Cervical Cancer

What is cervical cancer?

The cervix is the lower partof the uterus, or womb, that connects to the vagina. Cervical cancer starts on the surface of the cervix, and there are two types: squamous cell carcinomas, which account for around 80% to 90% of all cervical cancers, and adenocarcinoma, which account for around 10% to 20%.

Symptoms of cervical cancer

The first symptoms of cervical cancer might include:

• Discharge that is watery or has blood in it, and may smell bad
• Unusual bleeding, including between menstrual periods or after exercise
• Longeror heavier menstrual periods

When the cancer has spread to other tissues, symptoms might include:

• Pain when urinating
• Bleeding or pain from the rectum
• Feeling tired, losing your appetite or weight loss
• Generally feeling unwell
• Swelling in the legs or a dull back ache

If you experience any of these symptoms for more than 2 weeks, always see your doctor.

Diagnosing cervical cancer

Having regular pap smears and a pelvic examination will detect mostcases of cervical cancer. To confirm a diagnosis, your doctor will take a sample of tissue for a biopsy. If this confirms cancer, more tests will be done to see if the cancer has spread, which may include blood tests, urine tests, liver and kidney function tests, as well as x-rays of nearby organs.

Stages of cervical cancer

The tests listed above will be used to stage the cancer. The stages are as follows:

• Stage I: The cancer is only in the cervix
• Stage II: The cancer has spread beyond the cervix, to the pelvic wall
• Stage III: The cancerhas spread to the lower part of the vagina. It might have also spread to nearby lymph nodes and the pelvic wall
• Stage IV: The cancer has spread to the rectum, bladder, or other body parts

Treating cervical cancer

A gynecologic oncologist will recommend the best treatment for cervical cancer based upon many factors, including the cancer's stage, patientage, childbearing desire and general health. When diagnosed in the earliest stages, cervical cancer can be cured by removing the tissue that is cancerous. When the cancer is more advanced, a hysterectomy can be performed.

The three main types of treatment include:

1. Radiation: There are two ways radiation treatment is given. A device which delivers radioactive pellets can be placed internally, near the cancer, or an external device is used which sends radiation beams to the targetedarea
2. Chemotherapy: There are a number of drugs, that can be used in combination, used to kill cancer cells. Sometimes, chemotherapy and radiation are both given
3. Surgery: There are a number of types of surgery used to treat cervical cancer, including:

• Lasersurgery: A laser burns off cells or canremove a piece of tissue for doctors to study
• Cone biopsy: A cone-shaped piece of tissue is taken from the cervix
• Simple hysterectomy: The uterus is removed butnot the tissue next to the uterus, the lymph nodes, or the vagina
• Radical hysterectomy: The uterus, a small part of the vagina, pelvic lymph nodes and the surrounding tissue are removed

Risk factors for cervical cancer

Many casesofcervical cancer are linked toknown risk factors. Some of these can be avoided, while others cannot. Risk factors include:

• Irregular screening: If regular pap or smear tests are not taken, there is an increased risk of cervical cancer
• HPV Infection: Infection with the human papillomavirus (HPV) is a risk factor for cervical cancer, but only a very small number of women with HPV will go on to develop cervical cancer
• Smoking: Smoking is linked to an increased risk of cervical cancer

Preventing cervical cancer

Having regular pap smears and gynaecological examinations is the most important thing you can do to prevent cervical cancer. In the UAE, it is recommended that women aged 25 to 29 have a pap smear every 3 years, and women aged 30 to 65 have a pap smear every 5 years as well as an HPV test. Testing should be more frequent if there is a history of abnormal pap smears or if HPV is present.

Cervical cancer vaccination

A vaccination is approved for use in females aged 13 to 26, to offerprotection againstcervical cancer, by building immunity against HPV.