Cervical cancer, its symptoms, causes, prevention methods, and the best centers for its treatment in Turkey by the best doctors of obstetrics and gynecology in Istanbul.
Cervical cancer is one of the few cancers with a specific cause, which increases the possibility of preventing it. Regular gynecological examinations and cervical examinations are among the most important steps a woman can take to prevent cervical cancer, as many complications can be avoided if we follow what will be mentioned. later in the article.
According WHO Cervical cancer is the fourth most common cancer among women, and in 2022, an estimated 570,000 cases will be diagnosed worldwide.
What is cervical cancer?
Cervical cancer is caused by abnormal proliferation of cells in the cervix. There are two main types of cervical cancer: squamous cell carcinoma and adenocarcinoma.
Squamous cell carcinomas account for about 80% to 90% of cases, while 10% to 20% are adenocarcinomas.
An overview of the cervix
The cervix is the lower part of the uterus. The uterus consists of two parts, the upper part where the baby grows, called the corpus callosum, and the lower part, which is called the cervix.
The cervix has several functions, including that it connects the body of the uterus to the vagina (the birth canal), where it forms a passage for the passage of sperm to the body of the uterus, as well as a passage for the passage of the fetus at birth.
Another of its functions is that it secretes mucus that helps lubricate the female reproductive system.
Causes of cervical cancer and its risk factors
HPV, with some of its types, is a cause of cervical cancer, and it is one of the few cancers whose cause is known. In addition, there are many risk factors for infection with it, and some of the risk factors include the following:
- Irregular gynecological examination: Women who do not have a regular Pap test (smear) are at increased risk of developing cervical cancer.
- HPV infection: Some types of human papilloma virus are transmitted through sexual contact and can infect the cervix. Cervical infection with HPV is the main risk factor and cause of cervical cancer. However, a very small percentage of women with untreated HPV develop this cancer.
- Sexual history: A woman's multiple sex partners makes her more susceptible to infection with human papillomavirus and cervical cancer, and prevention of sexually transmitted diseases reduces the risk of cervical cancer.
- Smoking: Cigarette smoking is associated with an increased risk of any cancer in general.
- HIV infection: Women with HIV have a higher than average risk of developing this type of cancer.
You can also read on our website about Breast cancer And the latest treatment techniques for him in Turkey.
Symptoms of cervical cancer
The early stages of cervical cancer do not show any pain or other symptoms, and to know better about the symptoms and what may appear in the patient when she has cervical cancer, we will divide Symptoms of cervical cancer to early and late symptoms.
Early symptoms of cervical cancer
The first symptoms that could indicate the disease are likely to include:
- Watery or bloody vaginal discharge that may be thick and may have a foul odor.
- Vaginal bleeding after intercourse or exercise, between menstrual periods, or after menopause.
- Menstrual periods are heavier and last longer than usual.
Late symptoms of cervical cancer
If the cancer has spread to nearby tissues, symptoms may include:
- Difficult or painful urination, sometimes with blood in the urine.
- Diarrhea, pain or bleeding from the rectum when defecating.
- Fatigue, weight loss and appetite.
- Back pain or swelling in the legs.
If abnormal bleeding, vaginal discharge, or other symptoms persist for more than two weeks without explanation, a complete gynecological examination including Pap smear should be performed.
How is cervical cancer diagnosed?
Pelvic exams and Pap smears can help in the early detection of most cases of cervical cancer.
To get an accurate diagnosis, the doctor visually examines the cervix and takes a tissue sample to study any obvious abnormalities for a biopsy to diagnose cancer in this condition.
If the biopsy confirms the presence of cancer, more tests are done to see if the cancer has spread. These tests may include studies of liver and kidney function, blood and urine tests, and x-rays of the bladder, rectum and bowel.
Read more about Methods of diagnosing and treating cancer in Turkey.
Cervical cancer stages
- Stage I: The cancer is only present in the cervix.
- Stage 2: The cancer has spread outside the cervix but has not yet spread to the pelvic wall.
- Stage III: The cancer has spread to the lower third of the vagina or has spread to the pelvic wall and nearby lymph nodes.
- Stage IV: Cancer at this stage affects the bladder, rectum, or other parts of the body.
Are routine gynecological examinations necessary?
There is no consensus in the medical community about whether women need a pelvic exam in the years when they do not have to be screened for cervical cancer.
Some medical societies leave it up to the physician to decide whether to perform a pelvic exam, but other medical societies discourage pelvic examinations because of the inconvenience they cause to the patient.
Unfortunately, a pelvic exam has never been shown to prevent cancer, especially for the cancers that worry women the most, such as ovarian cancer.
Young women 25 years of age or younger who engage in sexual activity are advised to have an annual screening test for chlamydia.
Cervical cancer treatment
Treatment for cervical cancer depends on many factors, including the stage of the cancer, the patient's age, the woman's general health, and her desire to have children in the future.
The three main treatments for cervical cancer are radiation therapy, chemotherapy, and surgery.
Radiation or chemotherapy may be used to treat cancer that has spread outside the pelvis (stage IV) or recurrent cancer.
There are two methods of radiotherapy:
- Either a device loaded with radioactive granules is placed in the vagina near the cancer and held in place for a certain period of time.
- Or, the targeted areas are exposed to radiation over multiple sessions with the radiotherapist.
There are a variety of chemotherapy drugs that are used. Sometimes, surgery is used, radiotherapy and chemotherapy are used before or after surgery.
Can read more about Cancer chemotherapy in Turkey.
Different types of surgical techniques are used to treat cervical cancer. Here are some of the most common cervical cancer surgical treatments:
- Laser surgery: This surgery uses a laser beam to burn cells or to take a small piece of tissue for study.
- Cone biopsy: a surgical procedure in which a cone-shaped piece of tissue is removed from the cervix.
- Simple hysterectomyThis surgery involves removing the uterus, but not the tissues surrounding the uterus. The vagina or lymph nodes in the pelvis are not removed.
- Radical removal of the uterus and pelvic lymph nodes: In this surgery, the uterus and surrounding tissues and a small section of the upper part of the vagina and lymph nodes are removed from the pelvis.
Cancer in its early stages may be curable by removing the cancerous tissue. In advanced cases, a simple or radical hysterectomy is resorted to.
The latest methods of treatment of cervical cancer applied lately in Turkey
These treatments are either adjunctive to previous therapies, or they are used in special cases or as a last resort if other treatments fail.
Sentinel lymph node biopsy
This method can be used in any type of cancer, and its mechanism is that a biopsy or removal (during surgery) of the lymph nodes that are suspected to be infected before other lymph nodes, and in the event that doctors do not find a sign of cancer in these nodes (or node), There is no need to remove the rest of the nearby lymph nodes.
This procedure is of great benefit as it prevents complications caused by extensive lymph node removal, especially edema in the legs
still studies List of efficacy of this treatment in the treatment of cervical cancer.
Immunotherapy is a treatment that helps the body's immunity fight the random and rapid multiplication of cancer cells.
Most of the studies are based on Immune Checkpoint Inhibitors.
Targeted therapy is an advanced treatment method that is not available in all countries and is very expensive.
Bevacizumab is a targeted drug currently used to treat advanced cervical cancer, and other targeted drugs, such as Cediranib (which blocks certain growth factors that help cancer cells grow) have also proven helpful.
Cervical cancer vaccine
The cervical cancer vaccine, Gardasil®, is approved for girls and women ages 9-26 to prevent cervical cancer.
This vaccine also protects against genital warts (it has also been approved for males for this purpose). This vaccine works by stimulating the body's immune system to attack certain types of human papillomavirus (HPV), which have been linked to many cases of cervical cancer.
It is best to take the vaccination before the start of sexual activity. The vaccination consists of a series of 3 doses, the second dose comes two months after the first, and the third dose comes six months after the first dose.
Can cervical cancer be prevented?
Women can take some measures to prevent cervical cancer.
Regular gynecological examinations are among the most important steps a woman can take to prevent cervical cancer.
The American Society of Obstetricians and Gynecologists recommends the following guidelines for a regular cervical exam:
- All women should begin regular Pap smears when they are 21 years old, and the screening should be repeated every 3 years.
Further testing may be needed if any abnormal cells are found or if HPV is present.
- Starting at age 30, women with 3 normal Pap test results in a row can be screened every 5 years with a Pap test and a test for high-risk HPV infection. Another acceptable option is to get screened every 3 years. Years with just a pap smear test.
- Women with certain risk factors such as prenatal exposure to diethylstilbestrol (DES), HIV infection, or a weakened immune system due to organ transplantation, chemotherapy or chronic steroid use should be screened annually.
- Women ages 65 to 70 or older who have had three consecutive negative (normal) Pap smears and no abnormal Pap test results in the past 20 years should discontinue cervical cancer screening. Women with a history of cervical cancer, prenatal exposure to DES, HIV infection, or a weakened immune system should continue screening as long as they are otherwise healthy.
- Women who have had a complete hysterectomy (removal of the uterus and cervix) should also discontinue cervical cancer screening, unless they have a history of, or the possibility of, cervical cancer.
Women who have undergone the operation Hysterectomy Without removing the cervix, continue to follow the instructions above.
In the end, we find that cervical cancer is one of the most important cancers that affect the female reproductive system, and its early treatment and diagnosis is one of the most important things for women to ensure a healthy life, whether sexually, reproductively or psychologically. The Bimaristan Center also advises women to conduct periodic examinations and maintain a daily health system to avoid infection Cancer was.