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For many years, cervical cancer was the leading cause of cancer death among women in the United States. However, in the past 40 years the incidence of cervical cancer and resulting deaths have decreased.

The decline can be directly attributed to women receiving regular Pap smears, which can detect dysplasia (abnormal cells) prior the condition turning into cancer.
 
According to statistical data released in the United States, more than 12,000 women are diagnosed with cervical cancer and 3,000 women will die from the disease annually.  Annually, an estimated $2 billion is spent on cervical cancer treatment in the United States.

What is the Cervix?

The cervix is located in the lower portion of the uterus, and is sometimes called the uterine cervix.  The cervix is responsible for connecting the body of the uterus to the vaginal canal.  During menstruation the cervix opens and allows for the shedding of the endometrial tissue.

The primary function of the cervix for reproductive purposes, during childbirth the cervix will dilate to a size of 10 inches and allow the baby to pass through the birth canal and be born.

What is Cervical Cancer?

Cervical cancer is a malignant growth of cells in the cervix uteri or cervical area.  In a stage of pre-cancer the disease is referred to as “cervical dysplasia.”  The condition is classified as mild, moderate or severe.  Even though dysplasia by itself does not result in health problems, it is considered to be a pre-cancerous condition which can rapidly change to cervical cancer in situ or invasive (grow beyond the layer of cells in which it began) cervical cancer.

What Causes Cervical Cancer?

Cervical cancers begin with an abnormal change to the cervical tissues.  The development of abnormal cervical changes has been linked to certain risk factors including human papilloma virus (HPV) infection, engaging in sexual activity at a young age, multiple sexual partners, a compromised immune system, oral contraceptives and smoking cigarettes.
 
HPV is a group of more than 100 different viruses, these types of viruses are not actually cancer, but cause growths called papillomas.  The virus is transmitted from person-to-person during sexual intercourse including; vaginal, anal and oral sex.
 
Certain strains of the HPV virus, in particular the strains that cause genital and skin warts and other abnormal skin conditions, have been directly linked to cervical changes that could eventually lead to development of cervical cancer.

Signs and Symptoms

Early forms of cervical cancer generally produce no symptoms or warning signs.  However, as the cancer progresses, the following may occur:

  1. Vaginal bleeding particularly after sexual intercourse, between menstrual cycles or after menopause.
  2. Water, bloody-tinged vaginal discharge which could be heavy and possibly have an offensive odor.
  3. Pain in the pelvic region or pain during sexual intercourse.

How is Cervical Cancer Diagnosed?

Pap smears and check-ups are all a part of routine medical care a women undergoes at a yearly gynecological examination, if caught early cervical cancer has a better chance of being successfully treated.  During a Pap smear, a physician will take cells brushed off the cervix and send the sample to a lab to be examined.  A Pap smear can easily detect abnormal cells located in the cervix, if abnormal cells are found and left untreated, cervical cancer may develop.

A physician can also use an HPV DNA test to determine whether or not a woman is infected with any of the 13 types of HPV strains that are linked to cervical cancer.  The test is performed much the same way as a Pap smear, cells are collected from the cervix and sent to be evaluated at a laboratory.  The test differs from a Pap in that it can detect high-risk HPV strains in the cellular DNA, prior to cervical changes being seen.

If a woman has experienced any of  the signs and symptoms associated with cervical cancer, a physician may want to conduct further testing to make an affirmative diagnosis.  Such tests include:

Cervical examination: an exam called a colposcopy is performed using a special microscope called a colposcope, which is used to examine the cervix.  If the physician finds an unusual area, a small sample of the cells and tissue may be taken for a biopsy.

Sample of cervical cells:  during a biopsy, a physician might remove a sample of the abnormal cells using special tools. One type of biopsy is called a punch biopsy, the physician will use a sharp, circular instrument to remove a small circle-shaped portion of the cervix.  Other biopsies may be done depending on the location and size of the suspected area.

Removal of a cone-shaped portion of the cervix:  a cone biopsy (conization) involves taking a cone-shaped sample from the cervix, this allows a physician to obtain deeper levels of cervical cells for testing in a lab.  A scalpel, electrical wire loop or laser may be used to cut away the tissue for sampling.

If the samples determine a woman has cervical cancer, further testing will need to be done to determine whether or not the cancer has spread to other areas of the body, the process is called staging.  The stage of the cervical cancer will be the key factor in how the disease is treated and what the possible outcome will be.

What Can be Done to Prevent Cervical Cancer?

Because the most common forms of cervical cancer develop from precancerous cervical changes, there are ways to prevent the disease.  The best way to avoid the disease is to prevent pre-cancer, the next best method for prevention is to locate and treat the condition before it progresses.  Below is a list of things a woman can do to drastically reduce the chances of developing cervical cancer:

Avoid HPV exposure: most forms of pre-cancer can be prevented by avoiding exposure to HPV. Certain patterns of sexual behavior raise risk factors such as; having unprotected sex with multiple partners, engaging in sexual intercourse at a young age, sexual intercourse with an uncircumcised male and having sex with someone who has had many partners.

Do not have sexual intercourse at an early age:  waiting until a female is older will help avoid exposure to HPV.  Limit the number of sexual partners and never have unprotected sexual intercourse.  HPV can lay dormant for many years and produce no symptoms., it is possible someone can have the virus and transmit it without even realizing.

Using condoms:  condoms provide a modicum of protection against HPV.  A research study conducted found that when  women use condoms during sexual intercourse, the risk of HPV can be lowered by approximately 70%..  However, a condom does not provide 100% protection because an HPV infection can be present on other parts of the body.

Do not smoke:  Not smoking is another very important factor that can greatly reduce the risk of cervical dysplasia and cervical cancer.

Get vaccinated:  Vaccines have been developed to protect against the HPV virus strains most responsible for causing cervical cancer.  The vaccine is given in a series of 3 injections over a 6-month time span.  To be effective, the vaccine must be given prior to a female having sexual intercourse.

How is Cervical Cancer Treated?

There are different kinds of treatments available for female cervical cancer.  Some types of treatments are traditional and other forms are being tested during clinical trials.  A clinical trial is done to help improve current treatment options and to obtain information on new treatments.  For cervical cancer there are three standard treatment options available:

Surgery:  a procedure which involves removal of the cancer during a surgical operation, there are different types of surgical procedures that can be done for the treatment ofcervical cancer:  conization (removal of cone shaped biopsy for biopsy), total hysterectomy (removal of uterus and cervix through an abdominal incision), bilateral salpingo-oophorectomy (removal of both ovaries and both fallopian tubes), radical hysterectomy (surgical removal of uterus, cervix, ovaries, fallopian tubes and possibly nearby lymph nodes), pelvic exenteration (surgical removal of lower colon, rectum, bladder, cervix, vagina, ovaries and nearby lymph nodes), cryosurgery (abnormal cells are frozen and destroyed), laser surgery (surgical procedure using a laser beam to remove tissue), loop electrosurgical excision procedure (use of an electrical current passed through a thin loop to remove abnormal cells or cancerous tissue).

Radiation therapy:  the form of cancer treatment that uses high-energy rays and other forms of radiation to kill of cancer cells or to prevent the cells from growing.  Two forms of radiation include, external radiation (performed on the outside of the body) and internal radiation (used inside the body).  The form of radiation selected for treatment will depend upon the type and stage of the cancer being treated.

Chemotherapy:  the use of cancer treating drugs administered via an injection or orally. Chemotherapy either kills off the cancer cells or prevents the cells from dividing, the form of chemotherapy chosen will depend upon the stage and type of cancer being treated.

New forms of cervical cancer treatment are being explored during clinical trials.  For some women, participating in a cervical cancer trial could be the best treatment option available.  For patients who take part in a clinical trial, standard treatment could be administered or the person could be among the first to receive a new form of treatment.

Prognosis

For more than 30 years, the mortality rates for cervical cancer have consistently decreased.  A patients prognosis for cervical cancer will depend upon the age of the patient, overall  health, stage of the cancer, type of cervical cancer and size of the tumor(s). 

Depending upon how early the cancer is detected and type of treatment is received, the long-term survival rates are 92% for localized cervical cancer, 56% for regional cancer and 17% for metastasized cancer, after a period of 5 years.  However, with early diagnosis, patient education and proper treatment, cervical cancer is a disease that can be successfully treated.

  • www.cdc.gov/cancer/cervical/statistics/
  • en.wikipedia.org/wiki/Cervix
  • www.safemenopausesolutions.com/cervical-cancer-signs.html
  • www.siteman.wustl.edu/PDQ.aspx?id=652&xml=CDR62961.xml#_180
  • www.webmd.com/cancer/tc/cervical-cancer-topic-overview
  • www.emedicine.com/cervical_cancer/article_em.htm