Cervical cancer is a preventable disease. Early diagnosis and effective treatment are possible thanks to screening with smear/Pap-smears and HPV DNA tests.
Cervical cancer is the second most common cancer in women under the age of 45 in the world, and is the third leading cause of cancer death after breast and lung cancer. A woman dies of cervical cancer every 2 minutes worldwide, Although screening programs have a significant impact on the reduction of cervical cancer, women still die from cervical cancer. Cervical cancer is the 8th most common type of cancer in Turkey.
The Role of the Cervix
The cervix is the narrow neck of the uterus that opens into the vagina. The cervix also acts as an important barrier to help prevent infections from reaching the uterus. During pregnancy, the cervix remains tightly closed, helping to keep the baby inside the womb (uterus). When the baby is ready to be born, the cervix opens approximately 10 cm, allowing the baby to pass.
What is Cervical Cancer?
When cervical cells become abnormal and begin to grow uncontrollably, cervical cancer occurs.
The Cause of Cervical Cancer
The causative agent in almost all cervical cancers is the human papillomavirus (HPV). There are more than 100 different types of HPV. Most of them are low-risk types and have a negligible risk of causing cervical cancer. High-risk types can lead to the development of abnormal cells that can lead to cervical cancer. Indeed, most types of cervical cancer are caused by two types of HPV (HPV 16 and 18). In 70% of cervical cancer cases, HPV 16 and/or 18 is responsible.
Cervical cancer may not cause any complaints initially. When the symptoms develop, cervical cancer can manifest itself in the following ways:
Bleeding between menstrual cycles (periods) (when normally bleeding is not expected)
Bleeding after sexual intercourse
Bleeding after menopause
Abnormal vaginal discharge
Pain in the lower abdomen
These complaints can also be caused by many reasons besides cancer. We recommend that you consult your physician in case of abnormal vaginal bleeding.
Cervical Cancer Tests
Smear (Pap smear) and HPV tests are cervical cancer screening tests. Both tests can be performed simultaneously using speculum. Detailed information is given in Screening Tests in Gynecologic Cancers.
Cervical Cancer Staging
As with any type of cancer, cervical cancer is staged according to its spread. The ideal treatment option is offered to the patient according to several factors such as the stage of the disease, the age of the patient, concomitant health problems, desire to have children.
Treatment of Cervical Cancer
Cervical cancer can be treated in many ways. Ideally, a single treatment option should be used. In general, the treatment in cervical cancer can be outlined as follows:
a) Surgical Treatment:
Conization (cone biopsy): A piece of cone-shaped tissue is removed from the cervix to eliminate abnormal cells. Cancer cells are searched by examining this piece of tissue under a microscope. It is performed both for diagnosis and treatment of early-stage tumors.
Trachelectomy: In women who want a child, trachelectomy is a type of surgery in which the cervix (cervix), surrounding tissues (parametrium), part of the vagina and related lymph nodes are removed. You can reach our case series, that we operated due to cervical cancer (trachelectomy) and obtained pregnancy, live birth and healthy baby, in the Publications section.
Hysterectomy: The uterus and in some cases, the ovaries and/or lymph nodes can be surgically removed. Different surgical methods can be applied depending on the stage of the disease.
Radical hysterectomy; The uterus, the tissue around the uterus (parametrium), part of the vagina, tubes and related lymph nodes are removed.
b) Radiotherapy: Radiotherapy may be recommended for cases not suitable for surgery or when the disease relapsed after treatment (recurrent cancer). This procedure involves the regional treatment of cancerous areas using high energy rays. It can also be used to provide cure (complete removal of cancerous tissue) in early-stage cancers.
c) Chemotherapy: In patients scheduled for radiotherapy, chemotherapy is applied weekly at the level of 1/3 of the normal dose to increase the response of the tissue to treatment.
Preventing Cervical Cancer
Factors that increase a person’s chance of developing cancer are called risk factors, while factors that reduce the risk of developing cancer are called protective factors. While it is not possible to eliminate some risk factors such as genetic factors, it is possible to prevent some risk factors such as diet and smoking. Cancer prevention involves reducing the risk of developing cancer by hindering preventable risk factors and increasing protective factors.
Cervical cancer can be completely eliminated by performing HPV/smear tests at certain intervals.