Cervical Cancer: Causes, Symptoms, Treatment and Survival Rate

Cervical cancer arises in the cervix. It is a narrow part of the uterus which connects the body of the uterus with the vagina. It develops slowly over many years progressing from dysplasia (precancerous condition) into cancer if not removed or destroyed in time.

cervix cancer is one of the most common cancers in females. Its incidence is high in mid to low-socioeconomic countries.

Cervical cancer causes

Cervical cancer is primarily caused by persistent infection with certain types of human papillomavirus (HPV). HPV is a common virus transmitted through sexual contact, and while most HPV infections clear up on their own without causing harm, persistent infection with high-risk HPV strains can lead to cervical cancer over time. These high-risk HPV types, such as HPV-16 and HPV-18, are responsible for the majority of cervical cancer cases. HPV infection doesn’t always lead to cervical cancer, but it is a significant risk factor, particularly when coupled with other factors.

Another contributing factor to cervical cancer is a weakened immune system. A compromised immune system, often due to conditions like HIV/AIDS or immunosuppressive medications, can make it harder for the body to fight off HPV infections and other infections that may lead to cervical cancer development.

Lifestyle factors such as smoking can also increase the risk of developing cervical cancer. Smoking not only weakens the immune system but also exposes the cervix to harmful chemicals found in tobacco, which can lead to cellular changes that make the cervix more susceptible to HPV infection and the development of cancerous cells.

Furthermore, early initiation of sexual activity and having multiple sexual partners can increase the risk of HPV infection and subsequent development of cervical cancer. The more sexual partners a person has, the higher the likelihood of exposure to HPV or other sexually transmitted infections that may contribute to cervical cancer risk.

Cervical cancer is also influenced by genetic factors to some extent, as certain genetic variations may affect how the body responds to HPV infection and the development of abnormal cervical cells. However, genetic factors alone are not usually the primary cause of cervical cancer; they often interact with other environmental and lifestyle factors.

Cervical cancer Symptoms

Symptoms of cervical cancer depends on the stage at which it present. Early disease is often present with out symptoms and usually diagnosed on screening by PAP smear. Understanding the symptoms of cervical cancer according to its stages is crucial for early detection and effective treatment. Various symptoms according to the stage are as follows

Early Stage Symptoms:

• Abnormal vaginal bleeding between periods, after intercourse, or after menopause.
• Unusual vaginal discharge that may be watery, bloody, or have a foul odor.
• Pelvic pain or discomfort during intercourse.
• Painful urination or changes in bladder habits.
• Pain in the lower back or pelvic region that is not related to menstruation.

Advanced Stage Symptoms:

• Persistent and heavier vaginal bleeding, often accompanied by blood clots.
• Severe pelvic pain or pressure, especially if the cancer has spread to nearby tissues or organs.
• Painful or difficult bowel movements if the cancer affects the rectum or nearby structures.
• Swelling in the legs or lower extremities due to lymph node involvement.
• Fatigue, weight loss, and loss of appetite as cancer progresses.

Metastatic Stage Symptoms:

• Severe and continuous pelvic or back pain from widespread cancer spread.
• Urinary or fecal incontinence due to nerve compression or organ involvement.
• Swelling or pain in the legs, indicating lymphatic blockage due to advanced cancer.
• Bone pain, fractures, or weakness if cancer spreads to the bones.
• Jaundice (yellowing of the skin and eyes) if cancer spreads to the liver.

It’s important to note that these symptoms can also be caused by other conditions, and not all individuals with cervical cancer will experience all of these symptoms.

Cervical cancer Diagnosis

Diagnosing cervical cancer typically involves a series of tests and procedures designed to detect abnormalities in the cervix. The first step often includes a pelvic exam, where a healthcare provider examines the vagina, cervix, and surrounding areas for any unusual changes or signs of cancerous growths. During this exam, samples of cervical cells may be collected using a device called a speculum for further analysis.

A Pap test, also known as Pap smear, is a common screening tool used to detect cervical cell changes early. During a Pap test, cells are gently scraped from the cervix and examined under a microscope for any abnormalities. If abnormal cells are detected, further testing may be recommended.

An HPV test may also be performed in conjunction with a Pap test or on its own to check for the presence of high-risk HPV strains known to cause cervical cancer. This test analyzes cervical cells for HPV DNA and helps determine the risk of developing cervical cancer.

In some cases, if abnormalities are found during a Pap test or HPV test, a colposcopy may be performed. During a colposcopy, a special magnifying instrument called a colposcope is used to closely examine the cervix, allowing the healthcare provider to identify any suspicious areas for biopsy. A cervical biopsy involves removing a small tissue sample from the cervix for detailed examination under a microscope to confirm the presence of cancerous cells.

Cervical cancer Treatment

Cervical cancer treatment depends on several factors including the stage of cancer, the extent of spread, the patient’s overall health, and individual preferences. Treatment options may include surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, and palliative care.

1. Surgery: Surgery is often the primary treatment for early-stage cervical cancer. Procedures such as cone biopsy (removal of a cone-shaped piece of tissue containing abnormal cells) or hysterectomy (removal of the uterus) may be performed. Lymph nodes in the pelvic area may also be removed to check for cancer spread.
2. Radiation Therapy: Radiation therapy uses high-energy beams to kill cancer cells or shrink tumors. It can be external (external beam radiation therapy) or internal (brachytherapy). Radiation therapy may be used alone for early-stage cancers or combined with chemotherapy for more advanced cases.
3. Chemotherapy: Chemotherapy uses drugs to kill cancer cells or stop their growth. It may be given orally or intravenously and is often used in combination with radiation therapy (chemoradiation) for locally advanced cervical cancer. Chemotherapy may also be used for recurrent or metastatic cervical cancer.
4. Targeted Therapy: Targeted therapy drugs target specific abnormalities in cancer cells, such as genetic mutations or proteins, to block their growth. Drugs like bevacizumab may be used in combination with chemotherapy for advanced cervical cancer to target blood vessel growth in tumors.
5. Immunotherapy: Immunotherapy drugs help the immune system recognize and attack cancer cells more effectively. Pembrolizumab and nivolumab are examples of immunotherapy drugs used in recurrent or metastatic cervical cancer, especially in cases where other treatments have not been effective.

Palliative Care: Palliative care focuses on managing symptoms, providing pain relief, and improving the quality of life for patients with advanced cervical cancer. It is an essential part of treatment to address physical, emotional, and social needs.

Broadly speaking, early stage disease is generally managed with surgery and late more advanced stage diseases are managed with Radiation therapy with or without chemotherapy. In cases of metastatic stage IV disease, cancer growth is controlled with chemotherapy, Targeted therapy and Immunotherapy.

Cervical Cancer Survival Rates

Survival rate statistics depend on the stage at which cancer is diagnosed and also depends on the health of the patient at the time of diagnosis of cancer. The overall 5-year survival rate for cervical cancer is around 66%. However, this rate can vary significantly based on the stage of cancer.

For localized cervical cancer (confined to the cervix), the 5-year survival rate is approximately 92-95%. As the cancer spreads regionally (to nearby lymph nodes or tissues), the survival rate drops to about 57-62%. In cases where cervical cancer has metastasized (spread to distant organs), the 5-year survival rate is around 17-25% according to various studies.

As in all cancers, early detection by means of screening and timely treatment is associated with optimal treatment outcomes. Prevention of cervical cancer can be done by highly effective cervical cancer vaccines.