PD MD Heiko B. G. Franz
Cancer of uterine cervix (cervical carcinoma) is a common cancerous female disease. It’s on the fifth place in the list of cancerous diseases, because 7% of cancerous tumors are cervical carcinomas.
Statistics shows that this disease is typical of women from 35 to 50 years old. However, recently, tumors are being diagnosed in women older than 20. This type of disease is more widespread in Africa and Latin America, while it occurs twice less often in Eurasia.
First, we should understand the physiology of female body to understand what cancer of uterine cervix is. Cervix is the lower part of the uterine where so-called cervical canal is situated. Its upper end goes to the uterus, and the lower – to the vagina.
There’s one peculiarity of female body contributing to development of this disease. The thing is that there’s a special zone in the external gorge where multi-layer vaginal epithelium links up with cervical epithelium of uterus cervix. This zone is vulnerable, and malignant cells tend to develop there.
According to doctors, HPV, or human papilloma virus is the key factor of cancer development in female body. 95% of patients with cervical carcinoma had this virus revealed. The most dangerous types of human papilloma virus are 16 and 18. They tend to trigger development of cancerous tumors more often, and they are revealed in 70% of women with cancer of uterine cervix.
Since this virus is sexually transmitted, cervical cancer is typical of women who often change partners and disregard contraception. Sometimes barrier contraception (condoms) cannot prevent transmission of the disease. It’s proved that human papilloma virus in female body can increase the risk of cancer of uterine cervix ten times! However, presence of this virus does not necessarily mean that cancer will develop.
Together with human papilloma virus, there can be other factors contributing to development of tumor in uterine cervix:
Besides, heredity plays crucial role in development of cervical cancer. Women whose relatives suffered from similar oncologic diseases are under 3 times higher risk of having cancer of uterine cervix.
Cancer of uterine cervix is a dangerous disease that may either progress slowly, or, vice versa, be very aggressive and quick.
At the first stages, cancer develops without symptoms in 40% of women, which is bad, because it may actually be cured. Other 60% of women experience symptoms but tend to ignore them and don’t try to find the cause of feeling unwell. This is why the diseases usually progresses till the stage when treatment won’t solve the problem.
At early stages of carcinoma, women can develop the following symptoms:
When the disease progresses, cancer of uterine cervix becomes pronounced and is accompanied with other more pronounced symptoms like:
Depending on the type of affected epithelium, there can be two forms of cancerous tumors:
Also, depending on the intensity of cancerous tumor growth, cancer of uterine cervix can be divided into the following types:
This kind of cancer can be developing during years and even decades. Prior to formation of cancerous tumor, changes on the surface of cervix take place: these are called “dysplasia of uterine cervix”. If dysplasia is not treated, a woman may need to treat cancer in a few years, because benign cells can turn into malignant ones down the road.
As it has been mentioned, early detection of cancer of uterine cervix gives chance to live a long normal life. However, it’s almost impossible to avoid serious complications after the disease. The happiest end in such case is removal of cervical canal. Of course, a woman cannot have children after that. The same results are faced when the uterus, ovaries and appendages are cut out. If vagina is removed, a woman cannot have sex anymore. Cancer of uterine cervix affects reproductive system in young women, and the chance of having a child after treating the malaise is minor.
Diagnostic procedures for cancer of uterine cervix can be divided into several stages. Initially, a gynecologist performs a visual examination in a gynecological examination chair. After that, a patient needs to have laboratory tests. These include general research like general and biochemical blood analyses, and specific tests, including testing for human papilloma virus, bacterioscopical and bacteriological test of vaginal discharge, etc.
To confirm the diagnosis, doctors may also use such test methods as X-ray, renal nephrography, colposcopy (minimally invasive examination of organs with the help of a tiny camera), biopsy of uterine cervix tissues, and ultrasound of pelvic organs, as well as computer tomography and magnetic resonance tomography.
There’s also a Pap smear test (Papanicolaou smear) that allows revealing carcinoma of cervical walls at early stages. The precision of this method reaches 90%, and 9 out of 10 women can reveal the disease when it can be easily cured. All women from 25 to 50 years old are recommended to go through this test at least once in three years.
At its early stages, the disease is easily treated, and surgical removal of tumor is considered to be the best method. Doctors try to perform the surgery so that to remove the tumor so that to save reproductive function of a woman. If the tumor is revealed at the stage when it started spreading metastases (Stages III and IV), doctors have to remove the uterus, fallopian tubes, the ovaries and sometimes – vagina.
Surgical treatment can be performed several ways. It can be hyperthermia, cryodestruction, ultrasound, laser therapy or traditional removal of surgery with a scalpel. The choice depends on patient’s age, overall health, organs that should be removed, and many other factors.
After the surgery, radiation therapy can be applied, e.g. tumor treatment with radiation that decreased the amount of malignant cells and inhibits progression of tumor. It also helps to shrink the tumor.
Besides, a patient has to go through a chemotherapy course after the surgery. As a rule, this kind of treatment implies intake of anticancer agents that are injected intravenously. Chemotherapy is typically administered for patients in postmenopause period, because this kind of treatment affects both cancerous and healthy cells, being very harmful for overall health. It also affects general well-being and has a wide range of unpleasant side effects.
Vaccination against human papilloma virus is the key method of prophylactics for the cancer of uterine cervix. Gardasil vaccine prevents contamination with four types of human papilloma virus, including types 16 and 18 that provoke 70% of all cervical carcinomas. Specialists recommend performing vaccination of 11-13-year-old girls. A woman up to 26 years old can be vaccinated, but only in case when she does not have such types of viruses in her body.
Besides, to prevent development of cancer of uterine cervix, a woman should necessarily treat diseases of her female genitals. First and foremost, these include dysplasia of uterine cervix. In most cases, it takes 10-15 years to have precancerous state turn into the real cancer. It means that theoretically, every woman can avoid developing a cancerous tumor.
Of course, a woman should not forget that condom is the most reliable method of contraception. Use of barrier contraception means helps to protect body from human papilloma virus and, as the result, from development of cancerous diseases.