Cervical cancer is a growth of cells that starts in the cervix, the lower part of the uterus that connects to the vagina. According to the Centres for Disease Control and Prevention (CDC), a chronic infection with a high-risk strain of the human papillomavirus (HPV) is the cause of cervical cancer in many instances.
According to the World Health Organisation, cervical cancer is the fourth most common cancer in women globally, with around 660,000 new cases and around 350,000 deaths. In an interview with HT Lifestyle, Dr Lakhan Kashyap, consultant (medical oncology), Manipal Hospitals Baner, Pune, discussed why it is the most devastating condition in women, procedures for identification and diagnosis, and the benefits of vigilance.
Why cervical cancer is devastating for women
Calling cervical cancer one of the most ‘devastating cancers’ a woman can develop, Dr Kashyap explained that it is because women with cervical cancer usually do not experience symptoms in the early stages of the disease. “Women can be asymptomatic and develop symptoms later in the disease’s progression; it is impossible to diagnose it early,” he added.
Dr Kashyap explained that the cervix, which is situated at the lower end of the uterus, plays an extremely important role in reproductive health. He added, “While many women’s bodies will also eliminate HPV, some women can continue to have this risk (for example, in a high percentage of cases), and HPV can sometimes lead to changes to a woman’s cervical cells over time. These aberrant cervical cells have been shown to alter and grow into cancer in numerous cases throughout time.”
Why it can be dangerous to have no symptoms
Cervical cancer commonly doesn’t cause any pain, bleeding, or discomfort in its early stages, the oncologist warned. However, it can often be detected by routine screening tests, including Pap smears or HPV testing. “Even if there are no signs of a problem, people still need to undergo that preventive examination because of the cancer’s blind growth,” he advised.
Procedures for identification and diagnosis
According to Dr Kashyap, a gynaecologist might suggest identification or diagnostic techniques if abnormal cervical cells appear during cervical cancer screening. “A colposcopy, for instance, enables the physician to do a close examination of the cervix,” he added.
What happens in a colposcopy? “Suspicious part of the cervix is examined closely, and further tests are performed. A doctor can conduct a biopsy or take a sample of tissue for a histopathologist to examine in-depth,” he explained.
He added, “Doctors can conduct imaging tests (such as MRIs, CT scans, and PET scans) to determine the extent of the disease if cancer is confirmed. Because it helps determine the outlook and guides the treatment strategy, this staging procedure is important.”
Management of early-stage disease by surgery
The best chance of curing very early-stage cervical cancer is through surgery. According to Dr Kashyap, surgical alternatives consist of:
- Conization (cone biopsy): A conization treats extremely early lesions and removes a cone-shaped portion of cervical tissue. It also provides information about the lesions.
- Simple hysterectomy: This type of surgery, which involves removing the uterus and cervix, is effective for early malignancies that can be treated without more complex procedures.
- Radical hysterectomy: The uterus, cervix, a portion of the vagina, and surrounding tissues are removed during a radical hysterectomy. To check for cancer spread, a pelvic lymph node dissection can sometimes be performed in conjunction with a radical hysterectomy.
He adds, “Surgery to maintain fertility options, including radical trachelectomy, which aims to remove the cervix rather than the uterus, could be explored in certain circumstances. With this surgical procedure, the cancer is treated while maintaining the possibility of becoming pregnant in the future.”
The benefits of vigilance
Even though people right now have several kinds of surgical and medicinal treatment options, prevention and early detection are still thought to be the most efficient ways to lower the incidence and death rates from cervical cancer, according to the oncologist.
“It has been demonstrated that routine screening greatly reduces morbidity and mortality, as does HPV vaccination and follow-up on abnormal results,” he suggests.