Cervical cancer is a cancer arising from the cervix and there are two main types:-
Squamous cell: Squamous cell cancers are composed of the flat cells that cover the surface of the cervix and often begin where the outer surface joins with the cervical canal. Eight out of ten (80%) cervical cancers are diagnosed as squamous cell.
Adenocarcinoma: This cancer develops in the glandular cells which line the cervical canal. This type of cancer can be more difficult to detect with cervical screening tests because it develops within the cervical canal. It is thought that more than one in ten (15–20%) cervical cancers are diagnosed as adenocarcinoma.
Staging of cervical cancer:
Stage 1a: Cancer involves the cervix but has not spread to nearby tissue. A very small amount of cancer that is only visible under a microscope is found deeper in the tissues of the cervix.
Stage 1b: Cancer involves the cervix but has not spread nearby. A larger amount of cancer is found in the tissues of the cervix.
Stage2 a: Cancer has spread to nearby areas, but is still inside the pelvic area. Cancer has spread beyond the cervix to the upper two thirds of the vagina.
Stage 2b: Cancer has spread to nearby areas, but is still inside the pelvic area. Cancer has spread to the tissue around the cervix.
Stage 3: Cancer has spread throughout the pelvic area. Cancer cells may have spread to the lower part of the vagina. The cells also may have spread to block the tubes that connect the kidneys to the bladder (the ureters).
Stage 4a: Cancer has spread to other parts of the body, such as the bladder or rectum (organs close to the cervix).
Stage 4b: Cancer has spread to distant organs, such as the lungs (organs far away from the cervix).
There are usually no symptoms associated with cervical cancer in the early stages but some women report abnormal vaginal bleeding as an early sign. More advanced cervical cancer symptoms include:-
- Pain in the lower back or pelvis
- Pain in the side or back caused by the kidneys
- Incontinence (both urine and bowel)
- Urinating blood
- Swelling of one or both legs
It is thought that almost all cases are caused by the Human Papilloma Virus (HPV) which is a virus passed by any sexual contact with a man or woman.
There are more than 100 types of HPV, many of which are harmless, however some can cause abnormal changes to the cells of the cervix which can eventually lead to cervical cancer.
It is thought that HPV 16 and HPV 18 are responsible for most cases of cervical cancer but there are no symptoms associated with the virus so it can be difficult to know whether or not you have it.
It is important to note that it is very uncommon to develop cancer due to HPV.
Cervical screening or ‘smear tests’ invites women from age 25-64 to have the cells of their cervix screened. In women aged 25-49, they will be screened every three years and every five years for those women aged 50-64. A small sample of cells is taken from the cervix by a small brush and then checked under a microscope for abnormalities as it is these abnormal cells that can develop into cancer. Cervical screening is so important because it can remove the risk cells and also indicate the early stages of cancer.
If abnormal cells are detected the cervix will need to be examined for abnormalities and at a later date, a biopsy is usually taken to confirm the presence of cancer. If the cancer is caught early, the biopsy could be enough to have removed all cancerous cells. If there is still cancer present, a hysterectomy may be advised along with other treatments such as radiotherapy or chemotherapy.
Survival for cervical cancer is related to the stage of the cancer at diagnosis. Most patients are diagnosed at either stage 1 or two:
Stage 1: Around 95 out of 100 women (around 95%) will survive their cancer for 5 years or more after diagnosis.
Stage 2: More than 50 out of 100 women (more than 50%) will survive their cancer for 5 years or more after diagnosis.
Stage 3: Almost 40 out of 100 women (almost 40%) will survive their cancer for 5 years or more after diagnosis.
Stage 4: Around 5 out of 100 women (around 5%) will survive their cancer for 5 years or more after being diagnosed.
There are circumstances where medical negligence can arise as a result of a misdiagnosis or failure to properly report on the smear tests. Unfortunately, there are occasions where a smear test is not properly reported on and this can lead to a delay in diagnosing cervical cancer.