention. This non-invasive technology allows cervical cancer to be treated deep within the body without damaging healthy tissue.
  • Surgical treatment (da Vinci® robot-assisted cervical cancer surgery) - is a surgical operation to remove the affected organ using a robotic system. The da Vinci® system allows gynaecological surgeries to be performed using smaller incisions, reducing complications and recovery time.

Cervical cancer is a slowly progressive but life-threatening disease. However, the emergence and application of modern treatment methods mean that the patient has a better chance of recovery and life extension.

Icon chartStatistics and prognosis

According to the World Health Organization, cervical cancer is women's fourth most common cancer. In 2021, it accounted for more than 600,000 new diagnoses and more than 350,000 deaths worldwide. Not so long ago, the diagnosis of cervical cancer was the leading cause of death for women worldwide. But significant research in screening, diagnosis and treatment has reversed this unfortunate trend.

The American Cancer Society data shows that the five-year survival rate for stage I cervical cancer is 92%. The five-year survival rate for stage II-III cancer is 58%, and the five-year survival rate for stage IV cancer is 18%.

Statistics and prognosis

Cervix cancer is ​​curable! The effectiveness of cancer treatment depends on many factors, including the stage, type, and location of cancer. According to studies, only 10-15% of people with early-stage cervical cancer relapse after treatment. In addition, cervical cancer is preventable. However, it requires regular examinations.

Suppose you or your relatives are diagnosed with cervical cancer. In that case, the most important thing is to find a team of professionals to discuss the treatment plan and help you choose the best option for a speedy recovery. Like any other problem, cancer is only a problem if you haven't found a good answer or solution yet!

References:

  1. Healthline Media UK: Can cervical cancer be cured?
  2. Cancer Council NSW: Staging and prognosis for cervical cancer
  3. American Cancer Society: Risk Factors for Cervical Cancer
  4. WebMD: Cervical Cancer
  5. Cancer.Net: Cervical Cancer: Statistics
  6. NHS inform: Cervical cancer
  7. Healthline Media: Can You Die From Cervical Cancer? 15 Things to Know About Diagnosis and Prevention