Cervical Cancer: The Basics
Bobby N. Koneru, MD
Medical Director, Wendt Regional Cancer Center
The United States Congress designated January as Cervical Health Awareness Month
Approximately 11,000 American women develop cervical cancer yearly. Cervical cancer is a treatable disease and can be cured if caught early. Unfortunately, in many countries that do no not have adequate screening programs, cervical cancer continues to remain the second most common form of both malignancy and death among all cancer types in women.
The cervix is the bridge between the uterus (womb) and the vagina. The outer layer of the cervix is comprised mostly of squamous cells. These squamous cells are the most common type of cell that develop into cervical cancer.
The most common risk factor for cervical cancer is infection with the human papillomavirus (HPV). The HPV can be spread directly through any contact involving the genital area. Other risk factors include cigarette smoking and certain diseases such as HIV/AIDS.
The most common symptom from cervical cancer can be abnormal vaginal bleeding, such as bleeding between periods, bleeding after sex, or bleeding after menopause. Because cervical cancer can take years to develop, many women don't have any symptoms initially. Many cervical cancers are detected incidentally by screening with a pap smear.
Diagnosis is made by colposcopy. A colposcope is a scope which can magnify the cervix, allowing the gynecologist to examine any abnormalities. If any abnormalities are observed, the next step is a cervical biopsy. During the biopsy, a small piece of cervical tissue is removed and examined by a pathologist.
After diagnosis of cervical cancer, the next step is determination of stage. The stage is based on several factors including size of the cancer, the depth of invasion into surrounding tissue, lymph node involvement, and any distant organ involvement. There are four stages for cervical cancer. Stage I involves the cervix/uterus alone while stage IV has spread to distant organs like the liver or lungs. Staging is primarily determined by physical examination but may be assisted by certain imaging techniques such computed tomography (CT scan), magnetic resonance imaging (MRI), or positron emission tomography (PET scan).
There are several treatment options for cervical cancer including surgery, radiation therapy, and/or chemotherapy. The treatments can be used alone or in combination depending on the stage of the cancer. For early stage cervical cancer, the most common treatment option includes radical hysterectomy (surgical removal of the uterus, cervix, and a portion of the vagina). If any high risk features are found after the surgery including positive surgical margins, lymph node involvement, or a more advanced stage than initially suspected, additional treatment with radiation therapy and chemotherapy may be recommended.
The alternative to surgery is a combination of radiation therapy and chemotherapy. Radiation therapy involves the use of high energy x-rays that damage the cancer cells ability to further reproduce and grow.
The Finley Wendt Regional Cancer Center treats cervical cancer along with many other cancer types and serves nine counties in the tri-state area to provide over 20,000 cancer treatments per year.