Cervical Cancer

Cervical cancer is cancer of the uterine cervix.

Cervical cancer is the fourth most common cancer in women.
In 2018, an estimated 570,000 women were diagnosed with cervical cancer worldwide
about 311,000 women died from the disease.
Effective primary (HPV vaccination) and secondary prevention approaches (screening for, and treating precancerous lesions) will prevent most cervical cancer cases.

Cervical cancer starts with abnormal changes in the cellular lining of the cervix.
Typically these changes occur in the squamous-columnar junction of the cervix.
Here, columnar epithelial cells meet the protective flat squamous epithelial cells from the outer cervix and vagina in what is termed the transformation zone.
The continuous replacement of columnar epithelial cells by squamous epithelial cells in this area makes these cells vulnerable to take up foreign or abnormal genetic material

Cervical cancer is a sexually transmitted disease. HPV is the primary cause of cervical cancer. Some strains of HPV have a predilection to the genital tract and transmission is usually through sexual contact.

The pre-cancerous stage before the cells turn cancerous is called Cervical Intraepithelial Neoplasia (CIN)

May be silent until advanced disease develops
Symptoms of Invasion:
- Post-coital bleeding Z
- Foul vaginal discharge Z
- Abnormal bleeding Z - intermenustral
- Unilateral leg swelling or pain
- Pelvic mass
- Pelvic pain
- Gross cervical lesion

History
Physical examination
Investigation:
- Pap smear test: To Obtain Cells From the Cervix for Cervical Cytology Screening Z
- Cold cone biopsy
- MRI, a CT, blood tests or a X-ray
- Colposcopy, Z

Treatment of Early Disease
- simple hysterectomy Z
- microinvasive cancer Radical hysterectomy -removal of the uterus with its associated connective tissues, the upper vagina, and pelvic lymph nodes..
- Chemoradiation therapy
Advanced Staging
- Chemoradiation

Five types of standard treatment are used:

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