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Cervical cancer

 Cervical cancer cells originate in the lower region of the uterus where it joins the vagina, called the cervix. Most cases of cervical cancer are caused by various strains of the human papillomavirus (HPV), a sexually transmitted disease.


When exposed to HPV, the body's immune system can often prevent the virus from doing any harm. In a small fraction of people, however, the virus persists for years and enables some cervical cells to turn into cancer cells. You can reduce your chance of acquiring cervical cancer by getting screening exams and an anti-HPV vaccination.




Your prognosis and course of therapy are influenced by the type of cervical cancer you have. The cervical cancer types that are most prevalent include:

  1. Squamous cell carcinoma: This specific kind of cervical cancer originates in the thin, flat cells (squamous cells) lining the outer region of the cervix that extends into the vagina.
  2. Adenocarcinoma: This kind of cervical cancer originates in the column-shaped glandular cells that border the cervical canal.


Sometimes both kinds of cells might contribute to cervical cancer. 




Early-stage cervical cancer is typically not symptomatic.

Symptoms and indicators of cervical cancer that are more serious include:

  1. Bleeding from the cervix after menstruation, in between periods, or after menopause
  2. Vaginal discharge that is watery, red, and maybe heavy and odorous
  3. Pain in the pelvic or during sexual intercourse


Stages of cancer:


The following are the main categories according to FIGO classification:


  1. Stage I: cancer that is invasive but only affects the cervix.
  2. Stage II: Locoregional spread beyond the uterus, but not to the pelvic sidewall or the bottom portion of the vagina.
  3. Stage III: Cancerous spread to the lower third of the vagina or the sidewall of the pelvis, as well as hydronephrosis or a non-functioning kidney brought on by ureter invasion.
  4. Stage IV: Cancer metastasized into the bladder or rectum mucosa or beyond the pelvis.


The stages are further categorised as follows:


  1. Stage Ia cervical carcinoma: Preclinical invasive carcinoma that can be diagnosed only utilising microscopy
  2. Stage Ib cervical carcinoma: A clinically visible lesion that is confined to the cervix uteri
  3. Stage Ib1: Primary tumour’s diameter is not greater than 2 cm.
  4. Stage Ib2: Primary tumour’s diameter is greater than 2-4 cm.
  5. Stage Ib3: Primary tumour diameter is >= 4 cm.
  6. Stage IIa cervical carcinoma: Spread occurs in the upper two-thirds of the vagina without parametrial invasion
  7. Stage IIb cervical carcinoma: Extends to the parametrium but not into the pelvic sidewall
  8. Stage IIIa cervical carcinoma: Extends to the lower one-third of the vagina, without spreading to the pelvic sidewall
  9. Stage IIIb cervical carcinoma: Extends to the pelvic sidewall and/or invasion of the ureter, which might lead to non-functioning kidney or hydronephrosis
  10. Stage IIIc cervical carcinoma: Extends to pelvic/para-arotic lymph
  11. Stage IVa cervical carcinoma: Extends to the mucosa of the bladder or rectum
  12. Stage IVb cervical carcinoma: Extends beyond the true pelvis and/or by metastasis into distant organs



Differential diagnosis of stages:


Various tests can be done to see if cancer has spread, including:


  1. Proctoscopy or a cystoscopy to determine whether cancer has progressed to the rectum or bladder.
  2. a CT scan, which combines many X-rays to produce three-dimensional clarity and reveal different types of tissue, including blood veins.
  3. Three-dimensional body images are produced by magnetic resonance imaging (MRI), which uses magnets and radio waves. It may also be employed to distinguish between benign and malignant tumors.
  4. PET scan, also referred to as a positron emission tomography scan. An imaging test called a PET scan can help show how your tissues and organs are working and help in detecting the spread of the disease. To demonstrate this activity, a minimal quantity of radioactive material is required.


Alarming factors:


Complications are common in cervical cancer patients. These may develop as an immediate consequence of the malignancy or as a side effect of therapies including radiotherapy, chemotherapy, and surgery. Cervical cancer complications can range from relatively modest ones, like minor vaginal bleeding or needing to urinate frequently, to life-threatening ones, such as severe haemorrhage or renal failure.




To lower your risk of acquiring cervical cancer, one should do the following:

  1. HPV vaccines:  The HPV vaccine may reduce your chance of acquiring cervical cancer and other cancers associated with HPV. 
  2. Regular Pap tests:  Cervical precancerous abnormalities can be found by Pap tests, allowing for their observation or treatment to halt cervical cancer. Most medical organisations recommend beginning routine Pap tests at age 21 and having them redone every few years interval. 
  3. HPV DNA test
  4. Safe sex:  You may lessen your chance of developing cervical cancer by taking precautions against STDs, such as using a condom every time you engage in sexual intercourse and being in committed relationship.
  5. Avoid smoking.




  • A gynecologic oncologist is part of the cervical cancer treatment team (a doctor who specialises in cancers of female reproductive organs). Treatment for cervical cancer is based on a variety of factors, including the stage of the disease, your age and general health, and whether or not you intend to have children in future.
  • Cervical cancer is treated with surgery, chemotherapy, radiation, targeted therapy, and immunotherapy.
  • Radiation therapy employs the use of energy beams to kill cancer cells on your cervix. Radiation therapy is classified into two types:
  • External beam radiation (EBRT): A machine outside your body fires high-powered radiation at cancer.
  • Brachytherapy: Radiation is delivered to or near cancer in the cervix and upper part of vagina.





Cervical cancer is a type of cancer that develops in the cervix. It is a potentially life-threatening condition that affects women worldwide. The primary cause of cervical cancer is the human papillomavirus (HPV) infection and other risk factors, such as smoking, hormonal contraceptive use, and weak immune system. Symptoms of cervical cancer may include vaginal bleeding between periods or after sexual intercourse, foul-smelling white or blood tinged discharge, and low back or lower abdominal pain.  It is important for women to seek prompt medical attention if they experience symptoms or have concerns about their health. Early detection and appropriate treatment can greatly improve the outcomes and survival rate for cervical cancer patients.

Medanta Medical Team
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