Cervical cancer is a type of cancer that occurs in the cells of a woman’s cervix. In most cases, a woman infected with the sexually transmitted infection known as the human papillomavirus has unknowingly suffered a long time with the infection.
This longstanding virus can then contribute to some cells on the surface of the cervix to become cancerous. The good news? If caught early enough, cervical cancer treatments are known to be very helpful.
But before we talk about cervical cancer treatments, let’s take a look at the cancer itself.
What Is Cervical Cancer?
Cervical cancer begins in the uterine cervix, the lower end of the uterus that contacts the upper vagina. If detected early, cervical cancer actually has a very high cure rate, and some preventative measures can be taken against it, including vaccination against HPV, a known cause of cervical cancer.
Nearly all forms of cervical cancers are caused by longstanding infection with one of the HPVs. There are over 100 types of HPV, though only certain types have been linked to cancer. HPV infections are spread through skin-to-skin contact or sexual contact, and in most cases, the infection will resolve on its own.
For women, the HPV infection can persist and cause precancerous changes in the cells of the cervix. This is why regular cancer screenings are essential. Changes in the cells of the cervix will manifest in a pap smear, also known as a cytology-based screening.
This exam involves a doctor taking a swab of the cervix which is then sent off to be looked at. The lab will check for dysplasia of the cervix, also known as abnormal-appearing cells.
There are multiple types of cervical cancer, and it depends on where the cancerous cells are located.
- Adenocarcinoma – Cervical cancer that begins in the column-shaped glandular cells lining the cervical canal.
- Squamous Cell Carcinoma – Cervical cancer that begins in the thin, flat cells, known as squamous cells, lining the outer part of the cervix. This is the most common type of cervical cancer.
While it is rare, other cells in the cervix can also become cancerous, and the cells mentioned above can be involved in cervical cancer at the same time. The thing is, healthy cells grow and multiply at a given rate and they eventually die off.
Cancer cells continue to grow and reproduce out of control without dying off. These abnormal cells then form a tumor. These cancerous cells can also spread throughout the body, completely overwhelming the immune system.
Symptoms of Cervical Cancer
Like many other cancers, in the beginning stages, cervical cancer doesn’t usually have any noticeable symptoms. When symptoms do present themselves, they are generally very generic and can be mistaken for a number of different things. They can also vary from person to person.
Some common symptoms to watch out for include:
- Pelvic pain
- Pain during sex
- Vaginal bleeding after sex
- Abnormal vaginal bleeding, such as between periods or after menopause, or excessively heavy periods
- Vaginal discharge with a hint of blood
- Frequent urination
- History of untreated dysplasia of the cervix
What is vital to remember is that these symptoms are considered generic, meaning that they could be used to identify any number of other illnesses and diseases. However, just because they are considered generic doesn’t mean they are any less important. Any symptoms that are out of the ordinary should be noted and brought up to your doctor.
Testing for Cervical Cancer
A number of tests can be done to check for cervical cancer. It is best to have at least a regularly scheduled pelvic and pap test done to make note of any changes that may take place. Your doctor can tell you how often exams should be done.
Below are a few of the tests that can be done to check for cervical cancer.
- Pelvic Exam – A pelvic exam is an exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. A speculum is inserted into the vagina so that the doctor can take a look at the vagina and cervix to see if there is anything unusual. A pap test is usually done during this exam. The doctor will then insert one or two lubricated, gloved fingers into the vagina and place their other hand on the lower abdomen to feel the size, shape and general position of both the uterus and ovaries. The doctor may also insert lubricated, gloved fingers into the rectum to check for any lumps or abnormal surfaces.
- Pap Test – This procedure collects cells from the surface of the cervix and vagina. The cells are gently scraped from the vagina and cervix using a cotton swab or brush and then sent off to be viewed under a microscope to see if they are abnormal or not.
- HPV Test – This test uses cells that are collected from the cervix, and DNA or RNA from those cells are checked to see if an infection is present and, if it is, to check and see if the infection is caused by a type of HPV that is linked to cervical cancer.
- Endocervical Curettage – This procedure collects tissue or cells from the cervical canal using a curette. These samples are then taken and checked under a microscope for any signs of cancer.
- Colposcopy – This procedure uses a colposcope (a lighted, magnifying instrument) to check the vagina and cervix for any abnormal areas. Tissue samples may be taken using a spoon-shaped instrument known as a curette or a brush. These samples will then be checked for anything abnormal.
- Biopsy – If abnormal cells are found during a pap test, a biopsy of the cervix may be done so a pathologist can check for signs of cancer. A biopsy is a small sample of tissue cut from a given area to be tested for cancer.
Stages of Cervical Cancer
After a doctor has provided a patient with a cancer diagnosis, they will place the patient in a stage based on the extent of the cancer in the body. These stages are important because they can help in deciding the right cervical cancer treatment a patient will need.
Cervical cancer staging can get a little complex, but the stages run from 1 through 4. The lower the stage, the less the cancer has spread. The higher the cancer’s stage, the more advanced the disease is.
The staging then gets more complicated because it incorporates the TNM staging system.
- T – Tumor, indicating how far the primary tumor has grown into the cervix and whether it has grown into nearby tissues
- N – Nodes, the cancer has spread to lymph nodes near the cervix
- M – Metastasized, whether or not the cancer has spread to distant sites such as other organs
The numbers that follow any of these three letters also help stage the patient’s cancer. The lower the numbers and letters following the TNM staging, the lower-level the cancer.
Top 5 Cervical Cancer Treatments
Depending on the stage of the patient's cancer, there are some different treatment options. Depending on what their oncologist believes is the best form of treatment, one or more of these options may be made available to the patient.
When it comes to cervical cancer treatment options, many patients will undergo surgery in an attempt to remove the tumor or other cancerous tissues. Depending on the stage of the cancer, there are a few different surgical options that can be done.
Surgeries can range from killing off abnormal cells with cryosurgery to a hysterectomy to either remove the uterus and, in some cases, the ovaries and fallopian tubes.
Radiation therapy uses a high energy x-ray or radioactive particles to kill cancer cells. Two types of radiation therapy are most often used to treat cervical cancer:
- External Beam Radiation – Aims x-rays at the cancer from outside the body with strong radiation doses.
- Brachytherapy – A form of internal radiation therapy that puts a source of radiation in or near the cancer.
Chemotherapy uses anti-cancer drugs that are injected into a vein through an IV or given by mouth in the form of a pill. These drugs then enter the bloodstream, allowing them to reach all areas of the body to kill cancer cells.
Targeted therapy makes use of drugs that can specifically target the changes that are found in cancer cells. Some targeted drugs can block the growth of new blood vessels that tumors need to keep them nourished. These drugs are often used alongside chemotherapy.
This form of therapy uses medications to help stimulate a person’s immune system to help recognize and destroy cancer cells more effectively.
Drugs such as Keytruda target certain immune checkpoints to help boost the immune response against cancer cells, thereby helping shrink or slow the growth of tumors. This drug, for example, targets PD-1, a protein on immune system cells called T-cells that normally keep these cells from attacking other cells in the body. Keytruda blocks the PD-1, and the drug can help boost the immune response against certain cancer cells.
Proper Cervical Cancer Treatment Depends on The Patient
No one treatment is considered better than the other when it comes to cervical cancer or any cancer for that matter. It all comes down to what stage the patient is in and the speed of progression the individual patient is dealing with.
By working with their cancer treatment team, the patient will receive a treatment plan tailored to their needs.