Cervical Cancer: Causes, symptoms, Diagnosis, Treatment & FAQs

Cervical cancer is a leading cause of cancer deaths in females in India. 200 deaths everyday in India. A global strategy towards that goal was adopted by the World Health Assembly in 2020. The first targets, to be attained by 2030, consist of: 

1) worldwide vaccination of 90% of girls by 15 years of age,

2) screening of 70% of women with a high-performance test for detection of pre-cancerous lesions of the cervix, by the age of 35 and again by the age of 45 and,

3) treating 90% of the detected pre-invasive cancers and managing 90% of women with invasive cancers.

To achieve the above targets, we must follow vaccination and pap smears rigidly. Writing, reading, or listening about it won't solve the problem. Acting on it by getting all our girls and boys vaccinated and screening all sexually active females between 25-65 years age is the key to this Target.

Symptoms of Cervical Cancer:

Symptoms include

1. bleeding in between periods 2.  Bleeding after sexual intercourse.

3. Foul-smelling white discharge and 

4. lower back pain or lower abdominal pain may also occur. 

5. Sudden onset problems while passing urine.

6. In some cases, there may be no symptoms.

Risk Factors of Cervical Cancer: 

1. multiple pregnancy

2. Low immunity 

3. Immunocompromised patients 

4. Multiple sexual partners

5. Smoking

Causes of Cervical Cancer:

Long-lasting (persistent) infection with high-risk types of human papillomavirus (HPV) causes virtually all cervical cancers. Two high-risk types, HPV 16 and HPV 18, cause 70% of cervical cancers worldwide. Nearly all people who are sexually active will become infected with HPV at some point in their lives. But we can clear off this virus by our own biological immunity. 

However, if you or your partner is immunocompromised, this puts you at high risk of harbouring HPV for a long time.

Diagnosis of Cervical Cancer:

Pap test: A speculum is inserted into the vagina to widen it. Then, a brush is inserted into the vagina to collect cells from the cervix. The cells are checked under a microscope for signs of disease.

Pap smear: It is not only for diagnosis of cancer but any abnormal cells caused by HPV will be picked up early if we do 5 yearly screenings and then can be treated in pre-cancer stage without surgery.

Hence early diagnosis is crucial in this fight against cancer.

Treatment of Cervical Cancer

For the earliest stages of cervical cancer, surgery either open or robotic is the main stay of treatment. For later stages, radiation combined with chemo is usually the main treatment. Chemo (by itself) is often used to treat advanced cervical cancer.

 After treatment of cervical cancer 3-6 monthly follow up is also crucial to prevent the recurrence of cancer

FAQs:

1, Is cervical cancer genetic?

  No, cervical cancer is not genetic. Hence it doesn't pose any risk to you if your relative had it. 

2. Can it happen after hysterectomy (removal of uterus)?

   Yes, it can happen if you had subtotal hysterectomy which means the cervix was left. And even if you had the cervix removed sometimes some cells can be left which causes vaginal vault cancer.

3. I am not sexually active can I have it?

 Yes, you can, non-HPV LinkedIn cancer can happen 

4. Pap smear is painful?

No, it's not at all painful and it takes 5 minutes to do it in OPD 

5. Why should I get done Pap Smear?

In developed countries, 70 percent of women are getting 3-5 yearly screenings, and their death rate is 1-2 death everyday. 

In our country, less than 1 percent of women are getting screening and our death rate is 200 per day.

6. Can you prevent cervical cancer?

Cervical cancer vaccine for 9-26-year-old females and males.

Lifestyle changes-

Stop smoking, less alcohol, healthy diet, and barrier contraception (condoms).

7. What Types of HPV Vaccines Are There?

Three HPV vaccines—9-valent HPV vaccine (Gardasil 9, 9vHPV), quadrivalent HPV vaccine (Gardasil, 4vHPV), and bivalent HPV vaccine (Cervarix, 2vHPV)—have been licensed by the U.S. Food and Drug Administration (FDA) 

All are effective and safe against HPV. 

There's another vaccine called Cervavac which is quadrivalent just like Gardasil 4 and it's India made and it's proven to be safe and equally effective to foreign-made vaccines recently this year.