diease

Cervix Cancer


OVERVIEW OF Cervix Cancer :

Cancer cervica is also known as the cervical cancer. It develops in the cervix  (the entrance of the uterus)


STRUCTURE of Cervix Cancer :

The cervix is the lower most portion part pf the uterus and it acts as a connector between the vagina and uterus. The cervix is divided into two part such as ecto cervix and endo cervix

 The  ectocervix is the part of the cervix that projects with the vagina. It is lined by the stratifies squamous non keratinized epithelium

The endocervix is the the major interior portion of the uterus that is lined by the simple columnar epithelim which secreates  the mucus.

When the endocervix canal ends the Internal os leads the starting of vagina. Similarly when the ecto cervix canal ends the External os paves the way for the vagina.

The cervix helps in the passage of the sperms into the entry of the uterus and also it maintains the sterility of the upper genital tract by preventing the bacterial invasion into the uterus and also shedd the cells, secreate mucus and monitors the female genital tract.

Types of the cervical cancer:

Adenocarcinoma: it takes place by the glands present in the lining cells of the cervix

Squamous cell carcinoma: it takes place by the cells lining the cervix


EPIDEMIOLOGY :

Epidemiology:

Cervical cancer is the fourth most common cancer in women. In 2018, an estimated 570 000 women were diagnosed with cervical cancer worldwide and about 311 000 women died from the disease.


CAUSES :

Causes:

Human Papilloma virus(HPV)

Improper sexual contact

Smoking- in smoking the noxious substance carried primarily to lungs and then through blood stream it is taken to the cervix which leads to the cervical cancer.

HIV

Chlamydial infection

Gonorrhoea

Syphilis

Young pregnancy- getting pregnant within 20 years of age

Genetics

Overweight

Improper diet

Exposure to Diethylstilbesterol- A drug which is given to the women in older days to prevent from miscarriages. But nowadays it is stopped.


ROUTES OF TRANSMISSION :

infection by the  human papilloma HPV) is the most important risk factor for cervical cancer. HPV is a group of more than 150 related viruses. Some of them cause a type of growth called papilloma which are more commonly known as warts.

  • HPV can infect cells on the surface of the skin, and those lining the genitals, anus, mouth and throat, but not the blood or internal organs such as the heart or lungs.
  • HPV can spread from one person to another during skin-to-skin contact. One way HPV spreads is through sexual activity, including vaginal, anal, and even oral sex.
  • Different types of HPV cause warts on different parts of the body. Some cause common warts on the hands and feet; others tend to cause warts on the lips or tongue.

Certain types of HPV may cause warts on or around the female and male genital organs and in the anal area. These are called low-risk types of HPV because they are seldom linked to cancer.

Other types of HPV are also known as the high risk types because they are strongly linked to cancers, including cancer of the cervix, vulva and penile cancer in men, vagina in women, and cancers of the anus, throat and mouth in both men and women. 

Infection with HPV is common, and in most people the body can clear the infection by itself. Sometimes, however, the infection does not go away and becomes chronic. Chronic infection, especially when it is caused by certain high-risk HPV types, can eventually cause certain cancers, such as cervical cancer.


COMMON CLINICAL SIGNS AND SYMPTOMS :

Abnormal vaginal discharge and bleeding

Bleeding between the menstrual cycle

Bleeding after douching

Difficulty in eating

Bloating

Pain and burning sensation during urination

Pelvic pain or pressure in the pelvic region

Back pain

Itching and burning sensation in the vulva

Rashes, soreness in the vulva

Pain during sex

Bleeding even after menopause


DIAGNOSTIC :

Cervical smear test

The American Cancer Society estimate that healthcare professionals will make over 13,000 new diagnoses of invasive cervical cancer in 2019. The disease will be fatal in around 4,000 women. However, regular screening could prevent most of these deaths.

Screening does not detect cancer but looks for abnormal changes in the cells of the cervix. Without treatment, some abnormal cells can eventually develop into cancer.

HPV DNA testing

This test determines whether the individual has any of the types of HPV most likely to cause cervical cancer. It involves collecting cells from the cervix for lab testing.

The test can detect high-risk HPV strains in cell DNA before any anomalies become clear in the cervical cells.

If there are signs and symptoms of cervical cancer, or if the Pap test reveals abnormal cells, a doctor may recommend additional tests.

These include:

  • Colposcopy: This is visual examination of the vagina using a speculum and a colposcope, a lighted magnifying instrument.
  • Examination under anesthesia (EUA): The doctor can examine the vagina and cervix more thoroughly.
  • Biopsy: The doctor takes a small section of tissue under general anesthesia.
  • Cone biopsy: The doctor takes a small, cone-shaped section of abnormal tissue from the cervix for examination.
  • LLETZ: Diathermy using a wire loop with an electric current helps remove abnormal tissue. The healthcare professional then sends the tissue to the lab for checking.
  • Blood tests: A blood cell count can help identify liver or kidney or cervix problems.
  • CT scan: A medical professional might use a barium liquid to show up any cellular abnormalities.
  • MRI: Special types of MRI may be able to identify cervical cancer in its early stages.
  • Pelvic ultrasound: High-frequency sound waves create an image of the target area on a monitor.
  • Stages:
  • Stage 0:
  • The cancer is not spread but has potential development of the cancer in the future which is termed as carcinoma insitu.
  • Stage 1:
  • The cancer cells are consider to the localized area. This is also called the early stage cancer
  • Stage 2 and Stage 3:
  • It indicates that the cancer cell has spread to the nearby lymphnodes or tissues.
  • Type 4 :
  • It indicates that the cancer has spread to other parts of the body and also it easily gets metastasis. This is also called an advanced type of cancer.


TREATMENT AND PROGNOSIS :

Surgery to cut away the cancer cells:

      • This is done with the of cone biopsy. It is indicated for small sized cancer.
      • Trachelectomy:
      • This treatment is indicated for early stage cancer. This treatment involves the removal of cervix alone.
      • Hysterectomy:
      • It is the treatment used to remove the vagina, cervix and uterus.

 

  • Chemotherapy:
  • A chemotherapy is after the sugery or before the surgery to shrink the cancer cells. A chemotherapy is nothing but the delivery of drug intravenously.
  • Drug used:
  • Cisplatin Cisplatin
  • Carboplatin
  • Paclitaxel (Taxol)
  • Topotecan
  • 5 -fluorouracil
  • Radiation therapy:
  • It uses powerful x rays or emission of protons to destroy the cells. The radiation therapy also aids  in shrinkage of the cells and also relief the symptoms caused by the cancer.
  • Immunotherapy
  • it is a drug treatment that uses your immune system to fight cancer. Your body's disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that blind the immune system cells from recognizing the cancer cells. This immunotherapy boos those cells and helps the body to fight against it.

 


PROGNOSIS :

 

The chances of living for at least five years after being diagnosed with cervical cancer are:

  • stage 1 – 80-99%
  • stage 2 – 60-90%
  • stage 3 – 30-50%
  • stage 4 – 20%


PREVENTION :

Practise safe sex

Do douching with cautious

Avoid smoking and alcohol consumption

Maintain the healthy weight and diet


Medicines used in the Treatment :

  • Cisplatin Cisplatin
  • Carboplatin
  • Paclitaxel (Taxol)
  • Topotecan
  • 5 -fluorouracil