Cervical cancer used to be the leading cause of cancer death for cervix-having individuals living in the United States, according to statistics shared by the Centers for Disease Control and Prevention (CDC). But since the late 1970s, the numbers of deaths caused by cervical cancer have steadily declined, thanks to preventative measures like Pap smears and human papillomavirus (HPV) vaccines and testing.
That’s not to say cervical cancer is no longer a problem. The American Cancer Society estimates that, in 2018, approximately 13, 240 new cases of invasive cervical cancer will be diagnosed and about 4, 170 individuals diagnosed with cervical cancer will die because of it. While that’s far lower than the 63, 000 cases of uterine cancer the American Cancer Society predicts will be diagnosed in 2018, it’s clear that there’s still more to be done when it comes to preventing and treating cervical cancer.
Cervical cancer develops when healthy cells in the cervix, the narrow lower portion of the uterus that opens into the vagina, undergo genetic changes that cause them to mutate into abnormal cells.
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While healthy cells grow, multiply, and die at a set rate, cancer cells grow and multiply rapidly without ever dying off. As more and more of these abnormal cells accumulate, they form a cancerous mass—a tumor. The cancer cells then continue to multiply, causing the initial tumor to grow larger. Not only do the cancerous cells begin to invade healthy surrounding tissue, but they can also break off and spread to elsewhere in the body, a process known as metastasization.
So, what are the causes of cervical cancer? It’s not entirely clear, but experts agree that human papillomavirus (HPV), the most common sexually transmitted infection in the United States, plays a central role in its development. Yet in most cases—an estimated 14 million occur each year—HPV does not progress to cervical cancer, so other factors must play a role too.
The CDC predicts that between 80% and 90% of sexually-active individuals will be infected with at least one type of HPV (there are over 200 different strains) at some point in their lives. To be infected with HPV, your skin or mucous membranes must come in contact with the skin or mucous membranes of someone with the virus. It’s entirely possible to transmit HPV to someone else without ever realizing you had it to begin with, which is part of why the incidence rate is so high. Many people with HPV will never experience any symptoms and the infection will clear up on its own. Certain strains, however, can cause unpleasant issues like genital warts, while others can spur the development of cervical cancer.
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There are two types of sexually-transmitted HPV: low-risk HPVs and high risk HPVs. Low-risk HPV doesn’t lead to cancer, but does cause the growth of potentially irritating and uncomfortable genital warts. Most genital warts are caused by HPV strains 6 and 11. High-risk HPVs are called high-risk precisely because they can cause cancer. Researchers have identified roughly a dozen strains of high-risk HPV, but have found that just two—strains 16 and 18—cause most cases of HPV-related cervical cancer.
There are two primary types of cervical cancer as well: squamous cell carcinoma and adenocarcinoma. The most common is squamous cell carcinoma, which begins in the squamous cells, the thin, flat cells lining the outer part of the cervix that projects into the vagina. Adenocarcinoma begins in the column-shaped glandular cells lining the cervical canal that link the cervix and uterus. In some cases, both types of cells begin to mutate, while in very rare instances, the cancer develops in an entirely different type of cervical cell.
In the early stages of cervical cancer, most people notice no symptoms at all. That’s why screening and other preventative measures are such important ways of combating this kind of cancer.
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Symptoms of cervical cancer typically begin to appear once the cancerous cells have penetrated into the tissues beneath the top layer, at which point the diagnosis becomes invasive cervical cancer. And still, the symptoms that appear at this stage are often interpreted as harmless, or attributed to other causes. Here are a few early signs of cervical cancer.
Irregular vaginal bleeding is one of the most common symptoms of cervical cancer. The bleeding may occur between menstrual periods, after sex, or even after menopause, according to Dr. Taraneh Shirazian, a gynecologist at NYU Langone Health. Unfortunately, this symptom often gets dismissed as spotting. It’s true that cervical cancer is certainly not the only cause of vaginal bleeding between periods, but to be safe, it’s a good idea to consult a gynecologist whenever you experience unusual bleeding. For those who are postmenopausal, vaginal bleeding is definitely a cause for concern and should be evaluated by a medical professional.
Again, many factors can cause menstrual cycles to shift, some of which are no cause for alarm. But proactively discussing menstrual cycle changes with a doctor is a good way to assess whether there are any screenings or treatments that could be beneficial. This is especially true if the changes are dramatic, like a period that lasts for two weeks, or two periods within a single month.
Abnormal Vaginal Discharge, Smelling May Indicate Cervical Cancer –expert
The appearance and smell of vaginal discharge can be indicative of a range of vaginal health issues. Some indicators of cervical cancer include discharge that is:
In some cases, discharge may contain chunks of tissue, technically referred to as necrotic material. And since masses and tumors secrete fluid, continuous, inexplicable watery discharge can also be a sign of cervical cancer.
Advanced cervical cancer causes the cervix to become so enlarged, it begins to swell into the abdominal cavity. This compresses the gastrointestinal tract and stomach, which can cause nausea and acid reflux. Since nausea can result from many other causes, it’s best to address this symptom first with a primary care physician, rather than a gynecologist.
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The severe cervical swelling that comes in the advanced stages of the disease can also lead to weight loss, since a compressed stomach can’t hold very much food. Ongoing nausea and indigestion also make eating a far less pleasant activity than it can be under other circumstances. Individuals who have lost between 5% and 10% of their body weight over the course of six months without trying should consult with a medical professional.
Pelvic pain can definitely be an indicator that something’s amiss with the cervix. If cervical cancer spreads to the bladder, intestines, liver, or lungs, it can cause back pain. In some cases, that pain can even radiate down the legs. Both back and leg pain only occur when the cervical cancer is quite advanced, since the cervix itself doesn’t affect many nerves.
To determine whether or not cervical cancer is the cause of ongoing pelvic or back pain, speak with a primary care physician.
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This is a universal symptom of cancer, and again, one that appears once cervical cancer has progressed to an advanced stage. One reason for fatigue that’s specific to cervical cancer is abnormal vaginal bleeding, which can lower the amount of red blood cells and oxygen in the body, leading to deep and prolonged fatigue.
Advanced cervical cancer can result in kidney blockages, which cause urination to become uncomfortable. In some cases, it may lead to frequent urges to urinate, even when the bladder is not full. It can also become difficult to urinate.
The implementation of effective preventative measures and screening tests has been instrumental to lowering the number of deaths caused by cervical cancer. Here are eight ways to prevent as well as screen for cervical cancer.
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Given that HPV plays such a crucial role in the development of cervical cancer, the HPV vaccine can have a significant effect on preventing it. Gardasil, the most common and most effective HPV vaccine, protects against HPV strains 16 and 18, which cause 70% of cervical cancers, as well as strains 6 and 1, which cause 90% of genital warts. Because the vaccine is only effective prior to infection, the goal is to inoculate children before they become sexually active.
After a valid series of HPV vaccines has been completed, no additional doses will be needed. There are numerous side effects to consider before opting for the HPV vaccine. We explore those considerations in this article.
According to the CDC, 6 out of every 10 individuals diagnosed with cervical cancer have never received a Pap smear or have not been tested in the past five years. Dr. Eloise Chapman-Davis, a gynecological oncologist at Weill Cornell Medicine and New-York Presbyterian says not having regular Pap smears is one of the biggest risk factors for cervical cancer.
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The Pap smear, one of the most reliable cancer-screening tests available, detects abnormal, precancerous cells. When caught early, treatments can address these abnormal cells before they develop into full-fledged cancer.
The Office on Women’s Health recommends regular Pap smears to look for changes to cervical cells beginning at age 21, as well as HPV tests between the ages of 30 and 65. The general guidelines for Pap smears, per the Office on Women’s Health, are as follows:
Gynecologists and primary care doctors can perform Pap smears during
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