The causes of cervical cancer, symptoms and treatment

Cervical cancer is a slow-growing cancer that develops in the lining of the cervix, which is the lower, narrow part of the uterus that connects the uterus to the vagina. An estimated 12,200 women in the United States were diagnosed with cervical cancer in 2010 and 4,210 died from it during that year. Fifty-eight percent of those 12,100 women were between the ages of 45 and 74. The 5 year survival rate from 1999 to 2006 was 70 percent. New early screening tests and a new vaccine are contributing to improved outcomes for this form of cancer.

There are two main types of cervical cancer: squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma is the most common form, occurring in about 80 to 90 percent of all cases. It develops in the thin, flat cells, called squamous cells, that cover the surface of the endocervix, the portion of the cervix closest to the uterus. Adenocarcinoma is more common in younger women and forms in the gland cells within the endocervix.

Although scientists are not 100 percent sure on how cervical cancer develops, they have been able to identify a number of risk factors which can lead to the disease. The chief risk factor is associated with sexually transmitted viruses such as some types of the human papillomavirus, and human immunodeficiency virus (HIV). The bacterial based Chlamydia, also transmitted during sexual activity, is another risk factor for cancer of the cervix. Other factors which can lead to an increased risk of include: smoking, a diet low in fruits and vegetables, obesity, long-term use of oral contraceptives, and multiple pregnancies. A family history of cervical cancer is another high risk consideration.

Unfortunately, the symptoms of cervical cancer are asymptomatic (showing no symptoms) in the early stages. It is not until it has reached the later sub-stages and stages that it becomes noticeable. The most common symptoms include:

Abnormal vaginal bleeding
Abnormal vaginal discharge with light blood spots or light bleeding between periods.
A higher amount of blood loss than normal during menstruation.
Bleeding following intercourse, pelvic exam, or douching.
Pain during intercourse.
General pelvic pain.

A diagnosis of cervical cancer can be made with the aid of several instruments and imaging devices. The two most common instruments include a cystoscope, (a thin, tube-shaped instrument with a light and optical device at one end which is inserted into the vagina) and a proctoscope (similar to a cystocope but is inserted into the anal cavity to examine invasive forms of cervical cancer). The most common imaging tests include an x-ray, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and intravenous urography. Doctors may also perform a PAP smear, and a biopsy is taken in many cases.

While traditional cancer treatment methods of chemotherapy and radiation are often utilized in cervical cancer, there are eight different types of surgical procedures used which include:

Cryosurgery: A type of surgery which uses liquid nitrogen to freeze and kill cancer cells.
Laser Surgery: A type of surgery which uses a laser beam as a sort of knife to cut away tumors without causing bleeding.
Loop electrosurgical excision procedure (LEEP): Type of surgery which uses a thin wire loop positioned around the tumor and delivers a low intense electric current.
Conization: Type of surgery where a cone shape mass of tissue is removed from the cervix with the help of a laser or LEEP.
Simple hysterectomy: Removal of the uterus without adjacent tissues.
Total hysterectomy: Type of surgery where the uterus is removed together with adjacent structures or organs (parametria and uterosacral ligaments, the upper part of the vagina located next to the cervix, the lymph node, and sometimes the fallopian tubes and ovaries).
Trachelectomy: A new type of surgery where the cervix is removed while attempting to preserve as much healthy tissue as possible. The lymph nodes are also removed. A "purse-string" stitch is also created which will act as the opening to the cervix. Early trials show that women that have this type of surgery have fewer relapses of cervical cancer.
Pelvic exenteration: Similar to a total hysterectomy but more organs are removed which include: uterus, parametria and uterosacral ligaments, upper part of the vagina closest to the cervix, lymph node, fallopian tubes, ovaries, rectum, and part of the colon and urine bladder.

Cervical cancer can be prevented with changes to those risk factors associated with the disease. These changes include:

Delaying sexual intercourse until marriage
Limiting the number of sexual partners.
Avoiding sexual contact with promiscuous partners.
Quitting smoking.
Eating more fruits and vegetables, and foods high in vitamins and minerals.
Exercising.
Losing weight if obese.

Women can also receive Gardasil, a new vaccine aimed at HPV viruses 6,11, 16, and 18, which can all lead to cervical cancer. This vaccine prevents infection of HPV and can not be used to treat an existing infection. Gardasil requires a series of three injections over a six month period. Gardasil only works on these four types of HPV and does not prevent other HPV types from causing to cervical cancer, although these occurrences are extremely rare.