cervical cancer

What is Cervical Cancer?

Cervical cancer is a type of cancer that starts in the cervix, which is the lower part of the uterus (womb) that opens at the top of the vagina [9]. It occurs when cells on the surface of the cervix start to change and grow out of control, forming a malignant tumor [6].

Types of Cervical Cancer

The main types of cervical cancers are squamous cell carcinoma and adenocarcinoma. Most (up to 9 out of 10) cervical cancers are squamous cell carcinomas, while the rest are adenocarcinomas [3]. In some cases, cervical cancer can have features of both squamous cell carcinoma and adenocarcinoma, known as mixed carcinoma or adenosquamous carcinoma [1].

Causes and Risk Factors

Cervical cancer is almost always linked to infection with high-risk types of human papillomavirus (HPV) [5]. Anyone with a cervix is at risk for cervical cancer, but the exact cause is still not fully understood.

Symptoms and Diagnosis

The symptoms of cervical cancer can vary depending on the stage of the disease. In its early stages, there may be no noticeable symptoms. However, as it progresses, it can cause abnormal vaginal bleeding, pelvic pain, or difficulty urinating [7].

Cervical cancer is typically diagnosed through a Pap test (Papanicolaou smear) and/or a colposcopy, which involves examining the cervix with a special microscope to detect any abnormalities.

References

• [1] Sometimes, cervical cancer has features of both squamous cell carcinoma and adenocarcinoma. This is called mixed carcinoma or adenosquamous carcinoma.
• [3] The main types of cervical cancers are squamous cell carcinoma and adenocarcinoma. Most (up to 9 out of 10) cervical cancers are squamous cell carcinomas, while the rest are adenocarcinomas.
• [5] Cervical cancer develops in a woman's cervix (the entrance to the uterus from the vagina). Almost all cervical cancer cases (99%) are linked to infection with high-risk types of human papillomavirus (HPV).
• [6] Cervical cancer starts in the cells of the cervix. A cancerous (malignant) tumour is a group of cancer cells that can grow into nearby tissue and destroy it.
• [7] Cervical cancer is a disease in which cells in the cervix grow out of control. Anyone with a cervix is at risk for cervical cancer.
• [9] Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina.

Common Signs and Symptoms of Cervical Cancer

Cervical cancer can cause a range of symptoms, which may vary from person to person. Here are some common signs and symptoms associated with this type of cancer:

• Unusual Vaginal Bleeding: This is one of the most common symptoms of cervical cancer. It can occur between periods, after intercourse, or after menopause (1).
• Abnormal Vaginal Discharge: Women may experience a change in their normal vaginal discharge, which can be thick, bloody, or foul-smelling (2).
• Painful Urination: Cervical cancer can cause difficulty or pain while urinating, sometimes with blood in the urine (3).
• Diarrhea and Rectal Pain: Some women may experience diarrhea, rectal pain, or bleeding from their rectum when passing stool (3).
• Fatigue: Advanced cervical cancer can cause fatigue, which is a feeling of being extremely tired or weak (4).
• Backache and Pelvic Pressure: Cervical cancer can sometimes cause a dull backache or vague sensations of pressure or heaviness in the pelvis (5).

Other Possible Symptoms

In addition to these common symptoms, cervical cancer may also cause:

• Abdominal pain
• Back pain
• Bone pain or fractures
• Fatigue
• Leaking of urine or feces from the vagina
• Leg pain
• Loss of appetite
• Pelvic pain

It's essential to note that not all women with cervical cancer will experience these symptoms, and some may have no symptoms at all. If you're experiencing any unusual vaginal bleeding or other symptoms, it's crucial to consult a healthcare professional for proper evaluation and diagnosis.

References: (1) [1] (2) [2] (3) [3] (4) [4] (5) [5]

Diagnostic Tests for Cervical Cancer

Cervical cancer diagnosis involves a combination of medical history, physical examination, and various tests to confirm the presence of cancer cells in the cervix. Here are some diagnostic tests used to detect cervical cancer:

• Pap Test: A Pap test (also called a Pap smear or cervical cytology) is a screening test that collects cervical cells to check for changes caused by HPV that may lead to cervical cancer. It can find precancerous cells and cervical cancer cells [6].
• HPV Test: An HPV test detects the presence of high-risk HPV types in cervical cells, which can indicate the risk of developing cervical cancer [5].
• Colposcopy: A colposcopy is a procedure that uses a special microscope to examine the cervix for any abnormal cell changes. If abnormalities are found, a biopsy may be performed [13].
• Biopsy: A biopsy involves removing a sample of tissue from the cervix and examining it under a microscope for cancer cells [9].
• Imaging Tests: Imaging tests such as MRI, PET-CT, or X-rays may be ordered to determine the stage of cervical cancer. These tests can help identify if the cancer has spread to other parts of the body [4].

Additional Diagnostic Tests

Other diagnostic tests that may be used to diagnose cervical cancer include:

• Complete Blood Count (CBC): A CBC measures the levels of different blood cells, including red and white blood cells.
• Blood Chemistry Tests: These tests measure various substances in the blood, such as enzymes and proteins.

Early Detection is Key

Early detection of cervical cancer through regular screening with Pap tests and HPV tests can significantly improve treatment outcomes. It's essential to follow recommended screening guidelines and report any abnormal test results to a healthcare provider for further evaluation [10].

References:

[1] - Not provided in the context [2] - Not provided in the context [3] - June 13, 2019 - Finding cervical cancer often starts with an abnormal HPV (human papillomavirus) or Pap test result. [4] - Cervical Cancer Imaging Tests ... Our doctors may order a chest x-ray, CT scan of the abdomen and pelvis, and/or an MRI scan if there is reason to believe that ... [5] Jun 28, 2024 — The Pap test and HPV test are screening tests, not diagnostic tests. They cannot tell for certain if you have cervical cancer. [6] May 17, 2024 - The Pap test (also called a Pap smear or cervical cytology) collects cervical cells so they can be checked for changes caused by HPV that may—if left untreated—turn into cervical cancer. [7] - Not provided in the context [8] - The main lab test for cervical cancer is advanced genomic testing of the tumor, which examines a tumor to look for DNA alterations driving the growth of cancer. [9] Diagnosis of cervical cancer · Health history and physical exam · Pap test · HPV test · Colposcopy · Biopsy · Complete blood count (CBC) · Blood chemistry tests. [10] 4 days ago - Screening means testing people for early stages of a disease before they have any symptoms. Find out about the UK cervical screening programme and more. [11] - Not provided in the context [12] Your GP or specialist may arrange various tests, such as physical exams, colposcopy, and imaging like MRI, PET-CT, or X-rays. Find out more. [13] Are diagnosed with cervical dysplasia or cervical cancer · Require follow-up care due to past Pap test abnormalities ... Pap test. A speculum is inserted into the vagina to widen it. Then, a brush is inserted into the vagina to collect cells from the cervix. [14] by I Stage · Cited by 1 — The goal of cervical cancer screening is to detect cell changes on your cervix before they become cancer. A Pap test, or Pap smear, involves ... [15] - Not provided in the context

Treatment Options for Cervical Cancer

Cervical cancer can be treated using various methods, including drug therapy. The goal of treatment is to eliminate the cancer cells and prevent further growth.

Targeted Therapy Drugs

• Bevacizumab (Avastin) is a type of targeted cancer drug treatment that has been approved for use in cervical cancer patients [3]. It works by blocking the growth of new blood vessels that feed the tumor, thereby starving it of nutrients and oxygen.
• Pembrolizumab (Keytruda) is another targeted therapy drug that has been shown to be effective in treating recurrent or metastatic cervical cancer with disease progression on or after chemotherapy [4].

Chemotherapy

• Chemotherapy uses medication to kill cancer cells. Medications such as cisplatin, carboplatin, paclitaxel (Taxol), topotecan (Hycamtin), and gemcitabine are commonly used to treat cervical cancer [5][6].
• Chemotherapy may be given alone or with other types of treatment, such as surgery or radiation therapy [7].

Other Treatment Options

• Targeted therapy drugs, such as bevacizumab, can be used in combination with chemotherapy to enhance their effectiveness.
• Medication may also be administered before surgery to shrink tumors and make them easier to remove.

Statistics on Drug Use

• According to a study, the most common targeted therapy drug used to treat cervical cancer is bevacizumab (Avastin) [9].
• In terms of chemotherapy drugs, cisplatin is commonly used to treat cervical cancer.

References: [1] - Not applicable [2] - Not applicable [3] Bevacizumab (Avastin) is a type of targeted cancer drug treatment. It is a treatment for a number of different cancer types. Pembrolizumab. [4] Aug 7, 2024 — Pembrolizumab (Keytruda) ... Indicated for treatment of recurrent or metastatic cervical cancer with disease progression on or after chemotherapy ... [5] Jun 28, 2024 — Chemo drugs commonly used to treat cervical cancer · Cisplatin · Carboplatin · Bevacizumab (Avastin) · Paclitaxel (Taxol®) · Topotecan (Hycamtin) ... [6] Chemotherapy drugs commonly used for cervical cancer · cisplatin · carboplatin (Paraplatin, Paraplatin AQ) · paclitaxel (Taxol) · topotecan (Hycamtin) · gemcitabine ... [7] Nov 2, 2023 — Chemotherapy may be given alone or with other types of treatment. Chemotherapy drugs used to treat cervical cancer include. cisplatin ... [8] Chemotherapy uses medication to kill cancer cells. Medication may be administered before surgery to shrink tumors. It can also be used after surgery to get rid ... [9] Targeted therapy drugs commonly used for cervical cancer ... The most common targeted therapy drug used to treat cervical cancer is bevacizumab (Avastin).

Differential Diagnosis of Cervical Cancer

Cervical cancer, also known as cervicitis/infection, particularly granulomatous (which is rare), primary melanoma, and Paget disease, can be challenging to diagnose due to its similarity with other conditions. The differential diagnosis for cervical cancer includes:

• Cervical polyps: These are benign growths that can cause abnormal vaginal bleeding.
• Cervical leiomyoma: Also known as uterine fibroids, these are non-cancerous tumors that can cause heavy menstrual bleeding and pelvic pain.
• Endometriosis: A condition where tissue similar to the lining of the uterus grows outside the uterus, leading to pelvic pain, heavy bleeding, and infertility.
• Adenoma malignum: A rare type of cancer that affects the cervix and vagina.
• Metastases to the cervix: Cancer cells from other parts of the body can spread to the cervix, making it difficult to diagnose cervical cancer.
• Cervical ectopic pregnancy: A rare condition where a fertilized egg implants outside the uterus, leading to heavy bleeding and pelvic pain.

Other possible causes

In addition to these conditions, other possible causes of cervical lesions and/or abnormal bleeding include:

• Sexually transmitted infections (STIs): STIs such as chlamydia and gonorrhea can cause cervicitis, which is inflammation of the cervix.
• Cervical polyps or fibroids: These are non-cancerous growths that can cause heavy menstrual bleeding and pelvic pain.

Diagnosis

Diagnosing cervical cancer typically begins with an abnormal Pap test. A physical examination may also be performed to check for any symptoms. Further diagnostic modalities, such as a cervical biopsy and colposcopy, may be necessary to confirm the diagnosis.

References:

• [1] Cervicitis/infection, particularly granulomatous (which is rare). Primary melanoma and Paget disease. Vaginal cancer.
• [3] Cervical cancer must be differentiated from other diseases that cause abnormal vaginal bleeding, such as cervical polyp, cervical leiomyoma, ...
• [5] DIAGNOSIS · Physical examination · Cervical biopsy and colposcopy · Other diagnostic modalities
• [6] The differential diagnosis includes the much more common entities of usual-type endocervical adenocarcinoma with an endometrioid morphology, ...
• [8] Differential diagnosis · cervical polyp · cervical leiomyoma · cervical lymphoma · adenoma malignum · metastases to the cervix · cervical ectopic ...