|
 |
|
The cervix is the lower part of
the uterus (womb). The upper part, or body, of the uterus, is where
a fetus grows. The cervix connects the body of the uterus to the
vagina (birth canal). The part of the cervix closest to the body
of the uterus is called the endocervix. The part next to the vagina
is the ectocervix. Most cervical cancers start where these 2 parts
meet.
Cancer of the cervix (also known as cervical
cancer) begins in the lining of the cervix. Cervical cancers do
not form suddenly. Normal cervical cells gradually develop pre-cancerous
changes that turn into cancer. Doctors use several terms to describe
these pre-cancerous changes, including cervical intraepithelial
neoplasia (CIN), squamous intraepithelial lesion (SIL), and dysplasia.
There are 2 main types of cervical cancers: squamous cell carcinoma
and adenocarcinoma. Cervical cancers and cervical precancers are
classified by how they look under a microscope. About 80% to 90%
of cervical cancers are squamous cell carcinomas, which are composed
of cells that resemble the flat, thin cells called squamous cells
that cover the surface of the endocervix. Squamous cell carcinomas
most often begin where the ectocervix joins the endocervix.
The remaining 10% to 20% of cervical cancers are adenocarcinomas.
Adenocarcinomas are becoming more common in women born in the last
20 to 30 years. Cervical adenocarcinoma develops from the mucus-producing
gland cells of the endocervix. Less commonly, cervical cancers have
features of both squamous cell carcinomas and adenocarcinomas. These
are called adenosquamous carcinomas or mixed carcinomas.
Only some women with pre-cancerous changes of the cervix will develop
cancer. This process usually takes several years but sometimes can
happen in less than a year. For most women, pre-cancerous cells
will remain unchanged and go away without any treatment. But if
these precancers are treated, almost all true cancers can be prevented.
Pre-cancerous changes and specific types of treatment for precancers
are discussed in the section, "Can Cervical Cancer Be Prevented?"
Precancerous changes can be separated into different categories
based on how the cells of the cervix look under a microscope. These
categories are discussed in the section, "Can Cervical Cancer
Be Prevented?"Cancer is a disease in which certain body cells
don't function right, divide very fast, and produce too much tissue
that forms a tumor. Cervical cancer is cancer in the cervix, the
lower, narrow part of the uterus (womb). The uterus is the hollow,
pear-shaped organ where a baby grows during a woman's pregnancy.
The cervix forms a canal that opens into the vagina (birth canal),
which leads to the outside of the body.
If the Pap test finds serious changes in the cells of the cervix,
the doctor will suggest more powerful tests such as a coloscopy.
In this procedure, the doctor uses a tool called a colposcope to
see the cells of the vagina and cervix in detail.
If there are still some concerns of precancerous cells, the doctor
may use the LUMA Cervical Imaging System. The doctor uses this device
right after a colposcopy. This system, recently approved by the
FDA, shines a light on the cervix and looks at how different areas
of the cervix respond to this light. It gives a score to tiny areas
of the cervix. It then makes a color map that helps the doctor decide
where to further test the tissue with a biopsy. The colors and patterns
on the map help the doctor tell between healthy tissue and tissue
that might be diseased.
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. In advanced disease, metastases may be present
in the abdomen, lungs or elsewhere.
|
Symtoms
Most ot the time, early cervical cancer has no symptoms. Symptoms
that may occur can include:
• Continuous vaginal discharge, which may be pale, watery,
pink, brown, bloody, or foul-smelling
• Abnormal vaginal bleeding between periods, after intercourse,
or after menopause
• Periods become heavier and last longer than usual
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
• Leaking of urine or feces from the vagina
• Bone fractures
The early stages of cervical cancer may be completely asymptomatic
(Canavan & Doshi, 2000). 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. In advanced disease, metastases
may be present in the abdomen, lungs or elsewhere.
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, leaking of urine or feces from
the vagina, and bone fractures.
The possibility to identify premalignant changes on a cervical smear
has made screening the major cause for referral of women with possible
cervical neoplasia. In many countries, women are advised to have
a regular Pap smear to check for premalignant changes.[11] Recommendations
for how often a Pap smear should be done vary from once a year to
once every five years. [[According to practice guidelines written
by the ACS, recommendations for when to begin cervical cancer screening
should begin approximately three years after the onset of vaginal
intercourse and/or no later than twenty-one years of age (Reference
PMID 12469763).]] If cervical cancer is detected early, it can be
treated without impairing fertility. Consistently abnormal smears
may be a reason for further diagnosis despite complete absence of
symptoms
|
|
