Cervical Cancer is a cancer of the cervix, the lower part of the uterus which connects the uterus with the vagina. Cervical cancers develops over a long period, 15-20 years, often with no specific symptoms. This is what makes this cancer particularly dangerous as by the time the symptoms are visible, the cancer has progressed to an advanced stage with treatment becoming difficult and sometimes ending up completely untreatable. It is the second most common cancer for women in India and also the second most in number of deaths it causes. What should be noted is that Cervical Cancers is largely preventable via vaccination and regular checkups. Just how serious the problem is can be gauged by the fact that in the latest meeting of QUAD heads of state, a geopolitical meeting held in Washington, Prime Minister Narendra Modi committed to delivering 40 million doses of vaccines in the Asia-Pacific region. If something is bothering the heads of state of the largest and most powerful countries then it’s worth knowing more about.

Oh, and yes, it’s a myth that cervical cancer happens only to women. It can happen to men too. Read on to understand more.

 

How does Cervical Cancer develop in our bodies?

Cervical Cancer is one of the few cancers whose primary cause is a virus. HPV (human papillomavirus) spreads mainly due to skin-to-skin contact and sexual contact. This virus is something that most adults who have had sex will have in their bodies and is usually neutralised. However, some of the strains of HPV survive in the body and start damaging the DNA of cells in Cervix. Before cancer appears in the uterus, abnormal cells start appearing on the lining of the cervix. This stage is called dysplasia. These cells are graded from 1 to 3 depending on how much of cervical tissue has been impacted. Over time if these cells are not removed or destroyed, they turn cancerous.

There are mainly two types of Cervical cancer:
i. 90% of cervical cancers are squamous cell carcinomas which develop in the exocervix i.e. outer part of the cervix.
ii. The cancer which develops on the inside of the cervix, on the glandular cells lining of the cervix is called adenocarcinomas.

Symptoms of Cervical Cancer

Cervical Cancer develops slowly. This is a double-edged sword. On the one hand, it means that the chances of successful treatment are high if the cancer is detected in the early stage, but the absence of symptoms in the early stages also means that it goes undetected for a long time. This is one of the reasons why Cervical Cancer is also called silent killer. Some of the symptoms of Cervical Cancer are:
i. Abnormal bleeding or discharge from the vagina
ii. Chronic Pain in the pelvic region
iii. Pain during sex
iv. Problems during urinating or bowel movement.
v. Blood in urine

Please note that these symptoms can have many other causes and you don’t need to have Cervical Cancer. However, in case you have any of these symptoms, we recommend you should immediately contact your doctor for diagnosis.

What are the tests for Cervical Cancer?

Common tests used for detecting Cervical Cancers are:

i. Medical History and examination is done to understand the family history of the person and understand the appearance of symptoms and associated conditions. The doctor will assess you for the risk factors associated with Cervical Cancer.

ii. Pap Smear Test also known as Pap test is often done in conjunction with medical history and exam. This test collects cervical cells and detects the presence of high-risk HPV (human papillomavirus) strains. Please note that out of hundreds of strains of HPV, only fourteen have been known to cause cervical cancer. It is the most common test for Cervical Cancer.

iii. Colposcopy is a test mostly performed after the Pap Smear test has identified the presence of cancer cells. The doctor uses a Colposcope, a magnifying lens to view the surface of the cervix and also to collect the tissue for biopsy if needed. There are many types of biopsies that the doctor can do to be certain about the presence of cancerous cells in the Cervix. In cases where the cancer has not spread much, sometimes biopsy itself is the treatment with no need for further procedures.

iv. Imaging tests like X-ray, MRI, PET Scan etc are also done by medical professionals in addition to the tests mentioned above to determine the presence and spread of cancerous cells in the cervix.

Treatment for Cervical Cancer

Treatment for cervical cancer depends on several factors like age, health, stage of cervical cancer, and fertility choices of the patient. Treatment is a combination of various methods like Surgery, Radiation therapy & chemotherapy.

i. Surgery: For cervical cancers which are localised to Cervix and have not spread outside surgery is often the most popular treatment option. Depending on the spread the surgery can remove only the limited tissue, remove the cervix (trachelectomy), removal of cervix and uterus (hysterectomy).

ii. Radiation Therapy uses energy beams to kill the cancer cells and is used when the cancer has spread beyond the cervix.

iii. Chemotherapy is often used in conjunction with radiation therapy. It uses medicine to kill off the cancerous cells. Chemotherapy is given in cycles over weeks or months. It is very likely that the patient will experience side effects.

iv. Targeted Therapy is a newer form of treatment which also uses medicine, but which don’t kill the cancer cells. Instead, these medicines aim to attach to the proteins of the cancer cells and stop them from growing and spreading. Targeted therapy is generally believed to be more effective than Chemotherapy but is 5-6 times as costly as chemotherapy. Also, targeted therapy is typically not covered in insurance plans.

Cervical Cancer is a silent killer. However, it is a form of cancer that can be avoided by being proactive and getting vaccinated. That one step alone will make sure that you and your loved ones don’t have to suffer the pain and suffering this disease can bring to a person. And before we sign off, yes, Cervical Cancer can happen to Men too! They also need vaccinations. And the earlier, the better.

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