CERVICAL CANCER

 What is cancer?
The organs and tissues on our body are constructed of cells. Cells in different parts of the body may look and work differently but most reproduce themselves in the same way. Cells are constantly becoming old and dying, and new cells are produced to replace them. Sometimes there is an uncontrolled growth of cells causing a swelling or a tumour.

Tumours can be benign or malignant.

Benign tumours are not cancerous because they do not spread to beyond the original tumour growth area, however, they may cause a problem by pressing on the surrounding organs. They can be removed by an operation and do not usually cause any further problems.

A malignant tumour is a growth (group) of cancer cells. Cancer is a general term to describe uncontrolled, abnormal growth and division of cells. Malignant tumours have the ability to spread beyond the original tumour growth. Cancer cells have the ability to travel from one part of the body to another via the blood or lymphatic system. Newly formed tumours are called metastasis or secondary cancer. Cancer cells are also able to invade and destroy other tissue around them.

 EDUCATION ON CERVICAL CANCER, 

 The cervix is the lower, narrow end of the uterus (the hollow, pear-shaped organ where a fetus grows). The cervix connects the uterus to the vagina (birth canal).


Anatomy of the female reproductive system. The organs in the female reproductive system include the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus has a muscular outer layer called the myometrium and an inner lining called the endometrium.

Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through a series of changes in which cells that are not normal begin to appear in the cervical tissue. When cells change from being normal cells to abnormal cells, it is called dysplasia. Depending on the number of abnormal cells, dysplasia may go away without treatment. The more abnormal cells there are, the less likely they are to go away. Dysplasia that is not treated may turn into cancer, over time. The cancer cells grow and spread through the cervix. It can take many years for dysplasia to turn into cancer.


Early Symptoms of Cervical Cancer

There are usually no early symptoms of cervical cancer. However, regular cervical cancer screenings can help healthcare providers find abnormal cells before cancer develops -- even when no early signs or symptoms are present. As a result, it's important to talk to your healthcare provider about how often you should have Pap smears based on your particular situation.
An Introduction to the Early Signs and Symptoms of Cervical Cancer
Cervical cancer usually develops slowly over time, which means that before cancer appears in the cervix, the cells of the cervix go through changes known as dysplasia (precancerous changes). During dysplasia, cells that are not normal begin to appear in the cervical tissue. Later, cancer cells start to grow and spread more deeply into the cervix and to surrounding areas.


Specific Early Cervical Cancer Symptoms
There are usually no early symptoms of cervical cancer, which is why cervical cancer screenings are so important. Regular Pap tests allow doctors to see early changes in the cervix that could be the beginning of cervical cancer. It is important to note that pain is not an early cervical cancer symptom. Therefore, you should not to wait to feel pain before seeing a healthcare provider.

Why Early Cervical Cancer Screenings Are So Important
Cervical cancer screenings are extremely important because they can help doctors find abnormal cells before cancer develops. Finding and treating abnormal cells can prevent most cervical cancer, and treatment is more likely to be effective if cancer is found early.

The number of women who are diagnosed each year has been decreasing for the past several decades. Doctors believe that this decrease is directly related to the success of cervical cancer screening.

In order to reduce the risk of developing cervical cancer, healthcare providers recommend that women have regular Pap tests. A Pap test, also known as a Pap smear or cervical smear, is a simple test that is used to look at cervical cells.

Pap tests are important because they can find cervical cancer or abnormal cells that can lead to cervical cancer. Doctors generally recommend that:
 
Women should begin having Pap tests three years after they begin having sexual intercourse or when they reach age 21 (whichever comes first).



Most women should have a Pap test at least once every three years. Talk to your healthcare provider about what schedule is best for you.



Women age 65 to 70 who have had at least three normal Pap tests and no abnormal Pap tests in the past 10 years may decide, after speaking with their doctor, to stop cervical cancer screening.



Women who have had a hysterectomy to remove the uterus and cervix, also called a total hysterectomy, do not need to have cervical cancer screening. However, if the surgery was used as a treatment for precancerous cells or cancer, the woman should continue with these screenings.


Women should talk with their healthcare provider about when they should begin having Pap tests, how often they should have them, and when they can stop having them. This is especially important for women who have a higher-than-average risk of cervical cancer.

 Cervical Cancer Prevention

Cervical cancer in most cases occurs
due to a sexually transmitted infection
with Human Papilloma Virus (HPV).
Since the cause and risk factors are
known, prevention of this cancer is
possible to some extent. However,those with a genetic predisposition to
the cancer, may still go ahead to
develop the cancer despite preventive
measures.
Some of the preventive measures
include:

Safe sex measures

Since there is a strong association
between HPV infection and cervical
cancer, safe sex measures can
prevent cervical cancer. Barrier
contraception such as condoms
should be used especially at the
beginning of a sexual relationship and
sexual intercourse with a
promiscuous or little known partner.
Both partners should get regularly
tested for sexually transmitted
infections (STIs) at a sexual health
clinic. All tests are free and
confidential.

HPV vaccination

There is a vaccine against HPV. The
vaccine protects against HPV infection
provided it is given before an
individual begins his or her sexually
active life. Girls should be offered the
HPV vaccine as part of their routine
childhood immunisation programme.
The vaccine should be given to girls
who are 12 to 13 years old, with three
doses provided over a six-month
period. Boys also need to be
vaccinated against HPV for prevention
of genital warts, anal cancers and for
prevention of spread of HPV to their
potential female sexual partners.
Gardasil, is licensed and
manufactured by Merck & Co. is
a vaccine against HPV types 6, 11, 16 &
18. Gardasil is up to 98% effective. It
was approved by the US Food and
Drug Administration on June 8, 2006.
GlaxoSmithKline has developed a
vaccine called Cervarix which has
been shown to be 92% effective in
preventing HPV strains 16 and 18 and
is effective for more than four years.
HPV vaccines are targeted at girls and
women of age 9 to 26 because the
vaccine only works if given before
infection occurs
Routine screening for cervical
cancer
According to regulations, all women
between 25 and 49 are invited to get
screened for cervical cancer once in
every three years. Those between 50
and 64 years are asked to get tested
every 5 years. Those with an initial
abnormal cytology report may be
called in for screening more
frequently.
Various organizations have varying
recommendations on the intervals
between screening tests that vary
between 1 year to 5 years. The
American Cancer Society (ACS)
recommends that cervical cancer
screening should begin approximately
three years after the onset of vaginal
intercourse and/or no later than
twenty-one years of age.
Guidelines vary on how long to
continue screening. Most, however,
agree that women who have not had
abnormal smears can stop screening
about age 65 (USPSTF – United States
Preventive Services Task Force) to 70
(ACS).
Screening is performed using cervical
smear tests or Papinicoloau smears or
Pap smear tests. It is a painless and
relatively effective way to detect
abnormal changes in the cells of the
cervix at an early stage. Screening
tests are important even in women
who have been vaccinated against
HPV. The earlier the diagnosis is made
the better chances of cure there are.

Stopping smoking

Risks of cervical cancer may be
lowered by quitting smoking. Smokers
are less able remove HPV infection
from their bodies and are thus at a
higher risk of cervical cancer.
Adequate and appropriate
nutrition
Studies have shown that higher levels
of fruits and vegetables in diet is
associated with a 54% decrease risk of
HPV persistence that means reduction
in cervical cancer risk. Vitamin C also
lowers the risk of persistent HPV
infection.
Women with higher folate status also
in addition are significantly less likely
to be repeatedly HPV test-positive and
more likely to become test-negative.