Types of Gynecologic Cancer

Ovarian Cancer Ribbon

Ovarian Cancer

Uterine and Endometrial Cancer Ribbon

Endometrial Cancer

Vulvar Cancer Ribbon

Vulvar Cancer

Vaginal Cancer Ribbon

Vaginal Cancer

Cervical Cancer Ribbon

Cervical Cancer

Ovarian Cancer Ribbon

Ovarian Cancer

  • Ovarian cancer is a disease that originates in the ovaries, which are female reproductive organs located in the pelvis. The ovaries play a crucial role in producing eggs and releasing female hormones such as estrogen and progesterone, which regulate the development of female body characteristics, the menstrual cycle and pregnancy.

    Ovarian cancer begins in one of three ways:

    • Epithelial ovarian cancer typically begins in the cells that cover the ovaries' surface, but it can also start in the fallopian tubes or peritoneum and spread to the ovaries. Epithelial ovarian cancer is the most common type, accounting for nine out of ten cases.

    • Germ cell tumors develop from the cells responsible for producing eggs and typically affect teenage girls or young women.

    • Stromal cell tumors begin in the supporting structural tissue of the ovary that produces female hormones.

    The malignant ovarian cancer can invade nearby organs like the fallopian tubes and uterus, shed or break off from the primary tumor, or spread through the lymphatic system or bloodstream to distant organs like the liver and lungs. Metastatic tumors found in other organs are still considered ovarian cancer, rather than cancer specific to those organs.

    In terms of prevalence, ovarian cancer is the second most common gynecologic cancer, with a significant number of new cases diagnosed each year. Treatment may involve surgery to remove the tumor or affected ovary, as well as chemotherapy tailored to the specific type of ovarian cancer. Fertility-sparing options may be considered for younger patients with certain types of tumors.

    Ovarian cancer is a complex disease that affects the ovaries and can manifest in different cell types. Early detection is challenging, making it important for individuals to be aware of the potential symptoms and seek medical attention if any concerns arise. Treatment options are available and tailored to each patient's specific circumstances.

  • Ovarian cancer is a complex disease with various factors that can increase or decrease a woman's risk of developing it. The identified risk factors include:

    • Family history: Having a first-degree relative (such as a mother, sister, or daughter) with ovarian cancer, breast cancer, or colorectal cancer can increase the risk. Men in your family with such a family history may also contribute to an increased risk due to inherited genetic mutations.

    • Age: Ovarian cancer is most commonly diagnosed in women aged 55 to 64. However, in rare cases women younger than 40 with a genetic predisposition may also be at risk.

    • Obesity: Having a body mass index (BMI) of 30 or higher is associated with a slightly increased risk.

    • Reproductive history: Women who have never given birth or had their first full-term pregnancy after the age of 35 may have a higher risk.

    • Menstrual history: Starting menstruation at an early age and entering menopause at a late age.

    • Endometriosis: This condition, where the tissue lining the uterus develops outside the uterus, is associated with an increased risk of certain types of ovarian cancer.

    • Fertility drugs: Prolonged use of certain fertility drugs, such as clomiphene citrate (Clomid), may slightly increase the risk, especially in women who do not become pregnant.

    • Estrogen and hormone therapy: Long-term use of hormone therapy for menopause symptoms, particularly estrogen-only therapy, may raise the risk of ovarian cancer.

    • Talc and asbestos exposure: While there is no clear evidence linking talc alone to ovarian cancer risk, talc that was contaminated with asbestos in the past may have increased the risk. Asbestos exposure itself is known to raise the risk of ovarian cancer.

    In contrast, there are factors that can potentially reduce the risk of ovarian cancer, including:

    • Reproductive history: Giving birth at a younger age, particularly before the age of 26, and having multiple pregnancies may lower the risk. Breastfeeding might also have a protective effect.

    • Birth control use: Using oral contraceptives (the pill) or injectable contraceptives (e.g., Depo Provera) has been associated with a decreased risk of ovarian cancer.

    • Gynecologic surgery: Undergoing a hysterectomy (with the ovaries left intact) or tubal ligation (having the fallopian tubes tied) has been linked to a reduced risk of ovarian cancer.

    It's important to note that having one or more risk factors does not guarantee the development of ovarian cancer, and conversely, the absence of risk factors does not ensure immunity from the disease. Regular check-ups, discussions with healthcare professionals, and appropriate screenings are crucial for early detection and appropriate management of ovarian cancer.

  • Ovarian cancer symptoms can be vague and easily mistaken for other conditions, so it's important to be aware of your body and what is normal for you. While symptoms may vary from person to person, the following are commonly reported symptoms of ovarian cancer:

    • General abdominal discomfort or pain: This may manifest as a persistent feeling of bloating or swelling in the lower abdomen. Some individuals may also experience a loss of appetite or an early sense of fullness even after consuming small meals. Gas, indigestion, and nausea may also be present.

    • Changes in bowel and bladder habits: Ovarian tumors can exert pressure on nearby organs, such as the bowel and bladder, leading to symptoms like constipation, diarrhea, or increased frequency of urination.

    • Persistent fatigue: Feeling unusually tired or lacking energy on a regular basis.

    • Abnormal vaginal bleeding

    • Fluid accumulation around the lungs: In advanced cases, ovarian cancer may cause fluid to accumulate around the lungs, leading to shortness of breath.

    It's important to note that these symptoms can be caused by various conditions and may not necessarily indicate ovarian cancer. However, if you experience any of these symptoms almost daily or for an extended period, particularly if they are new to you, it is advisable to consult a doctor. Ovarian cancer often presents symptoms in later stages when it has already spread beyond the ovaries. Early detection is key to improving outcomes, so seeking medical attention for a proper diagnosis is crucial.

  • The diagnosis of ovarian cancer involves a combination of medical history, physical examination, and various tests.

    • Pelvic exam: During a pelvic examination, the doctor checks for any masses or growths in the vagina, rectum, and lower abdomen. The Pap test, which is used for cervical cancer screening, does not detect ovarian cancer.

    • Blood tests: Blood tests may be conducted to measure the levels of certain substances, including CA-125. However, it's important to note that a high or low level of CA-125 alone does not confirm or rule out cancer, and changes in its levels over time are considered for evaluation.

    • Biopsy: This is a definitive diagnostic procedure where a sample of tissue or fluid is collected and examined by a pathologist. This examination under a microscope helps determine the presence of cancer cells. Biopsies can be performed through surgical procedures like laparoscopy or fine-needle aspiration.

    • Imaging tests: Transvaginal ultrasound, which involves the insertion of an ultrasound device into the vagina, provides detailed images of the ovaries. While Computed Tomography (CT) scans may also be used to investigate other potential causes of symptoms.

  • The specific treatment for ovarian cancer is determined by factors such as overall health, extent of the disease, individual tolerances, and expectations for disease progression.

    Treatment for ovarian cancer may involve surgery, chemotherapy, immunotherapy, or a combination of approaches.

    • Surgery: removing the the uterus (hysterectomy), fallopian tubes and ovaries (salpingo-oophorectomy), lymph nodes around the aorta (para-aortic lymphadenectomy), lymph nodes from the pelvis (pelvic lymph node dissection), the omentum (omentectomy), and debulking surgery to remove visible tumors, potentially including the spleen and gastrointestinal tract organs.

    • Chemotherapy: used to kill cancer cells throughout the body.

    • Targeted therapy: specifically targets cancer cells with specific mutations or alterations.

    • Hormone therapy: used for recurrent disease.

    • Immunotherapy: stimulates the immune system to attack cancer cells.

    • Radiation therapy: rarely used in primary treatment but may be employed to alleviate symptoms caused by the cancer.

    Important considerations include the impact of treatment on fertility and sexuality, as ovarian cancer treatment may involve the removal of reproductive organs. Understanding potential side effects and proactively managing them is essential, as treatments can affect healthy cells and tissues.

Edometrial & Uterin Cancer Ribbon

Endometrial Cancer

  • Uterine cancer, the most common cancer of the female reproductive organs, can be categorized into two main types: endometrial carcinoma and uterine sarcoma.

    • Endometrial carcinoma, accounting for approximately 80% of cases, originates in the lining of the uterus (the endometrium). Treatment is often successful when detected early.

    • Uterine sarcoma, less common and more challenging to treat, develops in the muscular layer of the uterus. Uterine carcinosarcoma, a rare subtype, exhibits characteristics of both endometrial cancer and uterine sarcoma.

  • The exact cause of endometrial cancer is not fully understood, but it is known that the presence of estrogen and progesterone receptors on endometrial cancer cells may play a role. Hormonal imbalances, such as an excess of estrogen or progesterone, can lead to abnormal cell growth and the formation of cancerous tumors. Several risk factors are associated with endometrial cancer as follows:

    • Obesity

    • High blood pressure

    • Diabetes

    • Abnormal overgrowth of the uterine lining - endometrial hyperplasia or polycystic ovary syndrome.

    • A history of taking certain medications such as tamoxifen, a drug to treat breast cancer, or estrogen, for menopausal hormone therapy.

    • Previous radiation therapy of the pelvis.

    • Reproductive and menstrual factors such as never having children, early onset of menstruation (< 12 yrs old), and late menopause (> 55 yrs old) also contribute to the risk.

    • Family history of uterine, ovarian, and/or colon cancers. Additionally, a family or personal history of Lynch Syndrome.

    Endometrial cancer is more prevalent in older white women. However black women tend to have a higher likelihood of being diagnosed with uterine cancer in later stages, as well as facing more aggressive and challenging-to-treat forms of the disease. We call these differences cancer health disparities. The cause for such disparities is a focus of current research in the field.

  • Endometrial cancer can be detected through various symptoms, and it is crucial to consult a doctor if any of the following are experienced:

    • Abnormal vaginal bleeding not related to menstruation

    • Postmenopausal bleeding

    • Difficult or painful urination

    • Pain during intercourse

    • Pelvic pain and/or presence of a mass in the pelvic region.

    Abnormal or post-menopausal bleeding is a common indicator of uterine cancer and should not be disregarded as a normal part of menopause. Reporting abnormal or post-menopausal bleeding to physicians has proven to be crucial in the timely diagnose in many cases of this cancer, enabling detection during the uterine cancer’s most early and manageable stages.

  • Diagnosing endometrial cancer typically involves a thorough examination of medical history, a general physical exam, and several diagnostic procedures. These procedures may include:

    • Transvaginal ultrasound: A transducer is inserted into the vagina to perform an ultrasound test. This helps evaluate the thickness of the endometrium, and if it appears abnormal or polyps found, a biopsy may be recommended.

    • Hysteroscopy: This procedure involves the use of a thin telescope that is inserted into the uterus, allowing the physician to visualize the interior and inspect for any abnormalities, masses, or polyps. Biopsies from suspicious areas can be collected during this examination. This procedure is typically performed under local anesthesia.

    • Pap test: The pap smear, as it is also called, is a microscopic examination of cells collected from the cervix to detect any cancerous or precancerous changes. However, this test does not specifically detect endometrial cancer.

    • Endometrial biopsy: A small, flexible tube is inserted into the uterus to obtain a tissue sample, which is then examined under a microscope to identify the presence of cancer or abnormal cells. This procedure is often conducted in a doctor's office.

    • Dilation and curettage (D&C): If an endometrial biopsy is not possible or additional diagnostic information is needed, a D&C may be recommended. It involves dilating the cervix and scraping the uterine lining to collect tissue samples for examination by a pathologist.

  • The most suitable treatment plan for uterine cancer is determined by various factors, including overall health, cancer stage and grade, and the presence of specific genetic mutations. Surgery is commonly the initial treatment option, but additional therapies such as radiation, hormone therapy, and chemotherapy or immunotherapy drugs may also be recommended for many patients. The selection of treatments aims to provide the most effective approach tailored to each individual's circumstances.

    Treatment options may include the following:

    • Surgery: This involves the removal of the uterus, cervix, and any other affected tissues.

    • Radiation therapy: It can be used before surgery to shrink tumors, after surgery to kill remaining cancer cells, to prevent recurrence, or to relieve symptoms.

    • Chemotherapy: It may be administered before or after surgery to destroy cancer cells throughout the body.

    • Hormone therapy: This approach is utilized to slow down or halt tumor growth in cases where hormones fuel the cancer.

    • Targeted therapy: By interfering with specific proteins or enzymes that cancer cells require for growth, targeted therapy aims to attack and destroy cancer cells.

    • Immunotherapy: This treatment boosts the patient's immune system to enhance its ability to fight against the cancer.

    • Fertility-sparing treatment: In certain cases, hormone therapy is used initially, allowing time for childbearing before undergoing curative surgery.

Vulvar Cancer ribbon

Vulvar Cancer

  • Vulvar cancer is a rare form of cancer that affects the external genital area known as the vulva. The vulva includes the inner and outer lips of the labia, the clitoris, the vaginal opening, and the vaginal glands located in the perineum.

    This type of cancer typically develops slowly over several years, starting with the growth of abnormal cells. These cells are not cancerous at first but have the potential to become cancerous over time. Regular medical examinations are essential to detect them early. Early detection allows for easier treatment and can prevent the progression to vulvar cancer.

    The most common types of vulvar cancer are vulvar squamous cell carcinoma and vulvar melanoma. Squamous cell carcinoma originates from the thin, flat cells that line the surface of the vulva, while melanoma arises from the pigment-producing cells in the vulvar skin.

  • Early detection plays a crucial role in the successful treatment of vulvar cancer. Recognizing the risk factors and symptoms is essential for early detection and include:

    • Increasing age: The risk of vulvar cancer rises with age, as 80% are over 50, with the average diagnosis occurring around 65 yrs old.

    • Exposure to certain types of HPV. The HPV vaccines may help protect against these certain types and may lower your risk of getting this cancer.

    • Smoking

    • HIV infection

    • History of precancerous vulvar conditions: Vulvar intraepithelial neoplasia (VIN) is a precancerous condition that elevates the risk of vulvar cancer. Though most women with VIN do not develop cancer, periodic follow-up checks and treatment may be recommended.

    • Vulvar skin conditions: Lichen sclerosus, a condition causing thin and itchy vulvar skin, may slightly increases the risk of vulvar cancer.

  • Vulvar cancer can present with various signs and symptoms, and it's crucial to pay attention to any changes and consult a healthcare provider for proper evaluation. Common symptoms include:

    • Persistent itching

    • Changes in vulvar color and appearance

    • Abnormal bleeding or discharge unrelated to menstruation

    • Severe burning, itching, or pain

    • Presence of an open sore lasting for an extended period

    • White, rough skin on the vulva

    • Formation of a lump, thickening, or ulcer on the vulva

    • Alterations in mole appearance

    • Wart-like growths

    • Tenderness or pain in the vulvar area

    • Discomfort during sexual activity or urination

    • Unusual odor

    Regular self-examinations using a mirror can help detect these symptoms. If any of these signs are observed, it is essential to inform your healthcare provider for further evaluation, as they may indicate vulvar cancer or other underlying conditions.

  • When a symptom suggests the possibility of vulvar cancer, a doctor will conduct a thorough examination to assess your overall health. The following procedures may be performed:

    • Pelvic exam: This involves a careful examination of the vagina, uterus, bladder, and rectum for any irregularities.

    • Biopsy: If a suspicious area is detected, the doctor will take a sample of tissue for further analysis. The tissue sample will be examined by a pathologist under a microscope to determine if there is cancer or a pre-cancerous condition and identify the specific type, if present.

  • The treatment approach for vulvar cancer is determined by several factors, including the size and location of the cancer, the extent of its spread, and your overall health.

    Surgery:

    The main treatment for vulvar cancer is surgery, with the primary goal of completely removing the cancer while preserving a woman's sexual function. The extent of the surgery will depend on the size and invasion of the cancer. If the tumor is large (more than 2 centimeters) or has deeply invaded the vulva, it may be necessary to remove a significant amount of tissue. In some cases, this may involve the removal of the lymph nodes in the groin area.

    There are four main types of vulvar surgery commonly used in the treatment of vulvar cancer:

    • Laser surgery: This technique employs a focused beam of light to burn off abnormal cells on the skin. It is typically used for treating precancerous conditions rather than invasive cancer.

    • Wide local excision: This procedure involves the removal of the tumor along with some surrounding healthy tissue to ensure complete removal of the cancer. It aims to achieve clear margins around the tumor.

    • Vulvectomy: This surgical approach involves the removal of all or part of the vulva, which is the external genital area. There are different types of vulvectomy:

      • Skinning vulvectomy: This procedure involves the removal of the top layer of vulvar skin where the cancer is located. In some cases, skin grafts from other parts of the body may be necessary to cover the area where the skin was removed.

      • Simple vulvectomy: The entire vulva is removed.

      • Modified radical vulvectomy: the portion of the vulva that contains the cancer, along with a margin of normal tissue around it, is removed. The extent of tissue removal is determined based on the size and location of the cancer.

      • Radical vulvectomy: the entire vulva, along with nearby tissue, is removed. This procedure is performed in cases where the cancer has spread extensively.

    • Lymph node dissection: This surgery involves the removal of one or more lymph nodes to assess whether the cancer has spread to these nodes.

    • Pelvic exenteration: a complex surgical procedure that involves the removal of the lower colon, rectum, bladder, cervix, vagina, ovaries, and nearby lymph nodes. Artificial openings called stomas are created for urine and stool to be collected in bags outside the body. This procedure is used in advanced or recurrent cases of vulvar cancer to remove the cancer and improve quality of life.

    Radiation Therapy

    Radiation therapy involves the use of high-energy rays to kill cancer cells, primarily targeting the treated area. This type of therapy may be used if the cancer has spread to different areas in the body or prior to surgery to shrink the tumor.

    There are two primary types of radiation therapy:

    • External beam radiation therapy: the most common form of radiation therapy, where high-energy rays are directed at the cancerous area from outside the body using a machine.

    • Brachytherapy: This type of radiation therapy involves the internal delivery of radiation using radioactive implants.

    Chemotherapy

    Chemotherapy utilizes drugs to halt the growth of cancer cells, either by killing them or preventing division. It can be administered orally, intravenously, or locally, depending on the type and stage of the cancer.

Vaginal Cancer Ribbon

Vaginal Cancer

  • Vaginal cancer is a rare form of cancer that originates in the vagina, which is the muscular canal connecting the cervix to the outside of the body. When detected early, it can be effectively cured, but advanced stages of the disease that have spread to other parts of the body can be challenging to treat.

    Two most common types of vaginal cancer are:

    • Squamous cell carcinoma: This type of cancer develops in the thin, flat cells lining the vagina. It tends to spread slowly and usually remains near the vagina, but it can potentially spread to the lungs and liver. Squamous cell carcinoma is most commonly found in women aged 60 or older and accounts for about 70% of all vaginal cancers.

    • Adenocarcinoma: This cancer begins in the glandular cells, which produce and release fluids like mucus, in the lining of the vagina. Adenocarcinoma has a higher tendency to spread to the lungs and lymph nodes compared to squamous cell carcinoma. It is more commonly found in women older than 50 and represents approximately 15 percent of all cases of vaginal cancer.

  • While it is not possible to completely prevent vaginal cancer, there are measures you can take to reduce your risk:

    • Regular pelvic exams and Pap tests: These screenings can help detect any abnormal changes in the cells of the vagina or cervix.

    • HPV vaccination: HPV is a sexually transmitted infection that can increase the risk of developing vaginal cancer.

    • Avoid smoking: Smoking is a known risk factor for various types of cancer, including vaginal cancer.

  • Certain factors can increase the risk of developing vaginal cancer in women:

    • Age: Vaginal cancer is more common in women who are 70 years old or older.

    • Exposure to diethylstilbestrol (DES): If a woman's mother took DES during pregnancy (as synthetic form of estrogen prescribed from 1940-1971), it can increase her risk of developing vaginal cancer.

    • History of cervical cancer or precancerous conditions: Women with a previous history of cervical cancer or precancerous conditions are at a higher risk of vaginal cancer.

    • HPV infection: Infection with the human papillomavirus (HPV)

    • HIV infection: Women who are infected with the human immunodeficiency virus (HIV).

    • Vaginal adenosis: This condition, characterized by glandular tissue in the vagina, can increase the risk of developing vaginal cancer.

    • Vaginal irritation: Chronic vaginal irritation or inflammation may increase the risk of vaginal cancer.

    • Smoking: Tobacco smoking is a known risk factor for various cancers, including vaginal cancer.

  • Vaginal cancer can sometimes develop without causing noticeable symptoms. It is possible for the presence of abnormal cells to be detected by a healthcare provider during routine screenings, even if you do not experience any symptoms. However, if you experience any of the following symptoms for an extended period, it is important to consult your physician as they could be signs of vaginal cancer:

    • Bleeding or discharge not related to menstrual periods.

    • Pain during sexual intercourse.

    • Pelvic pain.

    • A lump in the vagina that can be felt

    • Constipation

    • Painful urination

    Since these symptoms can be associated with other conditions, it is crucial to seek medical evaluation for an accurate diagnosis and appropriate treatment if needed.

  • To diagnose vaginal cancer, your doctor may conduct several examinations and tests. These include:

    • Pelvic exam: where the vagina, uterus, bladder, and rectum are checked for abnormalities.

    • Pap smear: A test performed to collect cells from the cervix and vagina for microscopic examination for signs of cancer or HPV.

    • Colposcopy: This procedure involves using a colposcope to closely examine the vagina.

    • Biopsy: The removal of tissue samples from the vagina for further examination under a microscope by a pathologist.

    Based on the results, further imaging tests may be performed to determine the staging, how advanced the vaginal cancer is. These can include a CT or CAT scan, MRI, or a PET scan.

  • There are three types of treatment approach for vaginal cancer which are determined by several factors, including the size and location of the cancer, the extent of its spread, and your overall health.

    Surgery:

    • Wide local excision: This procedure involves the removal of the cancer along with some surrounding healthy tissue to ensure complete removal of the cancer.

    • Laser surgery: This technique employs a focused beam of light to make incisions in the tissue or remove surface lesions. It is typically used for treating precancerous conditions rather than invasive cancer.

    • Vaginectomy (partial or radical): This procedure involves the surgical removal of all or a portion of the vagina affected by cancer.

    • Total hysterectomy: This surgery involves the removal of the uterus, either through the vagina, a large incision or small opening in the abdomen. In some cases, lymph nodes near the tumor may also be removed to determine if the cancer has spread.

    • Pelvic exenteration: a complex surgical procedure that involves the removal of the lower colon, rectum, bladder, cervix, vagina, ovaries, and nearby lymph nodes. Artificial openings called stomas are created for urine and stool to be collected in bags outside the body.

    Radiation Therapy:

    Radiation therapy involves the use of high-energy rays to kill cancer cells, primarily targeting the treated area.

    There are two primary types of radiation therapy:

    • External radiation: In this radiation therapy, high-energy rays are directed at the cancerous area from outside the body using a machine.

    • Internal radiation: This type of radiation therapy involves the internal delivery of radiation using radioactive implants such as wires or catheters.

    Chemotherapy:

    Chemotherapy utilizes drugs to halt the growth of cancer cells, either by killing them or preventing division. It can be administered orally, intravenously, or locally, depending on the type and stage of the cancer. On it own, Chemotherapy isn’t an effective treatment for vaginal cancer, but is used alongside radiation to improve outcomes. Additionally, it may be used after surgery to treat vaginal cancer that has an increased risk of returning after treatment or has later returned.

Cervical Cancer Ribbon

Cervical Cancer

  • Cervical cancer originates in the cells lining the cervix, the lower part of the uterus that connects it to the vagina. Abnormal and uncontrolled growth of these cervical cells leads to the development of cervical cancer. The cervix is divided into two parts, each covered with different types of cells:

    • the endocervix: This is the opening of the cervix leading to the uterus, which is lined with glandular cells

    • the exocervix (ectocervix): This is the outer portion of the cervix which is visible during a speculum exam and is covered in squamous cells.

    The meeting point of these cell types is known as the transformation zone, where most cervical cancers originate.

    The primary cause of cervical cancer, 99% of the time, is infection with certain types of human papillomavirus (HPV). Vaccination has become an effective preventive measure against most cases of cervical cancer.

  • The primary cause of cervical cancer, 99% of the time, is persistent infection with certain types of human papillomavirus (HPV), which is commonly transmitted through sexual contact. Most HPV infections do not show symptoms and resolve without treatment, but chronic infection can lead to cell changes and dysplasia. The HPV vaccine is recommended by doctors for both boys and girls aged 9 to 26, ideally before any exposure to HPV. For individuals between 27 and 45 years old who have not received the vaccine, it may still be considered as an option. To determine eligibility for the vaccine, it is advised to consult with your doctor.

    Other risk factors for cervical cancer for those with a HPV infection include:

    • Skipping Pap tests. Approximately 60 to 80% of women diagnosed with invasive cervical cancer had not undergone Pap tests for a period of five years or more.

    • Smoking

    • Weakened immune system (e.g., due to HIV infection or immunosuppressive drugs)

    • Multiple sexual partners or a partner with multiple sexual partners

    • Long-term use of birth control pills.

    • Giving birth too many children.

    • Exposure to DES (diethylstilbestrol) before birth. This was a drug given to some pregnant women between 1940 and 1971.

    Regular cervical cancer screening, avoiding these risk factors, and HPV vaccination are important for reducing the risk of cervical cancer as there is no way to predict who will develop cervical cancer after exposure to HPV.

  • Cervical cancer often does not show noticeable signs or symptoms, particularly in its early stages. Regular cervical cancer screening is important from the age of 21 onwards; regardless of what age sexual intercourse occurred. Regardless, symptoms that may indicate cervical cancer include:

    • Pain or bleeding during or after sexual intercourse

    • Pelvic pain

    • Abnormal vaginal discharge

    • Blood or bleeding outside of the normal menstrual period

    • Difficulties with urination or bowel movements

    • Swelling in the legs.

  • Regular visits to a primary care doctor or gynecologist are recommended for women, including an annual pelvic exam to check for signs of cervical cancer. There are two common tests used to detect cancer, precancerous changes, or increased risks:

    • Pap smear: Cells from the cervix are collected using a swab and examined for abnormal cells in a lab.

    • HPV test: A sample of cervical cells is taken to check for high-risk strains of HPV in a lab. This test can be done alone or in conjunction with a Pap test.

    When abnormal Pap test or positive HPV test results are found, further procedures may be recommended to confirm or rule out the presence of cancerous cells:

    • Colposcopy: A minimally invasive procedure where a colposcope is used to examine the cervix closely. If abnormal cells are detected, a biopsy may be performed to determine their nature. Special staining techniques are used to enhance accuracy.

    • Biopsy: A small tissue sample is taken from the cervix and examined under a microscope by a pathologist to confirm or exclude cancer.

    • Cone biopsy or LEEP (loop electrosurgical excision procedure): These procedures remove abnormal tissue from the cervix. They can serve both diagnostic and therapeutic purposes by eliminating any precancerous cells. LEEP is typically performed in a doctor's office with local anesthesia, while cone biopsy is done in a hospital under general anesthesia.

    • Imaging tests: The doctor may require chest x-ray, CT, MRI, and/or PET scans based on the finding of the previous procedures.

    The treatment plan for cervical cancer or precancerous cells depends on various factors, such as age and the severity of cell abnormalities, and will be tailored to each individual's needs.

  • Invasive cervical cancer is categorized into four stages to describe its progression:

    Stage 1: The tumor has penetrated beneath the top layer of cells in the cervix, and cancer cells are limited to the cervix.

    Stage 2: The tumor has spread to the upper part of the vagina and may extend into nearby tissues close to the pelvic wall. However, it has not invaded the lower third of the vagina or the pelvic wall.

    Stage 3: The tumor has extended to the lower part of the vagina and may have invaded the pelvic wall. In some cases, the tumor may obstruct urine flow and affect kidney function.

    Stage 4: The tumor has invaded the bladder or rectum or has spread to other areas of the body.

    Recurrent cancer: The cancer has reappeared after treatment, either in the cervix or in other parts of the body, following a period when it was undetectable.

  • The choice of treatment depends on factors such as overall health, cancer stage, and fertility preferences. Surgery is commonly the primary treatment, but additional therapies like radiation, chemotherapy, targeted therapy, or immunotherapy may also be necessary.

    The typical treatment options for cervical cancer are as follows:

    Surgery:

    Various procedures can be performed to remove cancer cells, such as:

    • cone biopsy (conization): This procedure involves the removal of a cone-shaped piece of abnormal tissue or tumor from the cervix. It is commonly performed for early-stage cancers and can serve as the primary treatment in some cases.

    • trachelectomy: This involves the removal of most of the cervix while preserving the uterus. Depending on the cancer's stage, it may be a simple trachelectomy (removal of the cervix) or a radical trachelectomy (removal of the cervix, upper vagina, nearby lymph nodes, and other tissues). Trachelectomy is considered a fertility-sparing approach, allowing women to preserve their ability to become pregnant.

    • pelvic lymphadenectomy: This surgical procedure aims to remove lymph nodes in the pelvis to determine if the cancer has spread to nearby lymph nodes. Pelvic lymphadenectomy is typically performed alongside trachelectomy or hysterectomy.

    • hysterectomy: This procedure involves the removal of the uterus and cervix, and depending on the extent of the cancer, it may also include removing varying degrees of the vagina and surrounding tissue. In some cases, the ovaries may also be removed, particularly in menopausal patients..

    Radiation therapy:

    Radiation therapy involves the use of high-energy X-ray beams to destroy cancer cells and prevent their spread. There are two primary types of radiation therapy:

    • External radiation: In this radiation therapy, high-energy rays are directed at the cancerous area from outside the body using a machine.

    • Internal radiation: This type of radiation therapy involves the internal delivery of radiation using radioactive implants such as wires or catheters.

    Chemotherapy:

    Chemotherapy is a systemic treatment for cervical cancer that utilizes drugs and other anti-cancer agents to target and kill cancer cells. Unlike localized treatments such as surgery or radiation therapy, chemotherapy works throughout the entire body system.

    Targeted therapy:

    Targeted therapies are a class of drugs that specifically target cancer cells by disrupting molecules or components unique to cancer cells. They aim to inhibit cancer cell growth and spread while minimizing damage to healthy cells. By focusing on specific genetic mutations or characteristics of cancer cells, targeted therapies offer the potential for more precise and effective treatment, leading to improved outcomes for patients.

    Immunotherapy:

    Immunotherapy is an innovative strategy in cancer treatment that utilizes the body's immune system to combat cancer. By uncovering cancer cells that can evade the immune system, immunotherapy drugs and agents stimulate the body's natural defenses to recognize and target these cells.

    Fertility-sparing treatment:

    Cervical cancer is commonly detected in women who are younger and in their premenopausal years, typically between the ages of 35 and 44. Due to the age group affected, preserving fertility becomes a crucial factor in the treatment decision. Fortunately, many women with early-stage cervical cancer have the option to undergo surgical treatments that effectively address the cancer while also maintaining the possibility of preserving the uterus.