More than 50% of cancers among women in South India are uterine cancers.Cancer of the uterine cervix is the most common cancer that affects Indian women. This is a pity because risk of this type of cancer can be greatly decreased by adopting simple preventive measures. Awareness plays an important part in reducing its incidence.
The uterine cervix is the lower part or the “neck” of the womb. The cells here divide as per the body’s requirements. But when they begin to divide at an abnormal rate a mass of tissue forms. This need not be cancerous always. Polyps, cysts, and warts in the cervix could be benign growths.
Who is at risk?
Symptoms
Diagnosis
Staging
Treatment Options
Prevention
Who is at risk?
- Women who began having sexual intercourse in their teens.
- Women who have many sexual partners.
- Women with poor genital hygiene.
- Women whose spouses have many sexual partners.
- Women whose spouses started having sex in their teens or who have had sexual contact with women with cervical cancer.
There is no definitive evidence as to why these women are at risk. The involvement of viruses, such as the human papilloma viruses could be possible.
Some sexually transmitted HPVs cause genital warts (condylomata acuminata). In addition, scientists believe that some of these viruses may cause the growth of abnormal cells in the cervix and may play a role in cancer development.
All women who are infected with HPV don’t develop cervical cancer, and the virus is not present in all women who have cervical cancer.
The body’s ability to fight infection is also important in preventing the spread of cancer.The following will increase a woman’s susceptibility:
- Smoking
- Poor nutrition
- Infections like HIV that weaken the immune system.
Diagnosis
You will have to undergo the following tests to check if you have cancer of the uterine cervix.
Pap Smear Test
A sample of the cells is scraped gently from the cervix and examined under a microscope to detect changes.
Colposcopy and biopsies
A colposcope is a small microscope that is used to examine the cervix. Acetic acid is applied to delineate the abnormal area clearly. The doctor may choose to take a sample of cells for biopsy.
A cone biopsy may be done in which a small cone-shaped section of the cervix, enough to remove any abnormal cells, is taken for examination under a microscope. This may cause some bleeding. You will be advised not to do strenuous work for a couple of days after a cone biopsy.
Blood Tests
Blood tests may be advised to study kidney and liver function.
X Ray
Chest X-ray may be advised to detect abnormalities in the heart and lung. An IVP may be done (intravenous pyelogram) to detect the abnormalities in the kidneys or urinary system. For this test, a dye is injected and then an x ray is taken.
Treatment
Treatment depends on a number of factors like:
- Age
- General health
- The type and size of the tumour
- Appearance of the affected cells under the microscope
- Spread of cancer beyond the cervix.
Surgery
Surgery is usually the first treatment for cancer of the cervix in its early stages. The type of surgery required depends on the stage and site of the cancer. Some common surgical procedures used as part of treatment for cervical cancer are:
Cone biopsy: A cone-shaped piece of tissue is removed from the cervix. If it is microinvasive cancer, the cone biopsy may remove it totally and no further treatment may be needed.
Hysterectomy: The uterus is removed, but not the tissue next to the uterus.
Radical hysterectomy and pelvic lymph node dissection: The uterus, tissues next to the uterus, the upper part of the vagina, and lymph nodes from the pelvis are removed.
With further spread other parts near the cervical area may need to be removed.
The ovaries may be removed but are preserved in young women to prevent early menopause. If ovaries are removed the symptoms of menopause can be prevented by hormonal replacement therapy. After surgery the patient cannot become pregnant and will not have periods. It is advisable not to have sexual intercourse for at least six weeks after the operation, to allow the wound to heal properly. After a hysterectomy it is important to avoid strenuous physical activity or heavy lifting for about three months.
Radiotherapy
Radiotherapy is as effective as surgery but the side effects are greater. Radiotherapy for cancer of the cervix can be given externally by directing the high energy rays over the area of cancer or internally by inserting an applicator containing a radioactive substance into the cervix and often as a combination of the two. Radiotherapy is usually given if the cancer has spread beyond the cervix and is not curable with surgery alone. Radiotherapy may also be used after surgery to prevent recurrence.
The side effects of radiotherapy
The following are some of the common side effects of radiotherapy:
- Nausea
- Tiredness
- Diarrhoea
- A burning sensation when passing urine.
- Unfortunately, radiotherapy for cancer of the cervix affects the ovaries and it may cause menopausal side effects like:
- Hot flushes
- Dry skin
- Possible loss of concentration
- Decreased interest in sex and dryness in the vagina.
- A narrowing of the vagina, which can make sexual intercourse uncomfortable.
Hormone Replacement Treatment can help to overcome some of these problems.
Chemotherapy
Chemotherapy is the use of special anti-cancer (cytotoxic) drugs to destroy cancer cells. Chemotherapy may sometimes be used before surgery, to shrink the cancer and make the operation easier. It is sometimes given before the radiotherapy to shrink the cancer in an attempt to improve the results. Chemotherapy may also be given to patients whom cancer has spread to other parts of the body or whose disease has come back after radiotherapy.It is used in this situation to shrink and control the disease and relieve symptoms, with the hope of prolonging the quality of life.
Some side effects of chemotherapy are
- Susceptibility to infection
- Anaemia
- Nausea
- Hair loss
- Mouth ulcers.
Here are some safety measures that can help a woman avoid cancer of the cervix.
