ENWhat is Cervical Cancer (Cervix)? What are the symptoms of cervical cancer?
Cervical cancer , or cervical cancer as it is medically known, occurs in the cells in the lower part of the uterus called the cervix (neck) and is one of the most common gynecological cancers in the world. It is the 14th most common cancer type and the 4th most common cancer type detected in women.
The cervix is the neck-shaped part of the uterus that connects to the vagina. Various types of human papillomavirus (HPV), which causes sexually transmitted infections, are the most common biological agent of cervical cancer.
In most women, when exposed to the virus, the immune system prevents the body from being damaged by the virus. But in a small group of women, the virus survives for years. These viruses can start the process that causes some cells on the surface of the cervix to become cancer cells.
What are the Symptoms of Cervical Cancer?
The most common symptom of cervical cancer is vaginal bleeding. Vaginal bleeding can occur outside menstrual periods, after sexual intercourse, or in the post-menopausal period.
Another common symptom is pain during sexual intercourse, defined as dyspareunia. Unusual excessive vaginal discharge and abnormal disruption of the menstrual cycle are some of the early symptoms of cervical cancer.
In advanced stages, anemia may develop due to abnormal vaginal bleeding and may be added to the disease picture. Persistent pain in the lower abdomen, legs and back may accompany the symptoms. Due to the mass formed, obstruction in the urinary tract may occur and cause problems such as pain during urination or frequent urination.
As with other cancers, involuntary weight loss may accompany these symptoms. Passage of urine or feces may occur due to new connections formed in the vagina. These connections between the leaky bladder or large intestines and the vagina are called fistulas.
What are the symptoms of cervical cancer during pregnancy?
Symptoms of cervical cancer during pregnancy are the same as before pregnancy. However, cervical cancer usually does not cause symptoms in the early stages. Therefore, it is important to have regular gynecological examinations for early diagnosis of cervical cancer.
Symptoms of cervical cancer are:
- Vaginal bleeding
- Vaginal discharge
- Pelvic pain
- Urinary tract problems
If you are at risk of cervical cancer during pregnancy, you should consult your doctor.
Cervical Cancer Vaccine
The cervical cancer vaccine is a vaccine that protects against cervical cancer caused by a virus called Human Papillomavirus (HPV). HPV is a sexually transmitted virus and causes various types of cancer and diseases, such as cervical cancer and genital warts.
There is no upper age limit for the HPV vaccine, which provides serious protection against cervical cancer. HPV vaccine can be administered to all women starting from the age of 9.
What are the Causes of Cervical Cancer?
Mutations in the DNA of healthy cells in this area can be said to be the causes of cervical cancer. Healthy cells divide in a certain cycle, continue their lives, and when the time comes, they are replaced by young cells.
As a result of mutations, this cell cycle is disrupted and cells begin to proliferate uncontrollably. Abnormal cell increase causes the formation of structures referred to as masses or tumors. These formations are referred to as cancer if they are malignant, such as growing aggressively and invading other surrounding and distant body structures.
Human papillomavirus (HPV) is found in approximately 99% of cervical cancers. HPV is a sexually transmitted virus and causes warts in the genital area. It spreads between individuals after skin contact during oral, vaginal or anal sexual intercourse.
There are more than 100 different types of HPV, many of which are considered low risk and do not cause cervical cancer. The number of HPV types found to be associated with cancer is 20. More than 75% of cervical cancer cases are caused by HPV-16 and HPV-18, often referred to as high-risk HPV types. High-risk HPV types can cause cervical cell abnormalities or cancer.
However, HPV is not the only cause of cervical cancer. Most women with HPV do not develop cervical cancer. Some other risk factors, such as smoking, HIV infection, and age at first sexual intercourse, make women exposed to HPV more likely to develop cervical cancer.
In a person whose immune system is functioning normally, HPV infection can be eliminated by the body itself within a period of approximately 2 years. Many people are looking for an answer to the question "Does cervical cancer spread?" Cervical cancer, like other types of cancer, can separate from the tumor and spread to different parts of the body.
What are the Types of Cervical Cancer?
Knowing the type of cervical cancer helps your doctor decide what treatment you need. There are 2 main types of cervical cancer: squamous cell cancer and adenocarcinoma. These are named according to the type of cancerous cell.
Squamous cells are flat, skin-like cells that cover the outer surface of the cervix. 70 to 80 out of every 100 cervical cancers are squamous cell cancers.
Adenocarcinoma is a type of cancer that develops from columnar gland cells that produce mucus. Gland cells are scattered throughout the cervical canal. Adenocarcinoma is less common than squamous cell cancer; However, there has been an increase in the frequency of detection in recent years. More than 10% of women with cervical cancer have adenocarcinoma.
The third most common type of cervical cancer is adenosquamous cancers and involves both cell types. Small cell cancers are less common. Apart from these, there are other rare types of cancer in the cervix.
What are the Risk Factors for Cervical Cancer?
There are many risk factors associated with cervical cancer:
- Human papillomavirus (HPV) infection constitutes the most important risk factor for cervical cancer.
- Women who smoke have twice the risk of cervical cancer compared to non-smokers.
- In people with a weak immune system, the body is insufficient to destroy HPV infections and cancer cells. HIV virus or some drugs that impair immunity increase the risk of cervical cancer due to their weakening effects on body defenses.
- According to some studies, the risk of cervical cancer was found to be higher in women who showed signs of previous chlamydia infection in blood tests and cervical mucus examination.
- Women who do not consume enough fruits and vegetables in their diet may be at risk for cervical cancer.
- Overweight and obese women have a higher risk of developing cervical adenocarcinoma.
- Having a family history of cervical cancer is another risk factor.
- DES is a hormonal medication given to some women between 1940 and 1971 to prevent miscarriages. Clear cell adenocarcinoma of the vagina or cervix has been found to occur more frequently than normally expected in women whose mothers used DES while pregnant.
What are the Cervical Cancer Prevention Methods?
More than 500 thousand new cases of cervical cancer are detected every year around the world. Approximately 250 thousand of these women die every year due to this disease. Knowing a persons susceptibility to any type of cancer can be a cognitively and emotionally draining situation, but it is possible to reduce the risk of developing cancer with the right prevention methods for preventable cancers.
Cervical cancer is one of the few cancers that is almost completely preventable. A great deal of cancer prevention can be achieved by avoiding sexually transmitted human papillomavirus. The basis of protection is the use of condoms and other barrier methods.
There are vaccines developed against HPV types considered to be associated with cervical cancer. The vaccine is considered highly effective, especially if administered from the beginning of adolescence to the 30s. No matter what age you are, it is recommended that you consult your doctor and get information about the HPV vaccine.
A screening test called pap smear can be applied to prevent cervical cancer before it occurs. Pap smear test is an important examination that helps detect the presence of cells that tend to become cancerous in the cervix.
During the procedure, the cells in this area are gently scraped and a sample is taken, and then they are examined in the laboratory to search for abnormal cells.
In this test, which is a bit uncomfortable but takes a very short time, the vaginal canal is opened using a speculum, thus making access to the cervix easier. Cell samples are collected by scraping this area using medical tools such as a brush or spatula.
Apart from these, personal precautions such as avoiding smoking, which increases the risk of cervical cancer, eating a diet rich in fruits and vegetables, and getting rid of excess weight, also reduce the risk of developing cervical cancer.
How is Cervical Cancer Diagnosed?
Cervical cancer may not cause significant complaints in patients in its initial stage. After applying to physicians, the first stages of the diagnostic approach are taking the patients medical history and performing a physical examination.
The patients age at first sexual intercourse, whether he/she feels pain during sexual intercourse, and whether he/she complains of bleeding after intercourse are questioned.
Other questions that need to be considered include whether the person has had a sexually transmitted disease before, the number of sexual partners, whether HPV or HIV has been detected in the person before, tobacco use and whether the person has been vaccinated against HPV, menstrual pattern and the development of abnormal bleeding during these periods. .
Physical examination is the examination of the external and internal parts of the persons genital structures. In the genital area examination, the presence of suspicious lesions is examined.
Cervical screening test is a pap smear cytology examination. If no abnormal cells are detected in the examination following the sample collection, the result can be interpreted as normal. Abnormal test results do not definitely indicate that the person has cancer. Abnormal cells can be graded as atypical, mild, moderate, advanced, and carcinoma in situ.
Carcinoma in situ (CIS) is a general term used for the early stage of cancer diseases. Cervical carcinoma in situ is defined as stage 0 cervical cancer. CIS is cancer that is found only on the surface of the cervix and has progressed deeper.
If your doctor suspects cervical cancer or if abnormal cells are found in the cervical screening test, he will order some tests for further diagnosis. Colposcopy is a tool that allows your doctor to take a closer look at the cervix. It is usually not painful, but if a biopsy is required you may feel pain:
Needle Biopsy
It may be necessary to take a biopsy with a needle from the transition zone where cancer cells and normal cells are located to make a diagnosis.
Endocervical Curettage
It is the process of taking a sample from the cervix using a spoon-shaped medical tool called a curette and another brush-like tool.
If suspicious results are obtained in the samples taken with these procedures, further tests may be performed:
Cone Biopsy
In this procedure performed under general anesthesia, a small cone-shaped section is removed from the cervix and examined in the laboratory. In this procedure, cell samples can be taken from deeper parts of the cervix.
If cervical cancer is detected in the person after these examinations, the disease can be staged with various radiological examinations. X-ray, computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) are among the radiological examinations used for cervical cancer staging.
Stages of Cervical Cancer
Staging is done according to the extent of spread of the cancer. Cervical cancer stages form the basis of treatment planning and there are a total of 4 stages of this disease. Cervical cancer levels; It is divided into four: stage 1, stage 2, stage 3 and stage 4.
Stage 1 Cervical Cancer
The structure formed in stage 1 cervical cancer is still small in size, but it may have spread to the surrounding lymph nodes. At this stage of cervical cancer, discomfort cannot be detected in other parts of the body.
Stage 2 Cervical Cancer
The cancer tissue in the second stage of the disease is slightly larger than in the first stage of the disease. It may have spread outside the genitals and to the lymph nodes, but it is detected without further progression.
Stage 3 Cervical Cancer
In this stage of cervical cancer, the disease spreads to the lower parts of the vagina and outside the groin area. Depending on its progression, it may continue to exit the kidneys and cause obstruction in the urinary tract. Apart from these parts, there is no discomfort in other parts of the body.
Stage 4 Cervical Cancer
It is the final stage of the disease in which the disease spreads (metastasizes) from the sexual organs to other organs such as the lungs, bones and liver.
What are the Treatment Methods for Cervical Cancer?
The stage of cervical cancer is the most important factor in choosing treatment. However, other factors, such as the exact location of the cancer within the cervix, the type of cancer, your age, your general health, and whether you want to have children, also affect treatment options. Cervical cancer treatment can be applied as a single method or as a combination of several treatment options.
Surgery may be performed to remove the cancer. Radiotherapy, chemotherapy, or a combination of the two, radiochemotherapy, are other treatment methods applied depending on the stage of the cancer and the patients condition.
The treatment approach in early stage cervical cancer is surgical interventions. Deciding which procedure to perform can be based on the size and stage of the cancer and whether the person wants to become pregnant in the future:
- Removing Only the Cancerous Area
In very small cervical cancer patients, it may be possible to remove the structure with a cone biopsy procedure. Except for the cervical tissue removed in the form of a cone, other areas of the cervix are not intervened. This surgical intervention may be preferred, especially in women who want to become pregnant in later periods, if the degree of their disease allows it.
- Removal of the Cervix (Trachelectomy)
The surgical procedure called radical trachelectomy refers to the removal of the cervix and some tissues surrounding this structure. After this procedure, which can be preferred in early-stage cervical cancer patients, the person can become pregnant again in the future because there is no intervention in the uterus.
- Removal of Cervix and Uterine Tissue (Hysterectomy)
Another surgical method preferred in most early-stage cervical cancer patients is hysterectomy surgery. With this surgery, in addition to a region of the patients cervix, uterus (womb) and vagina, surrounding lymph nodes are also removed.
With hysterectomy, the person can completely get rid of this disease and the chance of its recurrence is eliminated, but since the reproductive organs have been removed, it is impossible for the person to become pregnant in the post-operative period.
In addition to surgical interventions, radiation therapy using high-energy rays (radiotherapy) may be applied to some patients. Radiotherapy is generally used together with chemotherapy, especially in advanced stage cervical cancer patients.
These treatment methods can also be used to reduce the risk of recurrence of the disease in some patients if it is determined that there is a high probability of recurrence.
Due to the damage to the reproductive cells and eggs after radiotherapy, the person may go through menopause following the treatment. For this reason, women who want to become pregnant in the future should consult their physicians about how their reproductive cells can be stored outside the body.
Chemotherapy is a treatment method that aims to eliminate cancer cells through powerful chemical drugs. Chemotherapy drugs can be given to the person orally or intravenously. In advanced cancer cases, chemotherapy treatment combined with radiotherapy may increase the effectiveness of the treatments applied.
Apart from these procedures, various drugs can be used within the scope of targeted therapy by revealing the various features of cancer cells. It is a treatment method that can be applied together with chemotherapy in advanced cervical cancer patients.
Apart from these treatments, drug treatment that strengthens the persons fight against cancer by stimulating his own immune system is called immunotherapy. Cancer cells can make themselves invisible to the immune system through the various proteins they produce.
Especially in advanced stages and people who have not responded to other treatment methods, immunotherapy can help detect and eliminate cancer cells by the immune system.
The 5-year survival rate for cervical cancer patients detected in the early stages is 92% after appropriate treatment. Therefore, if you notice the symptoms of this disorder, it is recommended that you contact healthcare institutions and get support.
How to Test for Cervical Cancer?
Cervical cancer tests are tests performed to detect abnormal cell changes in the cervix or HPV infection at an early stage. Pap smear (Pap swab test) and HPV are the most commonly used screening tests.
Frequently Asked Questions
At what ages is cervical cancer seen?
Cervical cancer usually occurs in the 30s and 40s. However, this is not a definitive situation. This type of cancer can occur at any age. The late 30s and early 60s are considered the high-risk period. Cervical cancer is less common in younger women, but in rare cases it also occurs in teenagers.
Can Cervical Cancer Be Treated?
Cervical cancer is one of the types of cancer that can be treated. The treatment plan usually depends on the stage of the cancer, its size, location, and the patients general health condition. Cervical cancer treatment; It includes surgery, radiotherapy, chemotherapy, or a combination of these.
Does Cervical Cancer Kill?
Cervical cancer is a curable type of cancer when detected and treated in the early stages. Regular gynecological examinations and cervical cancer screening tests increase the chance of detecting abnormal cell changes or cancer at an early stage. But cervical cancer is a deadly type of cancer.
What Causes Cervical Cancer?
The main cause of cervical cancer is infection caused by a virus called Human Papillomavirus (HPV). HPV is a sexually transmitted virus. In some cases, the body can clear the HPV infection on its own and eliminate it without any symptoms.