Cervical Cancer - Symptoms, Causes and Treatment By Dr. Sabhyata Gupta

Dr. Sabhyata Gupta is one of the best gynecologists in india with over 25 years of experience. Currently, the Chairperson of gynecology and Gynae Oncology, Medanta, Gurugram, Dr.Sabhyata Gupta specializes in Robotic Gynaecological Surgery, Colposcopy, Advanced Gynae Laparoscopy, and Gynae Oncology.

After completing her MBBS and MD (Gynaecology) from Government Medical College, Jammu, Dr. Sabhyata Gupta trained in Robotic Gynaecological Surgery from France and Endoscopic Gynaecology Surgery from Germany. Before Medanta, Dr. Sabhyata Gupta worked with the Tata Memorial Cancer Hospital, Mumbai India. She was the first gynecologist in Gurgaon to perform Robotic Gynaecological Surgery for cancers and benign tumors in India.

Dr. Sabhyata Gupta is a member of various esteemed medical organizations including the International Gynaecological Cancer Society, the Federation of Obstetrics and Gynaecology Societies of India, the European Society of Gynaecological Oncology, and the Indian Medical Association. She is the recipient of the “Arch of Excellence Award” at All India Achievers Conference, Delhi in 2009, the Bharat Jyoti Award Conferred by “India International Friendship Society”, Delhi, 2009, and many more. She has published her work in national and international acclaimed medical journals and is an active member of several medical workshops across the country.

Cervical Cancer

Cervical cancer refers to the growth of malignant cells in the lowest part of the uterus or cervix which joins with the vaginal canal. Cervical cancer ranks fourth among the most common cancers found in women after breast, colorectal and endometrial cancers. Cervical cancers are of mainly two types:

• Squamous Cell Carcinoma : This is the more common cervical cancer and starts in the thin flat squamous cells lining the outer part of the cervix.
• Adenocarcinoma : This type of cervical cancer starts in the glandular cells lining the cervical canal.

Cervical cancers have been known to grow at a much slower rate than other cancers and are treatable with higher success rates.

Symptoms of Cervical Cancer

In their early stages, cervical cancers do not show any symptoms. As cancer progresses, the symptoms may appear as follows:

• Intermittent bleeding: Bleeding between period cycles
• Post-menopausal bleeding
• Watery and bloody discharge from the vaginal
• Foul smell in the vagina
• Lower abdominal pain
• Lower backache
• Painful sexual intercourse
• Heavier and longer menstrual bleeding

Causes of Cervical Cancer

About 99 percent of cervical cancers occur due to the HPV or Human Papilloma Virus which is spread through sexual contact. Persistent infections with HPV strains are a common cause of cervical cancers. Apart from HPV infections, other causes include:

• HIV
• Suppressed Immunity
• Use of birth control pills (prolonged)
• Smoking

Preventing Cervical Cancer

HPV vaccines are instrumental in the prevention of cervical cancer. The HPV vaccine helps the immune system to recognize the cancer-causing strains of HPV 6, 11, 16, and 18 and develop antibodies against them.

Cervical Cancer Screening

Detection of cancers in the early stages is key to surviving cancer.

• PAP Smear : The pap smear test looks for changes in the cells of the cervix that may develop into cancer if left untreated.
• HPV Test : This test specifically looks for the presence of HPV.

For both tests, tissues samples are taken from the cervix by a gynecologist in a doctor’s clinic and sent to the lab for testing.

Women between the ages of 21 to 29 should screen for cervical cancer every 3 years. Women between the ages of 30 to 65 should screen themselves every 3 to 5 years as per the recommendations of the gynecologist. Women over the age of 65 may not require to be screened if their test results have been negative in the past years.

Diagnosis of Cervical Cancer

While Pap Smear Test and HPV Test may indicate the presence of altered cells or infection, they cannot be used to diagnose cervical cancer.

• Pelvic Examination: The gynecologist will check for abnormalities in the cervix, uterus, and ovaries.
• Colposcopy: A special instrument called a colposcope is used to magnify the cells of the cervix and the vagina. The colposcope helps in the biopsy of the cervix. 
• Biopsy: The most conclusive test for cancers is biopsy where a small amount of tissue is removed from the cervix and examined under a microscope.
• Imaging Scans:Imaging technologies allow 3Dimensional pictures of abnormalities such as tumors. Common scanning techniques used are:
  • CT Scan
  • MRI:
  • PET Scan:

Treatment of Cervical Cancer

After a conclusive diagnosis of cervical cancer, treatment may be started that may be a combination of the following:

• Surgery : Early-stage cancers are treated with surgery where:
  • Cancer of the cervix is removed when conducting the biopsy.
  • The cervix is removed or trachelectomy
  • The uterus and the cervix are removed or hysterectomy
• Chemotherapy : A combination of pharmaceutical drugs to kill the cancer cells is administered. For advanced cancers, a higher dose of chemotherapy is given.
• Radiation : High-powered beams of radiation are used to kill the cancer cells.
• Targeted Therapy : This is a drug treatment that analyses and targets the weaknesses of the cancer cells.
• Immunotherapy : This is a drug treatment that focuses on boosting the capability of the immune systems to spot cancer cells and kill them. Immunotherapy is used when other treatment options have been exhausted.

Conclusion

Cervical cancers are preventable cancers. With proper prevention, screening, and treatment cervical cancers can be controlled if not eliminated.