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Cancer of the Cervix

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Introduction

Cervical cancer is the cancerous infection that occurs as a result of abnormal growth of cells on the cervix. The cervix is the lower part of the uterus that is connected to the upper portion of the birth canal. Cervical cancer is the second most common and fifth most deadly disease in women globally. In 2008 it was approximated that there were roughly 473,000 cases of cervical cancer (Blaustein & Kurman, 2002). The annual deaths were at 253,500. This paper explores the pathological events that lead to infection of cervical cancer, its consequences, the related risk factors of the disease, signs and symptoms, diagnosis and treatment of the disease.

Pathological events leading to Cervical Cancer

Pathological studies that have been conducted demonstrate that cervical cancer develops as a result of the abnormal growth in the cervical tissue. The main cause of the cancer is the human papilloma virus (HPV). This virus is transmitted from one person to the other through sexual contacts (Shah & Rohan, 2004). The vulnerability is increased in women that have early sexual contacts and more than one sexual partner. These often lead to the development of cervical-related lesions that may later grow to become cancerous.

The Human Papilloma Virus (HPV) exists in various types. However, not all of the viruses cause cervical cancer. On the same note, one can have the HPV for several years without knowledge. However, results of the research conducted on cervical cancer indicate that 70% of cervical cancer globally is caused by HPV (Human Papilloma Virus). This virus can stay in the body and cause cancerous infection several years later. This explains the recommendations of the medical practitioners that women should undertake Pap tests as frequently as possible so that any changes in the cervical cells can be detected and treated before they develop to be cancerous (Blaustein & Kurman, 2002). Pap smear remains to be the commonest screening test for cervical cancer. However, confirmation of the diagnosis of the cervical cancer needs a biopsy. This is done through the use of colposcopy (Singer & Monaghan, 2000). If not detected and treated early enough, cervical cancer can spread out to the bordering organs like the kidney, the renal tract and the birth canal.

The survival rate for women diagnosed with cervical cancer is almost 100% if the precancerous changes in the cervix are detected and treated early. However, the success of treatment of invasive type of cancer is largely dependent on the stage of detection. Thus, the stage at which cervical cancer is screened, detected and treated determines the success and survival of the patient (Shah & Rohan, 2004). For the earliest stages of cancer of the cervix, that is 0, 1A, approximately 90% of women are able to prolong their lives by at least five years. The later stages of development of cervical cancer are relatively challenging to effectively deal with. At this stage, only 20% or fewer patients survive (Shah & Rohan, 2004). This is the same case with the stage IV of a developed cancer of the cervix.

Risk Factors of Cervical Cancer

The most common risk factor for getting cervical cancer is sexual activity. The risk is based on the association of cervical cancer with the human papilloma virus (HPV). This virus is transmitted through sexual contact with a person that has contracted it. This is particularly linked to the squamous cell cervical cancers (Shah & Rohan, 2004). Therefore women who have multiple sex partners are greatly exposed to the risk of contracting cervical cancer. This risk remains if the women are in sexual relationship with a man who has sexual contacts with other partners (Rosdahl & Kowalski, 2008).

The cancer of the cervix is common in women who have been celibate throughout their lives. Such women are exposed to the risk of an adenocarcinoma cancer of the endocervix. However, on a general note, all sexually active women are at risk of developing cancer of the cervix (Blaustein & Kurman, 2002). The risk of development of the cervical cancer is compounded further by smoking and sexual promiscuity on the part of the woman or her male sexual partner. Lack of regular Pap smear screenings also exposes women to the risk of developing cervical cancer. Those who are commonly diagnosed with cervical cancer are women who have not had regular and consistent screening of cervical cancer through Pap smear test (Shah & Rohan, 2004).

The risk factor that cervical cancer puts patients to include spread of the disease to other body tissues, organs and cells. For example, as the disease develops, it is growing to affect the neighboring tissues and organs such as the rectum, the lymphatic system, the birth canal, kidneys and even the liver (Shah & Rohan, 2004). This can be very fatal for the patient. Cervical cancer puts pregnant women at a great risk of spontaneous miscarriage especially if the cervix is manipulated or biopsied in the first trimester of the pregnancy. In some cases women diagnosed with cervical cancer can be rendered infecund. This happens when the treatment procedures require total pelvic removal. In such cases, the uterus, tubes, ovaries, bladder, colon and the vagina are all removed. Such surgical procedures would thus leave the woman permanently infertile. Of all the risks associated with cervical cancer the most dreaded one is the painful reality that eventually the patient has to succumb to death if the disease was not detected early enough and treated.

Diagnosis of Cervical Cancer

The progress that has been made in diagnosis of cervical cancer is by use of Pap smear. This should be a regular process that involves examination of the pelvis. Cells that are on the surface of the cervix are collected and examined on a slide. In order to diagnose cervical cancer, a biopsy is taken for analysis under a microscope. The biopsy is usually examined by specially trained physician who is experienced in the diagnosis of diseases through examination of body cells and tissues. Shah & Rohan (2004) cited that cervical cancer is also diagnosed through colposcopy. This is an examination procedure that involves the use of a special microscope known as colposcope to examine the cervix (Shah & Rohan, 2004). For this to be done, the entire cervix is stained with a dye that is not harmful so as to enhance visualization of abnormal cells with clarity. Another method for diagnosis of cervical cancer is the use of the loop electrosurgical excision procedure (LEEP). This involves the use of an electrified wire that is looped to pick samples of tissue from the cervix. This is often done by a gynecologist.

Signs and Symptoms of Cervical Cancer

The signs and symptoms of cervical cancer are evident only in the advanced stages of the disease. For women in their post-menopause ages, the clear sign of the disease is the abnormal bleeding (Issah, 2010). In the advanced stages cervical cancer causes abnormal vaginal discharge. Most patients diagnosed with cervical cancer also complain of pelvic pain that is persistent and not related to other normal conditions of menstruation. Issah (2010) writes that pain can range from a dull ache to sharp pains that can be lasting for several hours. In some cases women with cervical cancer may experience abnormal pain during vaginal coitus. Besides, patients diagnosed with the disease often complain of pain during urinal discharge. This is a symptom for advanced cervical cancer. Further, increased frequency of urination and urinary infection can be an indication of a developing cancer.

Treatment of Cervical Cancer

Cervical cancer may be treated by use of radiation especially in stages where surgery cannot be done. Biopsy and LEEP (loop electrosurgical excision procedure), though diagnostic procedures, can sometimes be used as treatment procedures as well (Rosdahl & Kowalski, 2008). These procedures involve examination of a section of the cervical tissue for detection of the disease. This will then inform the practitioner whether the disease needs further examination or the best possible treatment approach that can be adopted. Treatment of cervical cancer can also be done through the use of cryocautery. This treatment procedure uses a steel instrument that is cooled to subzero temperature. This is done through immersion of the instrument in liquid nitrogen (Shalini, Chitrathara & Amita, 2012). The intra-cooled instrument is thereafter applied to the cervical surface to freeze cells to the death. Once cells are dead they are sloughed-off and replaced by new cells of cervix. Infected tissues can also be treated through laser ablation. This involves application of a laser beam to the specific areas of the tissues or its entire surface. This laser destroys the affected cells and leaves healthy cells in their place (Singer & Monaghan, 2000; Shalini et al, 2012). However, success of cryocautery or laser ablation depends on followed follow-up examination such as the application of Pap smear.

Conclusion

The pathology, risk factors, prognosis, diagnosis and treatment of cervical cancer is a medical field that continues to attract scholarly research. However, the progress that has been made in this field indicates that cervical cancer still remains the greatest threat to women who are sexually active. The easiest and commonest screening procedure is the Pap smear. Although much effort has been made to contain the disease, the greatest level of success has been witnessed in protection and not treatment. Much more investigation is thus warranted.

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