Understanding cancer of the cervix

Introduction

CANCER is always named for the part of the body where it starts from, even if it spreads to other body parts later.

When cancer starts in the cervix it is termed cervical cancer. All women are at risk of cervical cancer. It occurs most often in women over the age of 30.

It is both scary and frustrating to be diagnosed with cancer of the cervix therefore, friends and family support is very crucial in managing the condition and it determines the outcome. In this case we uses medical terms to describe genitals however, I acknowledge and respects people who use words they are comfortable with (cisgender and transgender. )

Definition of terms

Cervical cancer sounds straight forward — it is the cancer of the cervix or cancer cells in the cervix. Cancer, tumour, growth or a lesion because some people use these terms interchangeably, is a disease in which abnormal cells divide uncontrollably and destroy body tissues.

The cervix is the lowest part of a woman’s uterus that connects the uterus to the vagina. It is made up of cells and covered in tissues — which can grow and change to pre-cancer cells.

Human papilloma virus (HPV) is a sexually transmitted virus and it is the major cause of cervical cancer.

Cervical cancer

Cervical cancer develops when the cells in the cervix become abnormal and proliferates rapidly. Cancer of the cervix is dangerous because it does not show any symptoms until the cancer becomes advanced and if left undetected can be life threatening.

During initial stages, the malignancy is contained within the cervix, thereafter, it might spread to other parts of the body including liver, bladder, vagina and rectum.

HPV is the major cause of cervical cancer and other causes include elements of sexual well-being (having multiple sexual partners), sexual transmitted diseases, smoking, HIV or organ transplant. Cancer of the cervix is one of the most preventable cancers in women because of the available screening and vaccinations. Regular screening tests are important to detect pre-cancerous growths.

Warning signs of cervical cancer

Abnormal vaginal bleeding — This is the most common symptom. It occurs when the cancer has spread to surrounding tissue be it after sexual intercourse, pelvic exam or menopause.

Unusual vaginal discharge — While vaginal discharge is normal, note the type of discharge one is having. With cancer of the cervix, the discharge is foul smelling and pink, brown or bloody in colour. Sometimes the discharge contains debris tissue or necrotic tissue as a result of infection.

Unexplained weight loss — In most cancers, weight loss is a red flag. There is loss of appetite associated with weight loss during cancer. If one has not made any dietary changes and weight is plummeting drastically associated with fatigue this could be an indicator of cancer of the cervix.

Painful sexual intercourse — This usually occurs in advanced stages of cervical cancer. A lot of pain is experienced during coitus and medically it is termed Dyspareunia because of the tumour or growth growing in and around reproductive organs. This may also affect sexual response during sex, including libido and also cause uneasiness.

Pelvic or lower back pain — Pain in the lower back or pelvic region is often an indicator of changes in the cervix. In case of cervical cancer one may experience continuous or incessant pelvic pain, if the cancer is at advanced stage and has metastasis or spread to the bladder, abdomen, liver and lungs one may also experience back or leg pain and usually people in my setting would want to call it, “Ndine chifo chemusana negumbo” meaning it’s a long term problem and one would never mind to seek medical advice until the cancer reached advanced stages. This pain could be secondary to cancer of the cervix or possible nerve compression.

Warning signs of cervical cancer

Disrupted bowel movements — Pain and incontinence during urination or bowel movements could be a sign that cervical cancer has spread to kidneys, bladder and colon region. The growth exerts physical pressure which blocks the areas that enable easy bowel movements and this is a late stage of cancer of the cervix.

Who is at risk for cervical cancer?

In many cases cervical cancer can be linked with known risk factors for the disease. Some risks can be avoided, while others cannot Risk factors within control are as follows:

◆ Screening history: Those who haven’t had pap tests are at high risk of cervical cancer.

◆ HPV infection: Certain types of HPV are linked to cervical cancer. Lowering risk for HPV can also lower risk for cervical cancer.

◆ Sexual history: Having sexual intercourse before the age of 18 and having many sexual partners puts one at higher risk of HPV.

◆ Smoking: Cigarette smoking is associated with an increased risk of cervical cancer.

◆ Weakened immune system: Makes body unable to fight infections.

Risk factors that can not be changed

Family history — cancer of the cervix may have a genetic component.

Diethylstilbestrol (DES) a hormone used to be prescribed to pregnant women to prevent miscarriage between 1940 and 1971.

Cancer of the cervix stages STAGE 1: Cancer is localised in the cervix .It has not spread and is small.

STAGE 2 : Cancer spread beyond the cervix and uterus but has not yet spread to pelvic wall.

STAGE 3: Spread to the lower part of the vagina and may have spread to pelvic wall, ureters and nearby lymph nodes.

STAGE 4: Spread to the bladder, rectum or other parts of the body.

Prevention of cervical cancer

Practicing safer sex by using condoms. However, condoms do not completely eliminate the risk of HPV transmission because the virus may be present on skin not covered by the condom.

Get HPV vaccine if eligible. The vaccine does not provide protection against HPV if one has already been infected. HPV vaccine is approved for children and adults ages 9-26 to protect against development of cervical cancer.

The vaccine works by triggering body immune system to attack human papilloma virus types which have been linked to many cases of cervical cancer. It is best to get the vaccine before being sexually active.

Stop cigarette smoking, limit sexual partners, get regular pap smear tests if appropriate colposcopies and anoscopies, if HIV positive take an effective ART combination

Cervical cancer treatment

There is no cure for cancer, however, it is highly treatable especially when detected early.

I am not going to discuss treatment modalities on this platform because treatment varies from one person to another depending on age, general health, location and size of the lesion or cancer, low grade or high grade, whether the cancer has spread to other parts of the body, whether or not to become pregnant. People with cervical cancer are referred to a gynaecologist or oncologist for treatment.

Although cervical cancer can be successfully treated, HIV positive individuals are at higher risk for having this cancer relapse therefore, it is important to follow up with regular pap smear tests 3-6 months.

Myths of cervical cancer or HPV

HPV means one is dirty, HPV is rare, HPV means one slut or sleep around, one cannot get HPV when using condoms, I have been vaccinated I cannot get cancer, if I have HPV then I will get cancer, I cannot have sex because I have cancer, I cannot get pregnancy because I have cancer, only HIV positive individuals can get cancer of the cervix, cancer of the cervix is a result of witchcraft.

There is cure for cancer.

◆ For more information: Contact Vavi. loice@ zimpapers. co. zw or 0772224231