Cervical cancer:
Cervical cancer is cancer of the cervix and the cervix is part of the female reproductive system. It is actually the end portion of the uterus. Where the uterus and the vagina meet. Cervical cancer is almost exclusively caused by infection with human papillomavirus or HPV. There are many different types of human papillomavirus but some are going to increase the risk of cervical cancer more than others. so these include types 16 and 18 and there's a very low risk with types 6 and 11. Cervical cancer is actually the third to fourth most common gynecological cancer worldwide and it's more prevalent in certain developing countries due to fewer screening programs in those particular countries. The average age of onset for getting cervical cancer is 52 years old.
The common causes of bad breath (halitosis)What are the most common signs and symptoms of cervical cancer?
Some cases of cervical cancer are asymptomatic meaning that there are no symptoms at all. If cervical cancer is diagnose early there can also be no symptoms at all but some symptoms are:
1.Abnormal vaginal discharge:
One of them is abnormal vaginal discharge. Vaginal discharge will start out as watery discharge and then as time goes on it can often become red to brown in coloration and it is very.
2.Vaginal bleeding:
There can also be abnormal vaginal bleeding. Abnormal vaginal bleeding would be easier to detect in patients who are post-menopausal. There could be post-coital bleeding so bleeding after sexual intercourse can also be another clinical feature of cervical cancer. As the condition worsens this post-coital bleeding will become more frequent. and there will be more frequent.
3.Vaginal discomfort and pain
4.Pelvic and or back pain
5.Dysuria so burning sensation when urinating
Then there are certain complications such as:
1.Constipation
2.Urinary obstruction
3.Hematuria so most
4.Leg edema
5.Hydronephrosis
It also causes cervical changes such as:
1.Friability
2.Ulcerated
Common and rare types of cervical cancer:
The most common type of cervical cancer is the squamous cell; carcinoma squamous cells are those cells that line the ectocervix squamous cell. Carcinoma accounts for up to 80 to 95 of all cervical cancer cases. Adenocarcinoma is the second most common type of cervical cancer. This accounts for approximately 5 to 20 percent of cases. It more likely to occur in younger patients and affects the endocervix more often. There are two other types that are rare one are known as small cells and the other one is known as adenosquamous.
How does HPV cause cervical cancer pathophysiology?
Almost all cases of cervical cancer are going to be cause by the HPV virus or human papillomavirus. It is a non-enveloped double-stranded DNA virus there actually are more than 100 types of this particular virus. Only 15 to 20 types are oncogenic meaning that they can cause cancer. But type 16 causes at least half of all cases of cervical cancer. So when the HPV virus is exposing to cervical tissue well it actually infects cells of the stratum basale and which is the layer of the cervix. And the infected cervix is differentiating into squamous epithelial cells.
So, the problem is that HPV will produce particular proteins E6 and E7. E6 protein actually inhibits p53. p53 is an important tumor suppressor and it's important in regulating the cell cycle. And an eE7 protein produced by HPV inhibits retinoblastoma protein or Rb which also is important in the cell cycle. So inhibiting these two types of proteins is to increase the cell cycle and causes more cellular proliferation causing dysplasia. Dysplasia is the growth of more cells and oftentimes these cells can become abnormal. So, Abnormal cells can increase the risk of a patient getting cancer after years of this occurring.
What are the major risk factor for getting cervical cancer?
- Unvaccinated against HPV
- Unprotected sex
- History or presence of other sexually transmitted diseases especially HIV infection actually increase the risk of cervical cancer about five-fold
- Sexual intercourse at a young age and having multiple partners
- Having a high-risk partner
- Smoking because can actually suppress the immune system
- Poor utilization of screening
- Certain vitamin deficiencies because vitamins are important in proper immune system functioning
- Immunocompromise (HIV infection and diabetes)
- Family history
What are the screening and diagnostic tests for cervical cancer?
Screening is very important in reducing the risk of cervical cancer.There are some tests that are used to diagnose it such as:
1.Pap (Papanicolaou) smear test:
Pap smear detects pre-cancerous changes and detects squamous cell changes. Because squamous cell carcinoma is the most common type of cervical cancer. Also screen all female patients starting at 21 years of age every three years.
2.HPV serologies
3. Diagnostic colposcopy
What is the treatment and cure of cervical cancer?
Treating the pre-cancerous lesions by cryosurgery and conization. Conization is that process the end of the cervix is remove this can be done by laser ablation or LEEP.
Stage 1 can be treating by surgery, trachelectomy, radial hysterectomy, colonization, and pelvic radiation therapy after surgery.
Stage 2 can be treating by surgery, trachelectomy, hysterectomy, combined external radiation therapy with brachytherapy, radical hysterectomy with bilateral pelvic lymphadenectomy, and chemotherapy.
Stage 3 and 4 can be treating by symptom palliation and radiation therapy and chemotherapy.
What can prevent cervical cancer?
Primary prevention:
Vaccination against HPV some vaccines against HPV can include Gardasil. It can be against HPV types 6 11 16 and 18. And then there can be another vaccine called Cervarix which only vaccinates against HPV 16 and 18. So it's primary prevention because it prevents the infection of the virus that causes the cancer.
Secondary prevention:
It would be apply when the patient had HPV and start to have those pre-cancerous changes. It include:
1.Pap smear because it detects precancerous dysplasia.
2.HPV serologies as another way to determine whether a patient has been infected with HPV or not.