Cervical Tumor Cancer Of The Cervix

Overview, Causes, & Risk Factors

The cervix is the opening between the vagina and the uterus.Cancer of the cervix is a malignant tumor on the cervix. Precancerous changesin the cells on the top layer of the cervix are an early sign that cervicalcancer may develop.

What is going on in the body?

Cervical cancer is fairly common cancer of the reproductive system that occursmost often among women aged 40 to 55.

Even though the cervix is located within a woman’svagina, its cells act very much like skin cells. These cells are exposed totoxins, viruses, and bacteria that may cause abnormal changes called cervical dysplasia.

Each stage of cervical dysplasia is judged by thethickness of the layer of abnormal cells. The earliest change that can be seenwith a microscope is called mild dysplasia. If not treated, these precancerouschanges may become moderate and then severe. The fourth, most severe, stage ofdysplasia is called carcinoma insitu. After this occurs, cancer cells may invade deeper layers ofthe cervix or spread to nearby sites. At that point, a woman has what is calledinvasive cervical cancer.

What are the causes and risks of the disease?

No one knows exactly what causes cancer of the cervix. Certain health problems,lifestyle choices, and other factors may increase a woman’s risk for developingit, including the following:

  • having had a sexuallytransmitted disease. Both Chlamydia trachomatis\. Sexually transmitted disease refers to any contagious disease transmitted from one person to another during sexual contact. chlamydia and humanpapilloma virus infections are strongly associated with cancer ofthe cervix.
  • having had an abnormal Papsmear. A Pap smear is an examination, under a microscope, of cellsscraped from the cervix.
  • becoming sexually active before age 18
  • having had more than 3 sexual partners
  • not using condoms with new sexual partners
  • having had cancer of the vagina or vulva
  • having a sexual partner whose previous partner had cancer of the cervixor cervical dysplasia, acondition of abnormal cells that precedes cancer
  • having a sexual partner who has or has had cancer of the penis
  • smoking
  • having a weakened immune system, for example, as a result of HIV or another immunodeficiency disorder
  • being the daughter of a woman who took DES, or diethylstilbestrol, during pregnancy
  • a history of cancer of the cervix in a woman’s sister or mother
  • Symptoms & Signs

    What are the signs and symptoms of the disease?

    Cervical cancer that is found early usually causes no symptoms. Once the cancerinvades surrounding tissues, the woman may have vague symptoms such as the following:

  • vaginal bleeding betweenperiods
  • menstrual bleeding that is longer or heavier than usual
  • bleeding after intercourse, douching, or a Pap smear
  • vaginal bleeding after menopause, the time in a woman’s life when her menstruation ends
  • Symptoms of more advanced cancer of the cervix include the following:

  • loss of appetite
  • weight loss
  • fatigue
  • nonspecific backpain
  • leg pain
  • inability to control urination or bowel movements
  • Diagnosis & Tests

    How is the disease diagnosed?

    Diagnosis of cancer of the cervix is done with a pelvic examination that includes a Pap smear. During a pelvic exam,the cervix, vagina, and vulva are checked for signs of changes. To do a Papsmear, a provider uses a small spatula and a brush to gently scrape cells fromthe cervix. These cells are sent to a lab for testing.

    If abnormalities are found, the Pap smear may berepeated in 3 months. Alternately, the healthcare provider may do the following additionaltests:

  • colposcopy, a procedure in which a special microscope allows theprovider to closely examine the cervix, vagina, and vulva
  • cervical biopsy, a procedure in which small tissue samples aretaken from the cervix. This procedure is generally done in a healthcareprovider’s office.
  • cold cone biopsy, aprocedure in which a large tissue sample is taken from the cervix. Thisprocedure is normally done in an operating room under general anesthesia. The cone biopsy often removes all of thecancerous tissue.
  • Tissue that is removed for a cervical biopsy is examined under a microscopeand used to determine the stage of the cancer. Following are the stages of cervical cancer:

  • stage 1, in which the tumor is in the uterus and cervix only
  • stage 2, in which the tumor has spread to the vagina
  • stage 3, in which the tumor has invaded the side wall of the pelvis
  • stage 4, in which the tumor has spread to the rectum, bladder, and distantorgans
  • Prevention & Expectations

    What can be done to prevent the disease?

    Many times, cancer of the cervix can be avoided by early detection andtreatment of cervicaldysplasia. Cervical dysplasia can be detected by a pelvic examination that includes aPap smear. Women shouldstart to have Pap smears and pelvic exams when they reach the age of 16 or assoon as they become sexually active.

    A woman can lower her risk for getting cervical cancer by taking the following steps:

  • quitting smoking
  • waiting to have intercourse until age 18 to 20
  • having only a few sexual partners in a lifetime
  • using latex condoms and practicing safer sex with each sexual encounter
  • A woman should ask her sexual partners about their sexual histories,so that those who seem to be high-risk can be avoided.

    Identification of early warning signs of cervical canceris also important. A woman should see her healthcare provider and may need tobe treated if she has any of the following signs or symptoms:

  • vaginal discharge that does not seem normal
  • vaginal bleeding betweenperiods
  • bleeding with intercourse
  • painful intercourse, known as dyspareunia
  • What are the long-term effects of the disease?

    If abnormal cells are found early and treated, it may be possible to avoidremoving the uterus so that a woman can still have children. Unfortunately,once cervical cancer occurs, more aggressive measures may be needed. If thecancer is found and treated early, there is an excellent chance of cure. Ifleft untreated, it may spread to nearby areas or more distant sites in thebody.

    What are the risks to others?

    Cervical cancer is not contagious and does not pose a risk to others.Sexually transmitteddiseasesassociated with cervical cancer, such as Chlamydia trachomatis\. Sexually transmitted disease refers to any contagious disease transmitted from one person to another during sexual contact. chlamydia and human papilloma virus, are contagious.

    Treatment & Monitoring

    What are the treatments for the disease?

    If cancer of the cervix is diagnosed early, the cancer may be removedsurgically. Options for surgical removal include the following:

  • cone biopsy, aprocedure in which a portion of the center of the cervix is removed. Thisprocedure is also used to diagnose the cancer. During the diagnostic cold conebiopsy, the cancer is often completely removed.
  • hysterectomy, or surgical removal of the uterus and cervix
  • Cancer is more likely to come back in a woman treated with cone biopsy.

    If the cancer has invaded deeper layers of the cervix and has spread to theuterus, more extensive treatment may be involved, such as the following:

  • modified radical hysterectomy. During this type of surgery, the uterus,cervix, upper vagina, and surrounding tissue are removed. Depending on theextent of the cancer and a woman’s age, the ovaries may be left in place.
  • radiation therapy, which is sometimes used before or after surgeryto shrink the tumor cells further
  • radiation therapyand chemotherapytogether. Sometimes a woman isn’t a good candidate for surgery, because of herage or other medical conditions. In this instance, radiation therapy may be usedalone or with chemotherapy.
  • biological responsemodifiers, BRMs, which are substances that help to help strengthenthe immune system’s fight against cancer or infection. Interferon is a BRM thatis sometimes used in treatment of cervical cancer, often in combination withchemotherapy.
  • What are the side effects of the treatments?

    Possible side effects and complications of hysterectomy are as follows:

  • inability to control urination
  • sexual problems
  • psychological stress
  • swelling in thelegs
  • bleeding that requires a bloodtransfusion
  • allergic reaction toanesthesia
  • Chemotherapy and radiation therapy may cause a wide variety of side effects,including hair loss,fatigue, decreasedabilityto fight infections, and nausea.

    Biologicalresponse modifiers such as interferon may cause flu-like symptoms,including body aches, nausea, and fatigue.

    What happens after treatment for the disease?

    The outcome for a woman with cervical cancer depends on many factors, such as the following:

  • the woman’s overall health
  • the woman’s age when she was first diagnosed
  • the type and growth of specific cancer cells
  • how far the disease has spread
  • the skill of the surgeon
  • After treatment, thechance that a woman will live for 5 more years depends on the stage of thecancer. Survival rates for the various stages are as follows:

  • stage 1, 80% to 85%
  • stage 2, 50% to 65%
  • stage 3, 30% to 40%
  • stage 4, less than 12%
  • How is the disease monitored?

    After treatment, a woman will be closely followed for signs that the cancer ofthe cervix has come back.

  • A pelvic exam and Pap smear, if the cervix is intact, will be done every 3months for at least 2 years and then every 6 months after that.
  • Because cancer tends to come back at the same spot or spread to thelungs and liver, chest X-rays and liver function tests aredone once a year.
  • If a woman has had a hysterectomy, the top of the vagina is cuffed, orclosed. Colposcopy maybe done at follow-up visits to examine the vaginal cuff.
  • Any new or worsening symptoms should be reported tothe healthcare provider.

    Article type: xmedgeneral