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Cervical cancer

Definition
The cervix is the opening between the vagina and the uterus. Cancer of the cervix is a malignant tumor on the cervix. Pre-cancerous changes in the cells on the top layer of the cervix are an early sign that cervical cancer may develop.

What is going on in the body?
Cervical cancer is third most common cancer of the reproductive system that strikes women in the US. It occurs most often among women ages 40 to 55.

Even though the cervix is located within a woman's vagina, its cells act very much like skin cells. These cells are exposed to toxins, viruses, and bacteria that may cause abnormal changes called cervical dysplasia.

Each stage of dysplasia is judged by the thickness of the layer of abnormal cells. The earliest change that can be seen with a microscope is called mild dysplasia. If not treated, these precancerous changes may become moderate and then severe. The fourth, most severe stage of dysplasia is called carcinoma in situ. After this occurs, cancer cells may invade deeper layers of the cervix or spread to nearby sites. At that point, a woman has what is called invasive cervical cancer.

What are the signs and symptoms of the disease?
Cervical cancer that is found early usually causes no symptoms. This is why an annual Pap smear is so important. Pap smears and pelvic exams can catch cancer in the early stages or can find precancerous changes of the cervix.

Some early warning signs are:

	bleeding or spotting between periods
	bleeding or spotting after intercourse
	vaginal discharge that is cloudy, bloody, or full of mucus

Whether or not she has entered menopause, a woman should have her healthcare provider evaluate any vaginal bleeding at unexpected times or any bloodstained vaginal discharge.
Symptoms of more advanced cervical cancer include:

What are the causes and risks of the disease?
Cervical cancer is believed to be caused by the prescence of one or more strains of the Human Papilloma Virus (HPV). Certain health problems, lifestyle choices, and other factors may increase a woman's risk for developing cervical cancer. These include:

	Exposure to the Human Papilloma Virus (HPV). Women who have certain types of HPV, including type 16, 18, 31, 33, 35, have a very high lifetime risk of getting cancer of the cervix or vulva, the outer part of the vagina. HPV is contracted through sexual intercourse or it may be passes own from your mother. It is estimated that over 80 percent of women today have one form of HPV.
	Having multiple sex partners.
	Becoming sexually active at an early age, before the age of 18.
	Poor nutrition and other infections can also be a risk factor.
	Having other sexually transmitted diseases.
	Having an abnormal Pap smear.
	Having had cancer of the vagina or vulva
	Having a sexual partner who has or had cancer of the penis
	Smoking
	Having a weakened immune system due to other infections and diseases.
	Being the daughter of a woman who took DES (diethylstibestrol) during pregnancy What can be done to prevent the disease? Women should have annual Pap smears and pelvic exams. Women should start to have Pap smears and pelvic exams when they reach the age of 16 or as soon as they become sexually active. A woman can lower her risk for getting cervical cancer by:
	Having an annual Pap smear
	quitting smoking
	waiting to have intercourse until age 18 to 20
	having only a few sexual partners in a lifetime
	using latex condoms and practicing safer sex with each sexual encounter How is the disease diagnosed? Cervical cancer is usually found during a routine Pap smear. The health care provider uses a small brush to scrape cells from a woman's cervix and vagina. These cells are placed on a slide and sent to a laboratory, like Aloha Laboratories, Inc. At the lab the cells are stained and then a special technician called a Cytotechnologist examined the cells through a microscope looking for any abnormal cells. If abnormalities are found, the Pap smear may be repeated in 3 months or the healthcare provider may choose to do a colposcopy. A colposcope is a special microscope that allows the healthcare provider to closely examine the cervix, vagina, and vulva. If an abnormality is seen, a cervical biopsy may be taken. A biopsy would involve removing a larger sample of cells from the area for microscopic study. What are the long-term effects? If abnormal cells are found early and treated, it may be possible to avoid removing the uterus so that a woman can still have children. Unfortunately, once cervical cancer occurs, more aggressive measures may be needed. If the cancer is found and treated early, there is an excellent chance of cure. If left untreated, it will spread to nearby organs and possibly the rest of the body. What are the treatments? A cone biopsy, where a portion of the center of the cervix is removed, or hysterectomy, in which the entire uterus is removed, may be done when cervical cancer is caught early. Cancer is more likely to come back in a woman treated with cone biopsy . If the cancer has invaded deeper layers of the cervix and has spread to the uterus, the treatments include the following:
	Modified radical hysterectomy. During this type of surgery, the uterus, cervix, upper vagina, and surrounding tissue is removed. Depending on the extent of the cancer and a woman's age, the ovaries may be left in place.
	Radiation therapy is sometimes used before or after surgery to shrink the tumor cells further.
	Sometimes a woman isn't a good candidate for surgery, because of her age or other medical conditions. In this case, radiation therapy may be used alone or with chemotherapy. What happens after treatment? Curing cervical cancer depends on many factors, such as:
	the woman's overall health
	the woman's age when she was first diagnosed
	the type and growth of specific cancer cells
	how far the disease has spread
	the skill of the surgeon THE BEST WAY TO CATCH CERVICAL CANCER EARLY IS TO HAVE AN ANNUAL PAP SMEAR This first and images are of a normal cervix with a normal biopsy below. This third and fourth images are of a high grade lesion of the cervix with the biopsy.