General Overview of Cervical Cancer - Research Paper Example

? Cervical Cancer of Introduction As defined by Saslow et al. (2002), cancer, medically known as malignant neoplasm, is an umbrella of various diseases that involve unregulated cell multiplication and growth. Cancerous growths occur when body cells grow or divide uncontrollably leading to formation of malignant tumors. These uncontrolled growths and divisions spread to other parts of the body through bloodstream or lymphatic system. Causative factors or agents for cancer directly damage genes or combine with existing genetic faults in a person resulting malignant growths. Various types of cancers exist, depending on where cancerous tumors develop at. However, detection of all types of cancers is done though presence of visible signs and symptoms, medical imaging, and screening tests. Cervical cancer, for instance, is among the common type of cancer in women (Smith et al., 2012). Several cancer centers are currently researching on effective control measures, easy diagnostic procedures, and suitable management procedures for cervical cancer. This paper explores some aspects of cervical cancer. General Overview of Cervical Cancer Cervix is the lower portion of a woman’s uterus. Cervix connects the uterus with the vagina. Cervical cancer occurs when there is abnormal growth in the cervix cells and/or invasion by other tissues or organs. Like other cancers, cervical cancer is curable if detected and immediate and appropriate treatment is administered. As a key feature, cervical cancers slowly progress from a normal cervical tissue to cancerous tissue changes. This slow progression is utilized by gynecologists, who detect the disease and give treatment at an early stage. Even though this early detection and administration of proper treatment has significantly lowered down prevalence of cervical cancer, a considerable portion of women still die of the disease every year. According to Smith et al. (2012), gynecologists are still challenged by invasive nature of the disease. As defined by Gadducci et al (2011), an invasive cancer means that the disease affects deeper cervix tissues and spread to other body parts. This kind of spread is defined by Walboomers et al. (1999) as metastasis. Causes of Cervical Cancer Several types of cervical cancers are caused by infection with human papillomavirus (HPV). Different strains of HPV exist and each strain has different effect in the body. Apart from causing precancerous growths in the cervix, HPV also causes various types of skin warts and other abnormal body surface and skin disorders. Being a cause of genital warts, HPV makes sexual contact a window through which cervical cancer is transmitted. The risk of infection is higher for women with multiple sex partners. At initial stages, HPV causes cervical lesions which slowly progress to cancer. Walboomers et al. (1999), however, observes that HPV infections, in some cases, do not lead to cancer. According to Walboomers et al. (1999), HPV causes cervical cancer if an individual is persistently infected with a particular type of HPV. Based on the claim, HPVs are classified according to cancer risks associated with each type. Three types of HPVs, thus, exist, which are high-risk, moderately-risk, and low-risk. Infection by high-risk HPVs, therefore, causes immediately cancerous tumors in epithelial cells of cervix. Cigarette smoking is another risk factor for occurrence of cervical cancer. Chemicals in a cigarette react with cervical cells causing precancerous modifications on the cells. These changes slowly progresses to cancer. Oral contraceptives, especially pills, increase chances of development of cancer of the cervix. The risk is pronounced in women who use pills for a long period. Just like the effect of tobacco, oral contraceptives react with cervical cells forming precancerous tumors. Other risk factors include: stress and stress-related disorders, multiple pregnancies, Chlamydia infection, dietary factors, family history, and weak immunity. Signs and Symptoms Sign and symptoms of cervical cancer depend on the maturity level of a cancerous growth. At early stages, the disease is, in most cases, asymptomatic. Nevertheless, vaginal bleeding or discharge, or contact bleeding is an indication of a malignant growth. In addition, pain during sexual intercourse is a sign of cervical cancer. In cervical cancer, metastases may be present in the lungs, abdomen, or any other body organ. Common symptoms at an advanced stage include: pelvic pain, excessive vaginal bleeding, loss of appetite and weight, swollen legs, leg pain, and bone fractures in extreme cases (Smith et al., 2012). Pathogenesis of Cervical Cancer Because of nature of cervical cancer, the disease has received enormous scrutiny in the recent days. Molecular analysis of the disease shows that etiology of cervical cancer in young women and old women is similar (Smith et al., 2012). HPV is considered as a vector that directly incites susceptibility to neoplastic conversion or transmutation to a malignant phenotype, especially in infected epithelial cells. The transformation begins at the cervical squamocolumnar junction. Varying scales of cervical intraepithelial neoplasia (CIN) exist depending on the extent of the transformation. Individuals with early invasive cervix cancer have cervices that appear normal when inspected by a naked eye. However, as the invasion continues, multiple ulcerated lesions start to appear. Real symptoms of cervical cancer appear in women with advanced benign inflammatory processes. At the latter stage, the disease is commonly shown by irregular vaginal bleeding. Advanced cervical cancer is also revealed by postcoital spotting, menorrhagia, and serosanguinous. Saslow et al. (2002) adds that rectal bleeding or hematuria and strong pain in the pelvis, lower abdomen, or at the back are also signs of mature cervical cancer. Invasive cervical cancers extend either through local spread or metastasis via hematogeneous routes. Cervical cancer, therefore, exhibits either ulcerative or exophytic appearance. Local extension involves extension to the vaginal fornices, which further progresses to parametrial tissues, bladder uterine corpus, or rectum. In the lymphatic system, the spread is a stepwise progression. Pelvic nodes are first infected leading to destruction of para-aortic and iliac lymph node chains. Hematogenous spread depends on the size and expansion rate of a cancerous tumor. Diagnosis Cervical biopsies and precancerous lesion grading are used in detection of the disease. Though Pap smear is considered as an effective screening test for the disease, diagnostic procedures, however, require cervical biopsy. The procedure is called colposcopy (Smith et al., 2012). It involves using dilute acetic acid to aid a magnified visual inspection of cervical surfaces. Accompanying devices include SpiraBrush CX and/or punch forceps. Colposcopic procedures, thus, estimate severity of the disease based visual inspection. Further diagnostic and management or treatment procedures include loop electrical excision procedure (LEEP) and conization. Here, inner lining of an infected cervix is removed for pathological examination. The latter procedures are performed if biopsy confirms a severe CIN. Cervical biopsies are effective if cancerous lesions are visible. In case of invisible precancerous growths, cervical intraepithelial neoplasia (CIN) grading is adopted. The method involves classifying abnormality in precancerous lesions into three categories which are mild dysplasia (CIN1), moderate dysplasia (CIN2), and severe dysplasia (CIN3 or CIS). Treatment and Prevention Cervical screening, which uses papanicolaou test, is commonly used as a preventive method for cervical cancer. The method, also known as Pap smear, detects presence of cervical cancer at any stage of development. According to Saslow et al. (2002), Pap smears are recommended once an individual reaches 21 years old. Apart from papanicolaou test, screening is also done by liquid-based cytology. The two cervical cancer screening methods use similar operational principles. Apart from screening tests, there are also other methods of preventing occurrence of cervical cancer. Vaccination, as one method, involves administration of HPV vaccines. Common vaccines used are cervarix and gardasil. Condoms also, to some extent, offer protection against the disease. Since the disease is transmitted through sexual intercourse, use of condoms significantly lower down chances of contacting the disease. Nutrition, as a preventive measure, involves consuming specific food stuffs with low risks of cervical cancer. For localized and pre-invasive lesions, modern surgical techniques are used to remove and/or destroy abnormal cells and prevent further spread of malignant growths. Other cervical cancer management methods include chemotherapy and/or radiotherapy. Conclusion Cervical cancer is caused by malignant growth in the cervical cells. Infection by HPV is known to be a major cause of cervical cancer. Although, there are other co-factors and risk factors associated with cancer of the cervix, HPV-related cancers exhibit the largest proportion. The disease is commonly revealed by abnormal vaginal bleeding and pain. Symptoms of cervical cancer in other body organs become visible at mature stages of the disease. Diagnosis at early stages is done by precancerous lesion grading, while biopsies are used in mature cervical cancer diagnosis. Treatment at early stages is done by local excision. At later stages, cervical cancer is managed through chemotherapy and/or radiotherapy. Other prevention measures include: use of condoms, avoiding multiple sex partners, proper nutrition, and use of HPV vaccines. References Gadducci, A. et al (2011). Smoking habit, immune suppression, oral contraceptive use, and hormone replacement therapy use and cervical carcinogenesis: a review of the literature. Gynecological endocrinology: the official journal of the International Society of Gynecological Endocrinology, 27(8), 597–604. Saslow, D. et al. (2002). American Cancer Society guideline for the early detection of cervical neoplasia and cancer. CA: a cancer journal for clinicians, 52(6), 342–62. Smith, S. et al. (2012). Cancer of the cervix: causes, symptoms, signs, diagnosis, treatments, stages of cervical cancer. 2nd Edition. CreateSpace Press. Walboomers, J. et al. (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J. Pathol., 189(1), 12–9. Read More