Cervical Cancer

SOME FACTS
Cervical cancer is the most common cancer among Indian women specially in the rural areas. This affects the cervix, the mouth or opening of the uterus (womb). More than 125,000 women are affected each year, needlessly claiming an estimated 50,000 lives.

RISK FACTORS:

  1. Early onset of sexual activity
  2. Early age at marriage ~ First pregnancy before 20 years of age
  3. Multiple pregnancies at short intervals. This leads to repeated injury to the cervix, leaving it no time to heal.
  4. Poor genital hygiene
  5. Genital tract infections especially HPV (human papilloma virus) infections
  6. Sexual promiscuity i.e. multiple male sexual partners or even a singe male partner having sexual relations with multiple
    female partners
  7. Tobacco addiction

Most of these factors are preventable but, unfortunately, because of ignorance, unhygienic conditions and lack of awareness about personal health, cervical cancer continues to be a cause of large number of deaths in India.

SIGNS AND SYMPTOMS:

  1. Bleeding / spotting between menstrual periods
  2. Bleeding during / after sexual intercourse
  3. Bleeding after a woman has attained menopause
  4. Unusual blood stained vaginal discharge
  5. Bleeding after Menopause
  6. Unexplained persistent pelvic / back pain
  7. Painful intercourse

Regular examination and simple tests like pap smear can detect early pre-cancerous cervical changes (Dysplasia) much before these signs and symptoms occur. Please note that these symptoms are not necessarily because of cancer always but are abnormal and need to be investigated further.

EARLY DETECTION
Regular examination by an oncologist or gynaecologist and pap smear helps in early detection of cervical cancer

What is a PAP smear test?
This test is simple and painless and is done in outpatient clinic while examining the patient. Using a wooden sterile spatula or brush, cells from the cervix are collected, spread over a glass slide and examined under the microscope to look for abnormal cells.

Liquid Based Cytology
It is similar to Pap smear but with higher sensitivity to detect abnormality. This can also help to detect HPV virus infection.

HOW TO PREVENT CERVICAL CANCER?

  • Regular Pap smear test done above the age of 30 or 3 years after initiation of sexual activity whichever is earlier – can help
    detect pre-cancer stage.
  • Delaying the age of marriage so that the age at first sexual intercourse also gets delayed.
  • Postponing the birth of the first child to after 20 years.
  • Avoiding multiple and rapid pregnancies through family planning.
  • Modifying lifestyle patterns like discouraging sexual intercourse at an early age, avoiding intercourse with multiple partners, stopping tobacco use.
  • Use barrier contraception (e.g. condoms) to prevent sexually transmitted infections. This would also help to space child-births.
  • Maintain good genital hygiene at all times, particularly while bathing and during menses (monthly periods). Your partner’s genital hygiene is equally important.
  • Sex education of adolescents with stress on safe sexual practices

If you have any of the above signs and symptoms, seek medical help from either your gynaecologist or the family doctor at the earliest. In case of doubt seek further expert opinion from an oncologist.

IS THERE A VACCINE TO PREVENT CERVICAL CANCER ?
HPV (Human Papilloma Virus) infection is the cause of 80-90% of cervical cancers in India. Vaccination against high risk strains of HPV may help in cervical cancer prevention.
Its best taken before the onset of sexual activity in one’s life. It may also be taken later in life up to 35 years of age – however, the efficacy of the vaccine goes down as the age advances.

HOW IS CERVICAL CANCER TREATED?
Treatment depends upon the stage of cancer and patient’s overall physical health Early stage upto IIA is usually treated with Radical Surgery that involves removal of Uterus, fallopian tubes, ovaries and lymph nodes.
Later stages and Bulky IB cancers are usually treated with a combination of Radiation and Chemotherapy.

IS PRESERVATION OF UTERUS OR FERTILITY POSSIBLE WHILE TREATING CERVICAL CANCER?
Very early stage of cancer of the cervix can be treated with minimal surgery preserving the Uterus, tubes and ovaries For more detailed information on above topics please consult your oncologist.

REMEMBER

“Once you are enlightened, its your duty to spread the message to others!”
“Awareness leads to early detection and timely treatment thus greatly reducing the pain, suffering, expenses and death caused by these cancers.”