Cervical cancer
The womb is the main breeding organ in a woman. It is intended to receive the fertilized egg to ensure the development of the fetus.
Located at the small pelvis, behind the bladder and forward of the rectum, the womb is a hollow organ, triangular shaped about ten centimeters high by 5 centimeters wide. The cervix, the lower part of the organ, leads to the vagina. The uterine body that represents the most voluminous part of the uterus intended to receive the fertilized ovum is connected by its upper straight and left ends to the uterine tubes.
The uterine wall consists of 3 layers:
The uterine mucous membrane called ′′ endometrial ′′ represents the inner wall of the womb;
The muscle intermediate layer called myometer;
Serous uterine is the external wall of the womb.
The cervix that connects the vagina to the womb is covered with a mucous membrane secreting the cervical glair. This mucous membrane plays a very important role in the biological functions of the womb. It consists of a first outer layer called the epithelium and a second, the connective tissue. Almost all cervical cancers begin at the epithelium level.
What is cervical cancer?
Cervical cancer comes from cervical cells. The latter consists of two parts: endocol (towards the womb) and exocol (towards the vagina).
The vast majority of cancers are born at the mucous membrane epithelium of the pass. Then we talk about carcinomas. Two types of carcinomas are distinguished:
Epidermoid carcinomas that account for more than 85 % of cases. They are developing at exocol level;
Adenocarcinomas in 15 % of cases. They are growing in endocol.
Cervical cancer represents the 12th most common cancer among women in France. The number of new cases is estimated at 3 and more than 1 patients die each year. Please note that the prognosis of this cancer is getting worse. The survival rate was indeed 68 % in the 1990 s and it fell to 62 % after 2005.
What are the risk factors?
The major risk factor for cervical cancer is exposure to human papillomavirus (HPV). This virus is transmitted through contact with the skin and mucous membranes, most often through sexual routes. Please note that the condom, even if it limits contact with the virus, does not allow complete protection.
Not all papillomaviruses are involved in cancer. Only certain types are involved, including HPV 16 and 18 which are involved in 70 % of cervical cancer.
Papillomavirus infection is extremely common. An estimated 80 % of women would have been infected at least once in their lives. However, in about 10 % of infection cases, the virus persists at the cervical mucous membrane. It may then be the origin of changing the epithelium. In this case we talk about precancerous lesions that can potentially evolve into cervical cancer.
Other risk factors increase the risk of developing this cancer:
Precocity of sexual intercourse
The number of sexual partners, the more they are, the more the risk increases;
Tobacco;
Immunosuppressive treatment (which lowers immune defenses and makes the body more vulnerable to infections);
prolonged use of hormonal contraceptives;
Being a carrier of the HIV virus (also lowers immunity);
Some sexually transmitted infections (chlamydia, herpes);
Having several children.
What symptoms?
At first, cervical cancer does not cause any particular symptoms. At this point, only screening smears can highlight it.
When cancer evolves, it creates symptoms including:
Vaginal bleeding after sex;
Vaginal bleeding out of period;
Pain during sex;
Vaginal losses;
Pain in the lower stomach;
Back pain.
Please note! Such symptoms must alert and lead to his doctor’s consultation.
Diagnosis, treatment and prevention
How to diagnose cervical cancer?
A gynecologist talks to her patient A cervical cancer can be mentioned in front of:
An abnormal smear;
Some symptoms (mentioned above).
In front of these two cases, the gynecologist conducts a clinical and gynecological examination completed or not completed further examinations.
The diagnosis of cervical cancer is confirmed by analysis of a tissue sample taken at the cervical level via a colposcopy most often.
To know! A colposcopy is an examination of the vagina and cervix with a speculum and a binocular magnifying glass. This exam is taking place at the gynecologist’s office.
When the diagnosis of cervical cancer is established, additional tests are required to determine the extent of cancer. Most often, a pelvis MRI is required. Position emission tomography (PET), cystoscopy (bladder examination) or rectoscopy (rectum examination) may also be required. A blood test is also systematically carried out.
What treatments?
Cervical cancer management is multidisciplinary and adapted to each case. The treatment is based on surgery, radiation and chemotherapy used alone or in combination. The choice of treatment depends on several criteria including the type of cancer, the organs affected, the stage of evolution, the age of the patient, the general health status, etc.
1-Surgical treatment
According to the evolution of cancer, several types of surgical procedures are possible:
The conisation of the cervix which consists in taking a conical shape fragment from the deep layers of the cervix. The intervention is carried out under general anesthesia or loco-regional. This approach removes all cancer cells.
The amputation of the cervix of removing the cervix. This method allows small tumours to be treated. This surgery keeps the womb and does not prevent a future pregnancy.
Hysterectomy or colpo-hysterectomy. This intervention consists of removing the uterus, cervix, trunk and upper part of the vagina or sometimes ovaries. This method is often associated with a ganglionic curetage (pelvis nodes removal).
2-radiation therapy
Radiotherapy can sometimes be associated with surgery. Radiotherapy is an X-ray treatment intended to destroy cervical cancer cells. There may be various side effects: skin inflammation in the irradiated area, diarrhea, hemorrhoids.
Brach therapy is a method of internal radiation therapy. In other words, the radioactive elements are directly placed in the cervix. Side effects are rare: white losses, bleeding.
3-Chemotherapy
chemotherapyUne chemotherapy may be required before and / or after surgery or radiation treatment. When it’s before, the goal is to reduce the size of the tumor to facilitate surgery. However, when required after surgery, it aims to complete treatment by blocking the multiplication and spread of cancer cells.
Side effects are common but not systematic: nausea, diarrhea or constipation, hair loss, fatigue.
Preventing cancer
There are currently two effective methods to prevent cervical cancer: regular screening smears and vaccination.
Cervical cancer screening is offered to all women aged 25 to 65 years old. The first smear must take place around 25 years old, then every 3 years old.
The human papillomavirus vaccine helps prevent infections with viruses most involved in the development of cervical cancer. Thus, the vaccine does not protect against all cervical cancers and all precancerous lesions. This vaccine is recommended for all young girls aged 11 to 14 years old. Catch up is possible for young women aged 15 to 19
Cervical cancer is a localized tumor at the uterine mucous membrane. This pathology occurs after prolonged exposure to human papillomavirus (HPV). Cervical cancer is among the most common cancers. Nearly 500 new cases are detected each year, and 250 deaths related to this disease. Yet a vaccine exists and helps prevent two thirds of cervical cancers.