Cervical cancer is one of the cancers affecting women and claims the lives of more than 270,000 women annually. It is a great health concern since it is the second most common cancer among women.
At All Women’s Care in Los Angeles, we provide screening and treatment services to women of all ages in dealing with the disease. Here is information on cervical cancer, the risk factors, causes, prevention, and treatment.
Overview and Causes of Cervical Cancer
Cancer that begins in the cervical tissues is known as cervical cancer. More than 500,000 are diagnosed with cervical cancer every year worldwide, with about 13,000 from the US. More than four thousand women succumb to cervical cancer every year in the US. Cervical cancer can occur in two main forms, including:
- Squamous cell carcinoma is common cancer, occurring in up to 90% of the cases. Cancer develops on the exocervix or the cells lining the outer cervix.
- Adenocarcinoma is the second common type of cervical cancer which begins in the glandular cells of the cervical canal (the cells that produce mucus)
You can develop both cancers as well.
The clear cause of cervical cancer has yet to be determined. However, HPV and genetics play a role in its development.
Cervical cancer develops from the HPV or the Human Papilloma Virus. HPV 16 and 18 are the strains commonly associated with cervical cancer.
When the virus enters the body (mostly through skin-to-skin contact with an infected area), the immune system works to eliminate it.
However, in some people, the virus is never fully eliminated from the body. In such cases, the virus alters the cells of the cervix leading to abnormal growth.
The cells of the body have DNA components that dictate the activities of the cell, including development, growth, and death. This cycle allows for the development of healthy cells.
However, HPV has certain proteins that alter the function of these cells, either preventing the growth of healthy cells or preventing the death of cells.
HPV is not the only cause of cervical cancer. Some of these cancers occur due to a genetic mutation. These mutations alter the normal cycle of cell formation, growth, and death. Most of these genetic mutations can be inherited or developed over time.
When the cells grow abnormally, they can eventually become cancerous. In case that happens, they can develop or metastasize to surrounding cells or distant parts of the body.
Risk Factors
Gynecologic oncologists have identified the common factors that increase the risk of a woman developing cervical cancer.
Having these risk factors does not automatically mean that you will develop cervical cancer. Understanding the common risk factors can help you avoid the avoidable ones and take preventative measures to reduce your risk of developing cervical cancer.
Some of the risk factors include:
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Developing an HPV infection
HPV consists of more than 150 viruses, some of which can cause infections such as warts. These infections can occur on the mouth, throat, genitals, and anus.
HPV viruses can either be low risk or high risk. Low-risk viruses are responsible for illnesses such as warts. High-risk types, on the other hand, are responsible for cancers such as those of the cervix, vagina, vulva, mouth, anus, throat, and penile cancer.
HPV does not have a cure, but you can have the HPV vaccine to prevent HPV infections. You can also have the doctor evaluate the strain of HPV to determine whether it is a high-risk one.
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Sexual Activity
Cervical cancer is likely to affect women who:
- Became sexually active at a younger age, usually before 18 years
- Have many sexual partners
- Have one partner who has several partners or has an HPV infection
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Smoking
Smoking is a risk factor for many types of cancers. When you smoke, you are exposing yourself (and others) to harmful carcinogenic substances. These substances will go through your lungs and to the bloodstream and other parts of the body, including the cervix.
Women who smoke have twice the risk of developing cervical cancer compared to non-smoking women. Substances from smoking can affect the DNA of the cervical cells, increasing the likelihood that you will develop cervical cancer.
Smoking also reduces your immune response, exposing you to more illnesses, including cervical cancer. When you have a weak immune system, you are also less likely to fight HPV infections.
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A weak immune system
A healthy immune system has better chances of fighting against cancerous cells. However, some infections, such as HIV, weaken your immune system and expose you to a greater risk of HPV infections.
The risk of developing cervical cancer also increases if you are using drugs to suppress the immune system. Such drugs are administered to people with autoimmune disorders whereby your body attacks healthy cells.
Having an organ transplant also reduces the strength of your immune system and increases the risk of developing additional diseases.
Precancerous cells develop faster in people with a weakened immune system compared to healthy individuals.
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Chlamydia
Chlamydia is a sexually transmitted bacterial infection that affects the reproductive system. Past and present chlamydia infections make it possible for HPV to grow on the cervix, thus increasing the risk of developing cervical cancer.
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Birth control pills
Long-term use of oral contraceptives gradually increases the risk of developing cervical cancer. However, the risk also decreases when the woman stops taking these pills. Therefore, you must evaluate, with the help of your doctor, whether the risk of using these pills is greater than the benefits presented.
You can lower the risk of developing cervical cancer by using an IUD. Intrauterine devices have a protective effect that protects against cervical cancer, even when used for less than a year.
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Economic status
While cancer affects people of different economic status, those in middle and low-income groups have reduced resources to dedicate to regular screenings. This makes it harder for cancer to be detected early, leading to a fatality rate of 85% from cervical cancer across the globe.
People of low economic means are also less likely to access a healthy diet, particularly with high fruit and vegetable content. Such foods provide a boost to the immune system and could help fight cervical cancer cells.
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Family History of Cervical Cancer
Cervical cancer might run in some families, meaning that the females in that family have greater odds of developing the disease.
Scientists link the risk of the disease being in the family due to inherited genetic factors. If your family has a lower ability to fight HPV, then you are at an increased risk of developing cervical cancer.
Prevention of Cervical Cancer
Cervical cancer develops over time, making it possible to prevent it. The World Health Organization classifies preventive measures as primary, secondary, and tertiary.
Primary prevention initiatives seek to provide vaccination against HPV. The HPV vaccine is given to both boys and girls to prevent HPV infections. Two approved HPV vaccines are administered to girls aged between 9 and 13 years.
The effectiveness of the vaccine increases when the person does not have previous exposure to the virus. It is given in three shots administered over six months.
In addition to providing the vaccine, WHO recommends providing age and culture appropriate sexual education, promotion of the use and provision of condoms for safe sex. Male circumcision also helps reduce the risk of HPV transition from males to females.
Secondary initiatives target women who are above thirty years but below 45-49 years. These initiatives involve regular screening and treatment as required.
Regular screening is the leading method of identifying abnormalities in the tissues of the cervix. Screenings can help identify precancerous cells, which are usually without symptoms.
Your doctor can use one of two screening methods of screening, including:
- Pap smear
- Testing for high-risk HPV types
Vaccination against HPV should not rule out the need for regular cancer screenings.
Tertiary cervical cancer prevention initiatives apply to women who have received a positive diagnosis of cervical cancer.
The initiative includes providing treatment services based on the needs of the woman. Treatment options will include surgery, radiation, or chemotherapy.
The doctor will also encourage you to continue with treatment to increase the chances of recovery. At this stage, doctors will also provide palliative care for patients who have exhausted the treatment options to relieve them from pain and suffering due to the illness.
Other prevention measures include:
- Practicing safe sex including using a condom and reducing your sexual partners to decrease your exposure to HPV
- Stop smoking (you can ask your doctor for help in quitting smoking)
Symptoms of Cervical Cancer
Primary and secondary prevention measures are the best at reducing the risks of developing cervical cancer. However, if you do get cancer, early detection can help in the prevention of its development and spread.
Cervical cancer in its early stages does not present any symptom; therefore, you must go for regular screenings and apply other preventive measures.
At its advanced stages, cervical cancer will present symptoms such as:
- Abnormal vaginal bleeding, including bleeding:
- Between periods
- After sexual intercourse
- After a pelvic exam
- After menopause
- After douching
- Pelvic pain that is unrelated to your menstrual cycle, for example, during intercourse.
- An unusual discharge that is either watery, thick, and with a foul odor
- An increased urge to urinate
- Pain when urinating
While these symptoms might be a sign of another condition, it is best to have cervical cancer ruled out.
If the doctor finds cancerous cells on your cervix, he or she can begin the treatment process.
Diagnosis and Treatment
The diagnosis of cervical cancer often begins with the results of a screening test. For instance, if the doctor notices some abnormalities, he or she will begin a thorough investigation to determine whether you have cancerous cells.
He or she will conduct a colposcopy to examine the tissues of your cervix for abnormal cells. During the examination, the doctor will collect a sample of your cervical tissue using several methods such as:
- Punch biopsy
- Endocervical curettage
- Electrified wire loop (conducted under local anesthesia)
- Cone biopsy
If these tests reveal that you have cervical cancer, the doctor will begin the staging test. Staging is the process where the doctor determines the extent of the spread of cancer cells.
Gynecologic oncologists outline stage cancers, from stage I to IV, with stage IV being the most advanced form. The stage of cancer will determine how serious your condition is, as well as the best treatment method.
Some of the determinants of the stage of cancer include:
- The extent to which cancer has grown into the cervix
- Whether cancer has extended to the nearby structures
- Whether cancer has reached the nearby lymph nodes and distant organs
Accurate staging of cancer will rely on exams such as imaging tests and a visual examination (using special scopes) of your bladder and rectum.
Once the doctor stages cancer, he or she will discuss the treatment options available, their benefits, shortcomings, and your outlook. Some of the treatment options include:
- Surgery
- Chemotherapy
- Radiation
Surgery is usually the most effective treatment for early-stage cancers and solid tumors.
Your doctor can apply different surgical procedures, including cryosurgery or laser surgery, to treat precancerous or early-stage cervical cancer. Surgery works against cancer by:
- Debulking the tumor to improve the efficiency of other treatments
- Removing the whole tumor
- Easing the pain from the cancer
Your doctor will consider factors such as whether you intend to become pregnant in the future. The extent of tissue removed will also depend on the extent and size of cancer.
The dentist might cut cancer out and leave the cervix intact. Such a procedure is possible through a cone biopsy. Your doctor will cut out a cone-shaped piece of the affected cervical tissue.
The doctor might also remove your entire cervix and some uterine tissue. A cone biopsy and trachelectomy leave your uterus intact, thus making it possible for you to get pregnant in the future. However, this treatment option is only available with early-stage cervical cancer.
Another common surgical procedure for treating cervical cancer is hysterectomy. Hysterectomy is the removal of the cervix, uterus, some parts of the vagina and the surrounding lymph nodes. It is an ideal treatment option when you want to prevent a recurrence and do not intend to get pregnant in the future.
A hysterectomy can be an open or minimally invasive procedure. Open hysterectomies are more effective but require longer recovery time. You can talk with your doctor to weigh the benefits and risks of each procedure based on your condition to determine the surgery option to take.
Chemotherapy is another cancer treatment, which targets fast-growing cancer cells using chemicals (drugs). It works by:
- Curing the cancer
- Reducing the chances of recurrence of the cancer
- Slowing the growth of the cancer
- Slowing the growth of cancer
- Shrinking cancer to reduce pain and ease other cancer symptoms
Your doctor can recommend chemotherapy as the only treatment option or combine it with options such as surgery or radiation therapy. Chemotherapy can play the following roles when combined with other treatment options:
- Reducing the tumor size in readiness for radiotherapy or surgery
- Improving the effectiveness of other treatment options
- Destroying remnant cancer cells after radiation therapy or surgery (adjuvant chemotherapy)
- Killing cancer cells that have spread to other organs or have returned
Your doctor will give chemotherapy in several ways, including:
- Orally as pills, liquids or capsules
- Intravenously
- Through injections
Chemotherapy can lead to side effects, such as hair loss and fatigue. However, these effects will go away once you finish treatment.
The duration of chemotherapy treatment will depend on several factors, including:
- The stage of cancer
- The goals of chemotherapy (to control the growth, cure or ease the symptoms of cancer)
- The type of chemotherapy
- The response of your body
Radiation therapy is another treatment option for cervical cancer. It works by exposing the cancer cells to high doses of radiation. Such high doses of radiation damage the DNA of cancer cells, thus slowing down their growth or killing them.
Radiation therapy is a slow treatment method. The process of DNA damage takes days to weeks, and death can occur over several months.
Your doctor can choose between two types of radiation, including internal or external beam radiation therapy. The choice of the type of therapy to use will depend on factors such as:
- The size of the tumor
- The nearness of cancer to healthy cells that are sensitive to radiation
- Your health
- Medical history
- Your age
- Medical conditions you have
Radiation can be combined with other treatment options such as surgery and chemotherapy. When used with surgery, it serves the following roles:
- To shrink the cancer cells before surgery
- During surgery to protect the surrounding cells
- To kill remaining cancer cells after surgery
Your doctor could also apply targeted therapy to treat cervical cancer. Targeted therapy takes advantage of weaknesses in the cancer cells to destroy them or reduce their growth.
Targeted therapy uses either small-molecule drugs or monoclonal antibodies. Small molecule drugs are used inside the cell, while monoclonal antibodies attach to the cancer cells and mark them so that they are more likely to be destroyed. Some cause these cells to self-destruct, while others contain substances that are toxic to the cancer cells.
Targeted therapy requires that your doctor examine the cancer cells to determine the right medication to use. This type of treatment works as a cancer treatment by:
- Improving the immune system’s ability to fight the cancer cells
- Stopping the growth of cancerous cells
- Stopping cancer cells from growing blood vessels to contain the growth of the tumor
- Delivering toxic substances to the tumor to kill it
- Killing cancer cells
- Preventing cancerous cells from accessing the hormones they need to grow thus leading to their death
Targeted therapy, however, presents certain risks such as:
- Development of resistance by the cancer cells
- Problems with developing targets due to differences in the structure and function of the target
Another cervical cancer treatment involves helping your immune system fight cancer through immunotherapy. Immunotherapy is a form of biological therapy, which improves the ability of the immune system to detect and fight cancerous cells.
When a tumor develops, the immune system may destroy some of these abnormal cells. However, cancer cells can alter their structure to make them undetectable, turn off immune cells, or change the surrounding normal cells such that they affect the immune system.
Immunotherapy uses several treatment types, including:
- Immune checkpoints inhibitors to increase the strength of the immune response against cancer cells
- T-cell transfer therapy by selecting the immune cells on the tumor that have the greatest effect on cancer. These cells will be separated in the laboratory then put into the body through your vein.
- Monoclonal antibodies which mark cancer cells for destruction
- Treatment vaccines
- Immune system modulators
Cancers between stage II b and stage IV can lead to significant pain to the patient. Palliative care helps ease the pain and improve the quality of life of the patient.
You can ask your doctor whether the facility offers palliative care or consult a care facility that offers these services.
Supportive or palliative care works alongside curative treatment and differs from hospice care. The latter is care offered to patients of terminal illnesses to improve the quality of their final months. Support care, on the other hand, helps you deal with the symptoms of cancer such as pain and nausea using additional care such as meditation, yoga, and acupuncture, among others.
Find Cervical Cancer Services Near Me
Cervical cancer is one of the leading cancers among women, but it is preventable and curable, especially if detected early. You can take proactive steps in the prevention of cervical cancer by practicing safe sex, maintaining a healthy diet, and getting regular cancer screenings.
At All Women's Care, we provide a wide range of cervical cancer services, including screening, treatment, and palliative care. Our services aim at early detection and intervention to increase the chances of survival and cure.
We encourage women to contact a gynecologist as soon as you notice unusual symptoms such as abnormal bleeding and pelvic pain.
If you are looking for a dedicated cervical cancer care team in Los Angeles, contact us at 213-250-9461 to book your appointment
