DEFINITION

Cancer that forms in tissues of

the cervix (the organ connecting the uterus and vagina). It is usually a slow-growing cancer that may not have symptoms but can be found with regular Pap tests (a procedure in which cells are scraped from the cervix and looked at under a microscope). Cervical cancer is almost always caused by human papillomavirus (HPV) infection.

SIGNS AND SYMPTOMS

The early stages of cervical cancer may be completely

asymptomatic. Vaginal bleeding, contact bleeding or (rarely) a vaginal mass may indicate the presence of malignancy. Also, moderate pain during sexual intercourse and vaginal discharge are symptoms of cervical cancer. Symptoms of advanced cervical cancer may include: loss of appetite, weight loss, fatigue, pelvic pain, back pain, leg pain, single swollen leg, heavy bleeding from the vagina.

CAUSES
Human papilloma virus (HPV) infection

For cervical cancer, the most important risk factor is infection with a virus known as HPV . HPV is really a group of more than 100 related viruses that can infect cells on the surface of the skin. Some types of HPV cause genital warts. Other types cause cancer of the cervix. The kinds that cause cancer are called "high-risk" HPVs. HPV is passed from one person to another by skin-to-skin contact such as vaginal, anal, or oral sex. But sex isn't the only way to spread HPV from one person to person. All that is needed is for there to be skin-to-skin contact with a part of the body infected with HPV. In fact, doctors believe that a woman must be infected by HPV before she develops cervical cancer.

 Smoking: Women who smoke are about twice as likely to get cervical cancer as

those who don't.

Chlamydia infection: This is a common kind of bacteria that can infect

women's sex organs. It is spread during sex. A woman may not know that she is infected at all unless she is tested for chlamydia when she gets her pelvic exam. Some studies suggest that women who have a past or current infection are at greater risk for cancer of the cervix.
Low income: Poor women are at greater risk for cancer of the cervix. This may

be because they cannot afford good health care, such as regular Pap tests. Family history: Cervical cancer may run in some families. If your mother or sister had cervical cancer, your chances of getting the disease are 2 to 3 times higher than if no one in the family had it. This could be because these women are less able to fight off HPV than other women.

 Diet: Diets low in fruits and vegetables are linked to an increased risk of

cervical cancer. Also, women who are overweight are at a higher risk of one type of cervical cancer.

Birth control pills: Long-term use of birth control pills increases the risk of

this cancer.

Having many pregnancies: Women who have had 3 or more full-term

pregnancies have an increased risk of this cancer.

Young age at the time of first full-term pregnancy: Women who were

younger than 17 years when they had their first full-term pregnancy are almost 2 times more likely to get cervical cancer later in life than women who waited to get pregnant until they were 25 years or older.

DIAGNOSIS

Diagnosing cervical cancer involves a series of medical

tests and procedures. Each test reveals more about the cervix and helps to confirm diagnosis. Once a cervical cancer diagnosis has been made, more tests will be done to determine what stage the cervical cancer is in.

 The Pap Smear: The Pap Smear is often the first step in diagnosing

cervical cancer. For women who do not get regular Pap smears or have never had one, it can be persistent symptoms that prompt them to seek medical attention. Cervical cancer symptoms do not often appear until the disease has progressed. This is why a regular Pap smear is vital to a woman's health.

Colposcopy:If a Pap smear has come back abnormal or symptoms suggest a

cervical abnormality, then a doctor will order a colposcopy. A colposcopy is an examination of the cervix with a colposcope, a lighted instrument that magnifies the cervix. The colposcope remains outside of the vagina during the examination.

 Cervical Biopsy:Depending on the findings during the colposcopy, the

doctor may want to do a biopsy of the cervix. A cervical biopsy is performed during a colposcopy. It is relatively painless and does not usually require local anesthesia. Results generally come back in less than two weeks.
Endocervical Curettage: Also known as ECC, an endocervical curettage

uses a curette or soft brush to remove tissue from the endocervical canal. The endocervical canal is the narrow passageway connecting the cervix to the uterus. The sample is then sent to pathology lab, where it is examined under a microscope for cancerous cells.
Cone Biopsy or Conization: Under general anesthesia, a doctor will

remove a cone-shaped tissue sample. This allows the pathologist to examine cells below the surface of the cervix. Conization is also used to remove precancerous area on the cervix.

STAGES

STAGE 0
Also called carcinoma in situ, stage 0 means

that cancerous cells that have not invaded deeper tissues. The cells are superficial and are only found on the surface.

STAGE 1
In stage I, cancerous cells have invaded the cervix, and cells are no longer

just at the surface. Cancer is still confined to the cervix and has not spread.
Stage IA: This is the earliest form of stage I cervical cancer. The cancer can

only be identified under microscopic examination. Stage IA1: The invasion area is less than 3mm(1/8 inch) deep and less than 7mm (1/4 inch) wide. Stage IA2: The invasion area is between 3 mm and 5 mm (about 1/5 inch) deep and less than 7 mm (about 1/4 inch) wide.
Stage IB: This stage indicated that cancer can be seen without a microscope.

It also include cancers that have invaded the connective tissue of the cervix, deeper than 5mm (1/5 inch). Stage IB1: Cancer is no more than 4 centimeters large (1 3/4 inches). Stage IB2: Cancer is larger than 4 centimeters (1 3/4 inches)

STAGE 2
In stage II, the cancer has spread to nearby tissues, but is still contained within the pelvic area.
Stage IIA: Cancer has spread to the upper part of the vagina. The lower third of the vagina has not been affected.

Stage IIB: In this stage, cancer has spread to tissue near the cervix. This tissue is called parametrial tissue.

STAGE 3
This stage indicates that cancer has spread to the lower portion of the vagina. It could have also spread to the pelvic wall in this stage.

Stage IIIA: Cancer has spread to the lower part of the vagina and is contained in that area.

Stage IIIB: Cancer has spread to the pelvic wall. This also includes cancer that blocks the flow of urine to the bladder.

STAGE 4
In stage IV, the cancer has spread to other areas of the body. This is the most advanced stage of cervical cancer. Stage IVA: This stage includes cancer that has spread to areas close to the cervix, such as the bladder or rectum. Stage IVB: Stage IVB cervical cancer is not considered curable. In this stage, cancer has spread to distant areas of the body, like the lungs.

TREATMENT
Lymphadenectomy

Surgical removal of the lymph nodes

Radical Trachelectomy

Removal of the cervix and its surrounding tissue while leaving the body of the uterus intact.
Radical Hysterectomy

Surgical removal of the uterus, cervix, and part of the vagina. In some cases, the ovaries, fallopian tubes, and lymph nodes are removed.

TREATMENT
Bilateral Salpingo-Oophorectomy

Surgical removal of both ovaries and the fallopian tubes.

Chemotherapy

Chemotherapy is prescribed to treat cervical cancer and also to help radiation therapy be more effective. Chemotherapy drugs work by killing cancer cells or preventing them from multiplying.
Radiation Therapy

Radiation therapy uses high energy beams to reduce the size of a tumor or to kill cancer cells

PREVENTION
Get a regular Pap smear. The Pap smear can be the greatest defenses for cervical

cancer. The Pap smear can detect cervical changes early before they turn into cancer.
Limit the amount of sexual partners you have. Studies have shown women who have many sexual partners increase their risk for cervical cancer. They also are increasing their risk of developing HPV, a known cause for cervical cancer.

Quit smoking or avoid secondhand smoke. Smoking cigarettes increases your risk of developing many cancers, including cervical cancer. Smoking combined with an HPV infection can actually accelerate cervical dysplasia. Your best bet is to kick the

habit.

PREVENTION
If you are sexually active, use a condom. Having unprotected sex puts

you at risk for HIV and other STD's which can increase your risk factor for developing cervical cancer.
Follow up on abnormal Pap smears. If you have had an abnormal Pap

smear, it is important to follow up with regular Pap smears or colposcopies, whatever your doctor has decided for you. If you have been treated for cervical dysplasia, you still need to follow up with Pap smears or colposcopies. Dysplasia can return and when undetected, can turn into cervical cancer.
Get the HPV vaccine. If you are under 27, you may be eligible to receive

the HPV vaccine, which prevents high risk strains of HPV in women.