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Cervical Cancer: Symptoms, Treatment and Prevention

Cervical cancer affects 10,000 American women — and kills 4,000 — each year, according to the Mayo Clinic. This type of cancer arises in the cervix, the area where the uterus meets the vagina, and it is typically diagnosed in women over thirty.

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Credit: Doctor's visit photo via Shutterstock

Symptoms

Unfortunately, most women with cervical cancer are symptomless until the cancer has advanced. At that point, women may experience bleeding after sex; it may even occur after menopause or at unusual points in the menstrual cycle. Excessive vaginal discharge may also occur.

As the cancer progresses, women may feel pain in the region of the pelvis — the bones that cradle the uterus. This pain may seem to occur for no reason, or it may appear during sex.

Diagnosis & Tests

Traditionally, a Pap test has been the primary method to test for cervical cancer. During this test, cells from the cervix are collected and sent to a lab for analysis. In women older than 30, a newer test, called the human papillomavirus (HPV) DNA test, can determine if infection by a "high-risk strain" is present. In other words, it can alert the physician to abnormal cells that are likely to become cancerous.

If cancerous cells are present, additional testing is required to confirm the diagnosis and determine how far the cancer has spread.

First, the physician may use a colposcope to look for abnormal cells in the cervix. A biopsy may be performed during which the doctor may remove a small area of cervical cells or, as in a so-called cone biopsy, a cone-shaped area comprising deeper layers of the cervix. These cells are also sent to a lab for analysis.

Computerized tomography (CT) scans and magnetic resonance imaging (MRI) further assist physicians in making a diagnosis by showing whether the cancer is limited to the cervix or if it has spread to other tissues and organs.

Treatments & Medications

If caught early enough, treatment consists of removing the cancer cells through a biopsy or surgery. In some cases, women may undergo a hysterectomy—removal of the entire uterus.

If the cancer is present throughout the cervix, or if it has metastasized or spread beyond the point of origin, several different treatments may be required. A hysterectomy is often performed and some patients may even require a radical hysterectomy in which part of the vagina and nearby lymph nodes are also taken out.

To destroy remaining cancer cells, radiation and chemotherapy are used. For example, a common chemotherapy agent is cisplatin. In the process of killing cancer cells, these treatments can be very damaging to normal cells, which is why there are many debilitating side effects associated with their use. Some of the side effects from chemotherapy include nausea and hair loss.

Yoga, meditation, healthy diet and exercise can help individuals cope with the disease.

Prevention

Most types of cervical cancer are caused by HPV, a sexually transmitted disease. Recently, two vaccines, called Gardasil and Cervarix, were developed that protects against the strains of HPV, which can cause cervical cancer. Both are indicated for cervical cancer prevention in 11- to 12-year-old girls, as well as females between 13 and 26 who have never had the vaccine (Gardasil may be used in boys and men aged 9 to 26 for protection against genital warts).

In addition to these vaccines, experts recommend that all women over the age of 21, and younger women who are sexually active, should speak with a physician about scheduling regular Pap tests.

Some scientists believe that in addition to the Pap test, the HPV DNA test should become a primary test for cervical cancer screening as well, especially in older women.

In a study published in the March issue of the journal Lancet Oncology, researchers from Italy and the United Kingdom showed that HPV testing was more effective at detecting pre-cancerous cells. Looking at almost 100,000 women between the ages of 25 and 60, the scientists concluded that screening with the HPV test was better at preventing invasive cervical cancer.

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