Dumaguing: A closer look at cervical cancer

Saturday, July 16, 2011

THE cervix is the lower end of the uterus (bahay-bata or matris) which extends into the vagina. Of cancers of the female reproductive system, cervical cancer, also known as cervical carcinoma is the second most common in all women and the most common in younger women. It usually affects women between the ages 35 and 55. This cancer may be caused by a virus (human papilloma virus or HPV) which can be transmitted during sexual contact.

Cervical cancer has been associated with the following factors: early sexual contact, multiple lovers, uncircumcised partners whose smegma - the whitish cheesy odorous substance that forms between the head of the penis and the overlying skin or prepuce - is a favorite culture medium for the HPV.

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About 85% of cervical cancers are squalous cell carcinoma, which develops in the scaly, flat, skin-like cells covering the outside of the cervix. The other forms are those that develop from gland cells adenocarcinoma or a combination of both types. Cervical cancer can penetrate deep beneath the surface of the cervix, thus passing into the rich network of blood vessels and lymphatics, therefore, facilitating its spread (metastasis) to other organs in the body.

Symptoms may start as spotting between periods or bleeding after sexual contact. A woman may not experience any pain or symptoms until late into the disease. If a growth, sore or lesion is seen or detected on a routine physical examination, the doctor can perform Punch biopsy in which a tiny piece of the cervix is removed for examination. Otherwise, they may also do endocervical curettage in which tissues are scraped from the canal of the cervix. Usually, these two procedures cause little pain, some bleeding and most of the time, suffice to make a diagnosis. If not, the doctor performs cone biopsy, in which a larger piece of tissue is removed for study.

If the woman has cervical cancer, the next step is to determine its size and location, a process called staging. Staging begins with a thorough physical examination of the pelvic area and a variety of tests like chest X-ray, cystoscopy (to see the urinary bladder, sigmoidoscopy, intravenous urography, Barium enema, Catscan, bone and liver function tests - to determine if the cancer is still in situ (localized) or has spread into other distant organs. Of course, the most encouraging news from the attending physician is that the lesion or biopsy result is normal. Next stage is cervical dysplasia - some early changes in the cells of the cervix, followed by severe dysplasia with more and more atypical or different cells, than carcinoma in situ - still localized lesion in the outermost layer of the cervix and finally, invasive or metastatic cervical cancer.

Next Week: Diagnosis, Vaccination and Treatment of Cervical Cancer.