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Home :: Cervical Cancer

Cervical Cancer - Causes, Symptoms & Treatment

Alternative names :- Cancer - cervix

The third most common cancer of the female reproductive system, cervical cancer is classified as either preinvasive or invasive.

Preinvasive carcinoma ranges from minimal cervical dysplasia, in which the lower third of the epithelium contains abnormal cells, to carcinoma in situ, in which the full thickness of epithelium contains abnormally proliferating cells (also known as cervical intraepithelial neoplasia).

Preinvasive cancer is curable 75% to 90% of the time with early detection and proper treatment. If untreated (and depending on the form in which it appears), it may progress to invasive cervical cancer.

In invasive carcinoma, cancer cells penetrate the basement membrane and can spread directly to contiguous pelvic structures or disseminate to distant sites by lymphatic routes. Invasive carcinoma of the uterine cervix is responsible for 8,000 deaths annually in the United States alone.

In almost all cases (95%), the histologic type is squamous cell carcinoma, which varies from well-differentiated cells to highly anaplastic spindle cells. Only 5% are adenocarcinomas. Usually, invasive carcinoma occurs between ages 30 and 50; rarely, under age 20.

Causes

Although the cause is unknown, several predisposing factors have been related to the development of cervical cancer: intercourse at a young age (under age 16), multiple sexual partners, multiple pregnancies, and herpesvirus II and other bacterial or viral venereal infections

Signs and symptoms

Early cervical cancer is often asymptomatic (does not produce symptoms). In women who receive regular screening, the first sign of the disease is usually an abnormal Pap test result. Symptoms that may occur include the following:

  • Abnormal vaginal bleeding (e.g., spotting after sexual intercourse, bleeding between menstrual periods, increased menstrual bleeding)
  • Watery, bloody discharge from your vagina that may be heavy and have a foul odor
  • Pelvic pain or pain during sexual intercourse
  • Loss of appetite, weight loss, fatigue
  • Leaking of urine or feces from the vagina
  • Bone fracture

Diagnosis

A cytologic examination (Papanicolaou [Pap] test) can detect cervical cancer before clinical evidence appears. (Systems of Pap test classification may vary from facility to facility.)Abnormal cervical cytology routinely calls for colposcopy which can detect the presence and extent of preclinical lesions requiring a biopsy and histologic examination.

Staining with Lugol's solution (strong iodine) or Schiller's solution (iodine, potassium iodide, and purified water) may identify areas for a biopsy when the smear shows abnormal cells but there's no obvious lesion. Although the tests are nonspecific, they do distinguish between normal and abnormal tissues: Normal tissues absorb the iodine and turn brown; abnormal tissues are devoid of glycogen and won't change color.

Additional studies, such as lymphangiography, cystography, and scans, can detect metastasis

Treatment

Appropriate treatment depends on accurate clinical staging. Preinvasive lesions may be treated with a total excisional biopsy, cryosurgery, laser destruction, conization (and frequent Pap test follow up) or, rarely, hysterectomy. Therapy for invasive squamous cell carcinoma may include radical hysterectomy and radiation therapy (internal, external, or both).
Prevention

Condoms don't prevent the transmission of HPV because the virus can be transmitted through skin-to-skin contact with any infected part of the body. However, wearing condoms is still critical to preventing other STD infections that could weaken your immune system.

The best ways to prevent cervical cancer are to:

  • Delay first intercourse
  • Have fewer sexual partners
  • Quitting smoking may decrease your chances of developing cervical cancer.

Electrosurgery, cryosurgery, podophyllum, and trichloroacetic acid are methods used to remove HPV in mucosal tissue. Removal is warranted because of the potential for developing into cancer.



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