What Is Cervical Cancer?
Cervical Cancer is the malignant growth of cells and tissue in any part of the Uterine Cervix, the part of the female reproductive system that connects the vaginal canal to the body of the uterus.
Cervical cancer is the only gynecological cancer that can be prevented by performing regular screening tests at your routine check-up through Pap Smears and, if necessary Colposcopies. The function of cytological testing is to detect Cervical Cancer in the early stages, ensuring greater efficacy of treatment options.
How Is Cervical Cancer Diagnosed Early?
Cervical Cancer is typically diagnosed following an abnormal result on a pap smear if atypical cell growth is detected. Pap tests can diagnose “Atypical Squamous Cells of Undetermined Significance” (ASCUS) , “Atypical Glandular Cells of Undetermined Significance” (AGUS), low-grade Squamous Intraepithelial Lesion (SIL), or high-grade Squamous Intraepithelial Lesion (SIL).
Following an abnormal cytology result on a pap smear, a colposcopy is performed to further confirm the diagnosis.
A colposcopy is a diagnostic procedure that uses a special magnifying instrument called a colposcope to closely examine the cervix, vagina, and vulva for abnormal areas following an abnormal Pap smear result.
While the Pap smear detects potential issues, a colposcopy allows for a more detailed examination and often includes taking biopsies of suspicious areas for further analysis.
What Are The Risk Factors Of Developing Cervical Cancer?
While it is unclear what specifically causes the development of cervical cancer, there are a handful of risk factors that increase the likelihood of a woman developing cervical cancer.
HPV Infection
Certain strains of the Human Papillomavirus, namely types 16 and 18 are the primary strains that cause cervical cancer and responsible for approximately 70% of cases.
Other high-risk HPV types that can also lead to cervical cancer include HPV 31, 33, 45, 52, and 58, among others. These high-risk strains are particularly associated with the development of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer.
Other Risk Factors of Cervical Cancer
Smoking and tobacco use have been linked to an increased risk of developing cervical cancer, particularly among females who have tested positive for HPV infection.
Other statistically significant factors include having more than 3 children, taking contraceptives for over 5 years in a row, taking immunosuppressants, and being between the ages of 40 to 55.
These risk factors do not guarantee that a woman will develop cervical cancer, but have been linked to increased incidence of cervical cancer development.
How Can Cervical Cancer be Prevented?
Over the last two decades, significant improvements have been made with regards to more accurate screening and treatment of premalignant cervical changes.
HPV Vaccination
With HPV infection being the leading cause of Cervical Cancer globally, the first line of prevention among adolescent girls and young women is vaccination from HPV.
HPV vaccines like Gardasil 9 and Cervarix have been developed to protect against high-risk HPV infection, but are most effective when administered prior to exposure to the virus.
It is also recommended that young males be vaccinated against HPV as the virus has been linked to male genital cancers as well.
Other Prevention Methods
The use of condoms during sexual activity and limiting the number of sexual partners has been statistically linked to reducing the risk of developing cervical cancer.
Diagnosis Of Advanced-Stages of Cervical Cancer
What Are The Symptoms of Cervical Cancer?
Cervical cancer is usually asymptomatic in its early stages which is why regular cytology tests should be performed periodically.
In advanced stages of cervical cancer, the most common symptoms include:
- Abnormal genital bleeding:
- Postcoital (most common)
- During the fertile age but between periods
- Post-menopause
- Abnormal vaginal discharge
- Pelvic pain
Following an abnormal result of cytology, a gynecologist must perform a series of procedures with the aim of confirming a diagnosis and, if so, determining the stage of the disease:
- Colposcopy and Cervical biopsy.
- LEEP (Loop Electro-Surgical Excision Procedure).
- Cervical conization.
If advanced-stage cervical cancer is detected following these procedures and treatment, additional diagnostic testing is required such as
- Computed axial tomography (CAT): is routinely performed prior to any cancer treatment to determine the extent of the disease outside the affected organ: lymph nodes, abdominal organs, or the chest cavity. It is usually performed with oral and intravenous contrast.
- Magnetic resonance imaging (MRI): is a useful complementary study for the diagnosis of the local extension of the disease.
- Cystography and Proctoscopy: in selected cases with suspected advanced stages of cervical cancer.
Cervical Cancer Treatment Options
The type of treatment recommended for cervical cancer is entirely dependent upon the stage of the progression of the disease, as well as the patient’s overall health, and desire to bear children in the future.
The vast majority of patients with Cervical Cancer are initially treated with Surgery. Although some surgical options usually involve removing the uterus, in some cases, it is possible to preserve it and treat the disease at the same time.
We are committed to developing innovative surgical techniques for the treatment of gynecological cancer, including cervical tumors.
LEEP & Cervical Conization
In situations where the cervical cancer is caught early enough, a Cervical Conization procedure can be carried out to remove the diseased tissue from the cervix. Cervical Conization is typically performed as both an initial treatment following the diagnosis of premalignant or malignant cell growth on a woman’s cervix that could progress into cancer if left untreated, as well as a diagnostic tool as the removed tissue is analyzed to determine the extent of the disease.
It is possible to perform multiple Conization Procedures to treat early-stage (Stage 1A1 and Stage 1B1) cervical cancer, provided that the patient follows up regularly to check for recurrence. Cervical conization is considered as a fertility-sparing treatment as its impacts on a woman’s ability to bear children are negligible.
Radical Trachelectomy
A novel approach to cervical cancer treatment, particularly among women who wish to still bear children is a Radical Trachelectomy. In this procedure, the entire cervix is removed from the bottom of the uterus, and the uterus is reattached to the vaginal canal. With this procedure, a woman may still have children but will require a cerclage to hold the uterus shut during gestation and will not be able to deliver vaginally.
Radical Trachelectomy treatments require regular follow-ups to monitor for recurrence, and it is typically recommended that women with a history of cervical cancer who have undergone a radical trachelectomy consider a hysterectomy after they have had children to mitigate the risk of recurrence.
Hysterectomy
Traditionally, cervical cancer has been treated through the removal of the uterus and cervix entirely in a surgery known as a hysterectomy. At our clinic, we perform laparoscopic hysterectomies to reduce recovery time and mitigate operative complications.
Lymphadenectomy
In situations where lymphovascular space invasion is detected, it may be necessary to remove lymph nodes from the pelvic region. To determine which nodes to remove, the Sentinel Node Technique is used which uses tracers to identify which lymph nodes have likely been exposed to disease.
After surgery, pathologists will carefully analyze all tissue removed to obtain a final diagnosis and determine the true extent of the disease. Next, the best postoperative therapeutic option is selected taking into account a series of factors that include:
The decision may be simply observation and follow-up, or it may include administering radiation therapy and/or chemotherapy on a case-by-case basis.
Cervical Cancer Follow-Up After Treatment
When treated in its early stages, recurrences of cervical cancer are generally low for Stage 1A1 and Stage 1B1 cervical cancer. For more advanced cancers, the rate of recurrence depends on the type of treatment that was carried out and progression of the disease before treatment.
Generally for the first 2 years after treatment, follow-ups should be carried out every three to six months to monitor for recurrence, as this is when the risk is highest. Outside of 2 years post-treatment, follow-ups can be done every six months to a year.
Beyond adopting the most effective follow-up standards, we also pay special attention and interest in maintaining and increasing the level of quality of life of our patients and achieving a rapid and effective re-insertion into daily life as before the diagnosis of their cancer.
The oncological follow-up period begins after the initial cancer treatment. Its main objective is to detect early a possible recurrence of the disease.
Frequently Asked Questions About Cervical Cancer
What causes cervical cancer?
Cervical cancer can be caused by a long-lasting infection by certain types of the human papillomavirus (HPV), which is the main cause of cervical cancer. HPV is a common virus that can be passed from person to person during sex.
How is cervical surgery performed?
The surgery begins with the placement of a speculum in the vagina in order to view the cervix. Next, a small, cone-shaped section of tissue is removed from the cervix, either with a scalpel, loop, or laser. The procedure takes about 15 minutes.
Read more about Cervical Conization by Doctor Lucas Minig in Valencia, Spain.
What organs does cervical cancer affect?
Cervical cancer in it’s early stages usually only effects the Cervix but if left untreated can spread to a woman’s entire reproductive system, abdominal organs, or metastasize throughout the body.
In general, there are 5 main types of gynecologic cancer that affect a woman’s reproductive organs: cervical, ovarian, uterine, vaginal and vulvar cancers. (A very rare sixth type of gynecologic cancer is fallopian tube cancer.)
Why choose a cervical cancer specialist?
Doctor Lucas Minig will carry out a Follow-up for the appropriate treatment for each patient affected by Cervical Cancer, offering personal attention to improve the patient’s health and allow the correct development of the surgery treated by the specialist in cervical cancer, not However, screening tests and the vaccine against the virus called HPV can help prevent cervical cancer.
When cervical cancer is detected in its early stages, its chances of treatment are very high and it is associated with long survival and good quality of life.
Opinions patients with Cervical Cancer.
Doctor Lucas Minig Specialist in Cervical Cancer in Valencia, Spain
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