Cervical cancer is one of the most preventable yet deadly types of cancer affecting women worldwide. Thanks to the development of regular screening methods and the HPV vaccine, early detection and prevention have become more accessible. Still, understanding the stages, causes, symptoms, diagnosis, treatment, and prevention of cervical cancer is crucial for timely action. This article provides a complete guide to cervical cancer, offering valuable insights for patients, caregivers, and healthcare professionals.
What is Cervical Cancer?
Cervical cancer begins in the cervix—the lower part of the uterus that connects to the vagina. Most cases are linked to persistent infections with high-risk types of human papillomavirus (HPV), a sexually transmitted virus. Over time, HPV can cause cervical cells to change, potentially becoming precancerous or cancerous. When detected early, cervical cancer is highly treatable, but without intervention, it can spread to other parts of the body.
What are the Different Types of Cervical Cancers?
Cervical cancer is not a single disease but rather a group of cancers that originate in the cells of the cervix, each with unique characteristics, growth patterns, and responses to treatment. These variations are determined by the type of cell in which the cancer begins and how those cells behave. Here are some types of cervical cancers:
Squamous Cell Carcinoma
Squamous cell carcinoma is the most common type of cervical cancer, accounting for about 70% to 90% of all cases. It originates in the squamous cells—thin, flat cells that line the outer part of the cervix (ectocervix). This type is closely linked to persistent infection with high-risk types of human papillomavirus (HPV), especially HPV-16 and HPV-18.
Adenocarcinoma
Adenocarcinoma arises from the glandular cells that line the cervical canal (endocervix). These cells are responsible for producing mucus. Though less common than squamous cell carcinoma, adenocarcinoma accounts for approximately 10% to 25% of cervical cancer cases. It has become increasingly prevalent in recent years. Adenocarcinomas tend to be more aggressive and are often harder to detect early through Pap testing because they originate higher up in the cervical canal. Like squamous cell carcinoma, adenocarcinomas are also linked to high-risk HPV infections.
Adenosquamous Carcinoma
Adenosquamous carcinoma, also known as mixed carcinoma, is a rarer form of cervical cancer that contains both squamous and glandular cell components. This dual nature makes it more complex in behavior and sometimes more aggressive than either squamous cell carcinoma or adenocarcinoma alone. Due to its mixed histology, diagnosis and treatment may be more challenging, and it often requires a combination of therapies. Despite its rarity, it underscores the importance of thorough pathological evaluation in cervical cancer cases.
Small Cell Carcinoma of the Cervix
Small cell carcinoma is a rare and highly aggressive type of cervical cancer classified as a neuroendocrine tumor. It represents less than 5% of all cervical cancers and tends to grow and spread much faster than other types. Small cell carcinoma often requires a more aggressive treatment approach, including a combination of chemotherapy, radiation, and sometimes surgery. Due to its rapid progression, early diagnosis is critical, though it is often detected at an advanced stage.
What are the Symptoms of Cervical Cancer?
Early stages of cervical cancer often present no symptoms. However, as the condition progresses, patients may experience certain symptoms which may require doctor’s consultation. This is why regular screenings are essential for effective cervical cancer treatment. Certain symptoms may appear, including:
- Abnormal vaginal bleeding (between periods, after intercourse, or post-menopause)
- Unusual vaginal discharge (watery, pink, or foul-smelling)
- Pelvic pain or pain during intercourse
- Pain during urination
- Increased urinary frequency or urgency
What Causes Cervical Cancer?
The primary cause of cervical cancer is persistent infection with high-risk types of human papillomavirus (HPV). HPV is extremely common, and in most cases, the body clears the infection on its own. However, in some women, the virus lingers and can cause the cervical cells to become abnormal.
Other contributing factors include:
- Genetic mutations in cervical cells
- Weakened immune system (e.g., due to HIV or immunosuppressant medications)
- Smoking (which increases risk by impairing immune response)
- Long-term use of oral contraceptives (linked with increased risk in some studies)
What are the Risk Factors of Cervical Cancer?
Several risk factors may increase the likelihood of developing cervical cancer. Understanding risk factors help individuals make informed decisions about preventive care and lifestyle modifications. Risk factors of cervical cancer include:
HPV Infection
Persistent infection with high-risk HPV strains (especially HPV 16 and 18) is the most significant risk factor.
Early Sexual Activity
Beginning sexual activity at an early age can increase the risk of HPV exposure.
Multiple Sexual Partners
More partners mean a higher chance of acquiring HPV.
Smoking
Tobacco use increases the risk of cervical and other cancers.
Weakened Immune System
Women with HIV or those undergoing immunosuppressive therapy are at higher risk.
Family History
A family history of cervical cancer may increase your risk.
Lack of Screening
Women who do not undergo regular Pap smears are at greater risk for late diagnosis.
When to Consult the Doctor for Cervical Cancer?
Timely diagnosis is essential for effective cervical cancer treatment. Get in touch with the gynaecologist in Gurgaon if you experience the following:
- Unexplained vaginal bleeding
- Pain during intercourse
- Persistent pelvic pain
- Abnormal vaginal discharge
How is Cervical Cancer Diagnosed?
Cervical cancer diagnosis typically begins with a Pap smear, which detects abnormal cells on the cervix. The gynaecologist may recommend several tests and perform certain examination which can help accurately detect the extent of abnormal cancer growth (if any) and rule out other medical condition:
HPV Testing
It helps determine the presence of high-risk HPV strains.
Colposcopy
A magnified visual inspection of the cervix using a special instrument.
Biopsy
Biopsy involves taking tissue samples for histological examination.
Imaging Tests
Imaging tests such as CT, MRI, or PET scans help determine cancer spread (staging).
Pelvic Examination Under Anesthesia
Gynaecologists may recommend this test for advanced-stage assessment.
What are the Treatment Methods for Cervical Cancer?
The treatment for cervical cancer depends on the individual, taking into account factors such as the stage of the cancer, the size of the tumor, the patient’s age, and whether they wish to preserve fertility. The primary goal is to eliminate cancer while minimizing side effects and preserving quality of life. Below are the main treatment methods used for cervical cancer:
Surgical intervention
Surgery is often the first line of treatment for early-stage cervical cancer and involves removing the tumor or affected tissues. The choice of surgical procedure depends on the cancer’s stage and the patient’s preferences.
Conization
This procedure involves the removal of abnormal tissue from the cervix, often when precancerous changes are found. It helps preserve the cervix and is typically used for early-stage cancers or precancers.
Hysterectomy
A more extensive surgery, where the uterus and cervix are removed. This is often recommended for women with more advanced stages of cervical cancer, or if fertility preservation is not a concern.
Trachelectomy
For patients who wish to preserve fertility, a trachelectomy is a fertility-sparing surgery that removes only the cervix while leaving the uterus intact. This is typically performed for early-stage cancers in younger women who have not yet had children.
Radiation Therapy
Radiation therapy is a common treatment for cervical cancer, especially in cases where the cancer is localized or has spread to nearby tissues. It uses high-energy rays to kill cancer cells or shrink tumors. Radiation may be used alone or in combination with chemotherapy, depending on the cancer’s stage and the patient’s specific needs. External beam radiation is commonly used, but internal radiation (also known as brachytherapy) may be employed for more localized tumors.
Chemotherapy
Chemotherapy involves the use of drugs to destroy cancer cells throughout the body. It is often used for more advanced stages of cervical cancer or when the cancer has spread beyond the cervix. Chemotherapy can be given alone or in combination with radiation therapy (chemoradiation) to increase the effectiveness of treatment. Common chemotherapy drugs for cervical cancer include cisplatin, carboplatin, and paclitaxel. Side effects of chemotherapy vary depending on the drugs used but may include nausea, hair loss, and fatigue.
Targeted Therapy
Targeted therapy uses drugs that specifically target cancer cells without harming normal cells. These drugs are designed to block the growth of cancer cells by interfering with specific molecules or pathways that the cancer cells rely on. Targeted therapy for cervical cancer targets the blood vessels that supply the tumor, effectively starving it of nutrients. Targeted therapies are typically used for advanced or recurrent cervical cancers.
Immunotherapy
Immunotherapy is a newer treatment approach that boosts the body’s immune system to fight cancer. This treatment is especially useful for patients with advanced or recurrent cervical cancer that has not responded to traditional therapies like chemotherapy or radiation. Immunotherapy works by stimulating the immune system to recognize and attack cancer cells more effectively.
Treatment for cervical cancer can be either curative or palliative depending on the stage and how advanced the cancer is. Early-stage cancers can often be cured with surgery or radiation, while more advanced cases may require a combination of treatments for better control or symptom management.
How can I Prevent Cervical Cancer?
Cervical cancer is one of the most preventable forms of cancer, largely due to the availability of effective screening methods and the human papillomavirus (HPV) vaccine. Prevention focuses on reducing risk factors, catching precancerous changes early, and promoting a healthy immune response. Here are several proven ways to prevent cervical cancer:
Get Vaccinated Against HPV
The most effective way to prevent cervical cancer is by receiving the HPV vaccine, which protects against the high-risk HPV strains most commonly associated with cervical cancer (especially HPV-16 and HPV-18).
Who should get vaccinated?
- The vaccine is recommended for girls and boys aged 11–12, but it can be given as early as age 9.
- Catch-up vaccination is recommended up to age 26 for those who missed it earlier.
- Adults aged 27–45 may benefit in certain cases and should consult with a healthcare provider.
Undergo Regular Cervical Screening
Routine screening can detect precancerous changes before they develop into cancer.
- Pap smear: Detects abnormal changes in cervical cells.
- HPV test: Identifies high-risk HPV infections.
Screening guidelines:
- Women aged 21–29 should have a Pap smear every 3 years.
- Women aged 30–65 should have a Pap smear and HPV test every 5 years, or a Pap test alone every 3 years.
Regular screening is essential even if you’ve been vaccinated, as the vaccine doesn’t protect against all cancer-causing HPV strains.
Practice Safe Sex
Since HPV is primarily transmitted through sexual contact, practicing safe sex can significantly reduce your risk.
- Limit the number of sexual partners.
- Use condoms, which offer partial protection against HPV and other sexually transmitted infections (STIs).
- Open and honest communication with partners about sexual health is also key.
Quit Smoking
Smoking has been shown to weaken the immune system’s ability to fight HPV infections and increases the risk of cervical cancer. Quitting smoking can significantly lower your chances of developing cervical or other cancers.
Maintain a Healthy Immune System
A strong immune system helps clear HPV infections more effectively. You can support your immune health by:
- Eating a balanced, nutrient-rich diet
- Getting regular exercise
- Managing stress
- Getting adequate sleep
- Avoiding excessive alcohol and substance use
Follow Up on Abnormal Test Results
If a Pap smear or HPV test returns abnormal results, follow your doctor’s recommendations for further testing or treatment. Many precancerous changes can be treated easily and effectively if caught early.
Complications of Untreated Cervical Cancer
Cervical cancer treatment if delayed, or remains undiagnosed can lead to serious complications:
- Spread to Nearby Organs: Bladder, rectum, or beyond
- Chronic Pain: Especially pelvic and back pain due to nerve involvement
- Kidney Failure: From obstruction of urinary pathways
- Severe Vaginal Bleeding:
- Fistula Formation: Abnormal connections between organs (e.g., bladder and vagina)
- Emotional and Psychological Impact: Including anxiety, depression, and body image issues
- Infertility: Due to surgical or radiation effects
Frequently Asked Questions
Can men get HPV and transmit it?
Yes, men can carry and transmit HPV even if they show no symptoms.
Can cervical cancer come back after treatment?
Yes, recurrence is possible; regular follow-ups are crucial.
Is cervical cancer hereditary?
It’s not directly inherited, but family history can increase your risk.
Can you get cervical cancer after a hysterectomy?
If the cervix was not removed, there is still a small risk.
Is cervical cancer painful?
Pain typically occurs in advanced stages, particularly in the pelvis or back.
Are there any natural remedies for cervical cancer?
There’s no proven natural cure. Complementary therapies should only be used alongside medical treatment.
