Cervical cancer occurs in the cells of the cervix. The cervix is the lower part of uterus that culminates in the vagina . It is one of the most common cancers in women in India and a leading cause of death. Almost all cases of cervical cancers are associated with Human Papilloma Virus (HPV) infection which is a sexually transmitted disease.

When exposed to a build-up of HPV cells, the body’s natural defences often shut it down and prevent the virus from spreading and harming the system. However, the virus is often quite resilient and may survive in the body for years. In the process, cervical cells turn cancerous and cause cervical cancer. The cells may accumulate in the cervix and cause a mass to grow. This shows as a tumour during a pelvic MRI or biopsy.

Types of cervical cancer

There are mainly two types of cervical cancer. They are:

1. Adenocarcinoma. This is a type of cervical cancer that originates in the column-shaped glandular cells lining the cervix.

2. Squamous cell carcinoma. This is a type of cervical cancer that originates in the thin cells lining the outer cervix. This is the most common type of cervical cancer.

Risk factors for cervical cancer

Though most cases of cervical cancer are attributed to the HPV in the cervix’s cells, the exact cause of why this disease affects some women is still not known. However, there are some risk factors that can increase the chances of contracting this dreaded cancer:

  • Multiple sexual partners – this increases the chances of higher HPV activity
  • Unprotected intercourse
  • Contracting STIs (Sexually Transmitted Infections) that increase the risk of overactive HPV. These include chlamydia, syphilis and gonorrhoea
  • Reduced immunity or illness for which a course of certain antibiotics was taken
  • Oral contraceptive drug usage
  • Smoking
  • Human Papilloma Virus infection
  • Symptoms of cervical cancer

    Most cases of cervical cancer go undetected because the disease does not show any symptoms at first. Another reason why it goes undetected, is that its symptoms may often be confused with those of other reproductive health issues, ranging from fibroids to PCOS. Most times, women simply ignore the symptoms till there is pain and any abnormality that prompts a visit to the gynaecologist.

    Early stage cervical cancer has little to no symptoms. However, when the disease progresses, it causes symptoms like:

    • Heavy watery or bloody discharge from the vagina in between the menstrual period. The discharge is thick and has a foul smell
    • Bleeding from the vagina after sexual intercourse, despite lack of forced entry or even if the woman has already entered menopause.
    • Pain in the pelvic region during sexual intercourse

    In advanced disease: there could be loss of appetite, Severe weight loss, fatigue, pelvic pain, swollen legs, fractures, leakage of stool and urine to vagina. These are due to spread of the cancer to different organs called metastatic spread.

    Warning signs that you might have cervical cancer – knowing when to get yourself tested

    Most women remain unaware that they may have cervical cancer as this disease develops very slowly over a period of 10 – 20 years.but, once developed the progression to full blown disease and involvement of multiple organs is swift. If you or any woman you know has these symptoms, then it might be a good idea to check for this kind of cancer:

    • Unexplained weight loss, with the weight not returning even with increased food intake and reducing exercise
    • Lower back pain, which has increased in intensity in recent times
    • Pelvic pain which is either constant, or which comes and goes in waves
    • Pain during sexual intercourse, often resulting in bleeding
    • Foul smelling vaginal discharge, often brown, curdy white, or mixed with blood
    • Pain in one or both legs, which becomes near constant after a few weeks
    • All women over the age of 25-30 years should undergo cervical cancer screening for early detection.

    If you notice any of these unusual signs, it is best to consult with your doctor without further delay. This kind of cancer progresses quite rapidly, so any delay can be detrimental to positive outcomes from treatment.

    Cervical cancer treatment largely comprises prevention. Treatment for advanced stages of the disease becomes difficult, though some doctors recommend a colposcopy to examine the diseased cervix better. Often, prevention is a better tool. Here’s how women can practice prevention against cervical cancer:

    Preventiing Cervical Cancer:

  • Get vaccinated against HPV
  • Undergo a full gynaecological examination and tests, with mandatory pap tests. Pap tests use a smear from the cervix to determine the presence of HPV and cancer cells in the cervix. Pap tests must be done every year after the age of 25 even if the woman is otherwise healthy
  • Avoid smoking or inhaling second-hand smoke
  • Practice safe sex, and avoid having multiple sexual partners at the same time

  • Diagnosis:

  • Once suspected a complete gynaecological evaluation, Pap smear, punch biopsy, ultrasound are done to confirm diagnosis
  • Once diagnosed different endoscopic and imaging studies are carried out to check the extent of spread and staging
  • Depending on the stage and extent of spread the treating cancer specialist may decide on a single or combination of:
      - Surgical removal of the lesion, cervix or uterus with removal of lymphnodes
      - Anti-cancer medications
      - Radiation therapy either to whole body externally or localised internally through a device inside vagina called brachytherapy

  • Disclaimer : The details provided herein is meant for informative purposes only. For detailed information related to the disease and its treatment please consult a relevant qualified specialist.

    The prognosis of early detected cervical cancer which is small and hasn’t spread if trated appropriately is excellent with very high survival rates.

    If detected in late stages, the prognosis and survival may be poor and have to be explained in detail by the specialist doctor to the individual. Focus in all cases should be improving the quality of life, pain management and stress management.

    • Healthy diet and regular exercise if movements are not restricted. Combined with Yoga it could help in stress management as well
    • Regular reviews and follow ups with the treating doctor.
    • Understanding warning signs and having a open line of communication is crucial
    • Joining Self help groups and community discussions with people with same conditions helps in managing the anxiety and associated stress better.