WOMEN’S BODIES: CANCER OF THE CERVIX

Filed under Women's Health by admin

Many cells of our bodies (and especially those that form covering or lining me branes, and glands) divide often to place ‘worn-out’ or shed cells. In health, cell division is well controlled so that just as many new cells are formed as are needed. When cell division becomes uncontrolled, too many new cells are produced. These cells are usually abnormal in appearance and function. This is primary cancer.

At first the cancer is small and remains within normal tissue boundaries, but with time the mass of cells outgrows its site
and breaks through these boundaries to invade nearby tissues and organs. This is invasive cancer.

If the cancer cells invade blood lymph vessels, they may travel and set down to grow in distant parts of the body. This is metastatic cancer, and the growths that spread to distant parts of the body are called metastases or secondary cancers. The time taken for cancers to and spread is very variable, depending on the type of cells affected, the age of the patient, and many other factors not well understood.

Cervical cancer is the sixth most common cancer in Australian women, after breast, bowel, lung and two types of skin cancer. About one in a hundred women will die of cancer of the cervix: eight times as many women die of breast cancer. The highest rate of cervical cancer occurs in women aged 50-54 years.

There are two types of cervical cancer. By far the most common begins in the squamous cells that cover the ectocervix. Less common (though recently seen more frequently, especially in younger women) is cancer that begins in the lining of the cervical canal.

What causes cancer of the cervix?

We don’t know. Some factors are suspected because they are often found in women who develop cervical cancer.

Sexual behaviour

Women who don’t have sex rarely develop squamous cervical cancer. The greatest number of cancers and abnormal Pap smears (possibly pre-cancerous) are found in women who began sex early and/or have many partners. However, the majority of women with similar sexual behaviour don’t develop abnormal Pap smears or cancer.

The wart virus

Evidence of wart virus can be found in some women with cervical cancer. However, in older women with cervical cancer associated wart virus is rare. It is suspected that certain types of HPV are more likely to cause abnormal cell divisions in younger women. The majority of women with HPV don’t get cervical cancer.

Immunodeficiency

Smoking and dietary deficiencies are known to alter immune resistance. Cancerous cells are more likely to survive and grow in some types of reduced immunity. Development of cancer of the cervix is now counted as a sign that women with HIV infection have progressed to AIDS.

Symptoms

It is believed that it can take up to 30 years to progress from the earliest precancerous cell changes to cancer of the cervix. Before it becomes invasive, squamous cervical cancer rarely causes symptoms and is seldom detected by looking at or feeling the cervix; after invasion, the most common symptoms are bleeding between periods and after sex, and pelvic pain. Any woman with these symptoms should always be checked to exclude cervical cancer, even if the Pap smear is normal. Sometimes the first symptoms come from organs that have been invaded, such as bleeding or other symptoms from the bladder or bowel.

Treatment

Hysterectomy is always advised, plus removal of as much as possible of any cancerous spread beyond the uterus. Radiotherapy may be given after surgery to destroy spread to parts that can’t be removed by surgery.

Treatment of cervical cancer after it becomes invasive is difficult and not always successful. However, it can’t be repeated too often that pre-invasive cancer and the cell abnormalities that precede it can, in almost every case, be completely removed by simple means, and the progress of the invasive cancer stopped. Established cancer is much more likely to be cured by treatment if it is picked up early by Pap smear. Hence if all women were screened by regular Pap smears, most deaths from cervical cancer could be prevented.

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