Cervical Cancer: Symptoms, Causes, and Treatment

What is cervical cancer?

Cervical cancer develops in the cells of the cervix, the lower part of the uterus connecting to the vagina. It starts with abnormal changes in cervical cells, known as precancerous changes or dysplasia, which can develop into cancerous tumours over time. This type of cancer progresses slowly, providing opportunities for early detection and intervention.

Prevalence of cervical cancer in Singapore

Despite an advanced healthcare system, cervical cancer remains a significant health issue in Singapore. According to the Singapore Cancer Registry, it is one of the top ten cancers affecting women in the country.

Who is at risk of cervical cancer?

Several factors increase the risk of developing cervical cancer, including:

1. HPV infection

   • Persistent infection with high-risk strains of HPV is the leading cause of cervical cancer.

2. Smoking

   • Tobacco use increases the risk of cervical cancer and can worsen the effects of HPV infection.

3. Weak immune system

   • Conditions or medications that weaken the immune system can increase susceptibility to HPV infection and cervical cancer.

4. Multiple sexual partners

   • Engaging in sexual activity with multiple partners or having a partner who has multiple sexual partners increases the risk of HPV infection.

5. Early sexual activity

   • Initiating sexual activity at an early age is associated with a higher risk of HPV infection and cervical cancer.

What are the symptoms of cervical cancer?

Cervical cancer may not cause noticeable symptoms in its early stages, making regular screening crucial. As the cancer progresses, symptoms may include:

• Irregular bleeding between periods

• Bleeding after sexual intercourse

• Bleeding after menopause

• Heavier or longer menstrual periods 

1. Pelvic pain or discomfort

   • Persistent pelvic pain unrelated to menstruation or other known causes.

     

   • Pain during sexual intercourse (dyspareunia)

2. Unusual vaginal discharge

   • Increased vaginal discharge that may be watery foul-smelling

   • Discharge may contain blood or occur outside of menstrual periods

3. Pain or bleeding during urination

   • Painful urination (dysuria)

   • Blood in the urine (hematuria)

4. Other symptoms

   • Pain or discomfort in the lower back or abdomen

   • Fatigue or weakness

   • Unexplained weight loss

   • Swelling of one or both legs (edema)

Treatment of cervical cancer

Treatment depends on the stage of the cancer, overall health, and patient preferences. Options include:

1. Surgery

   • Surgical procedures such as hysterectomy (removal of the uterus) or trachelectomy (removal of the cervix) may be recommended for early-stage cervical cancer.

2. Radiation therapy

   • High-energy beams are used to destroy cancer cells, often combined with surgery for locally advanced cancer.

3. Chemotherapy

   • Drugs are used to kill cancer cells, either with radiation (chemoradiation) or as palliative treatment for advanced cancer.

4. Targeted therapy and immunotherapy

   • These treatments target specific molecular pathways and harness the immune system to fight cancer cells.

In addition to these treatment modalities, supportive care such as pain management, nutritional support, and psychological support plays a crucial role in improving the quality of life for women with cervical cancer.

FAQs

What are the screening tests for cervical cancer?

Screening aims to detect precancerous changes or early-stage cancer for timely intervention. The main screening tests include:

1. Pap smear (Pap test)

   • This test collects cells from the cervix and sends them to a laboratory for analysis. The Pap smear can detect changes in cervical cells that may indicate precancerous or cancerous conditions.

2. HPV DNA test

   • This test detects high-risk HPV strains in cervical cells, identifying women at higher risk of developing cervical cancer due to persistent HPV infection. It is often used in conjunction with the Pap smear. 

How is cervical cancer diagnosed?

1. Colposcopy

   • If abnormalities are detected during screening, a colposcopy examines the cervix in greater detail, and areas of abnormality can be biopsied.

2. Biopsy

   • A small tissue sample is removed from the cervix for examination under a microscope to confirm the diagnosis and provide information about the type and stage of the cancer.

   • There are different types of biopsies which may be performed depending on the location and extent of the abnormality. A biopsy allows for the definitive diagnosis of cervical cancer. 

3. Imaging tests

   • Ultrasound, CT scan, or MRI may be used to assess the extent of the cancer and guide treatment decisions.

Can cervical cancer be prevented?

Yes, cervical cancer can be prevented through several key strategies:

1. HPV vaccination

   • Vaccination against HPV is highly effective in preventing cervical cancer. It is recommended for adolescents before sexual activity but can also benefit those who have been sexually active.

2. Regular cervical cancer screening

   • Pap smears and HPV DNA tests detect abnormal cells or HPV infection early, allowing for timely intervention.

3. Safe sex practices

   • Consistent condom use and limiting the number of sexual partners reduce the risk of HPV infection.

4. Smoking cessation

   • Quitting smoking reduces the risk of developing cervical cancer.

5. Healthy lifestyle choices

   • A balanced diet, regular physical activity, and avoiding excessive alcohol consumption support a strong immune system.

     

6. Screening and treatment of precancerous lesions

   • Prompt treatment of precancerous changes can prevent progression to invasive cancer.

   • Procedures such as cryotherapy, loop electrosurgical excision procedure (LEEP), or cone biopsy may be used to remove abnormal cervical tissue.

Additional support

Early detection and intervention are essential in the fight against cervical cancer. If you have any concerns about cervical cancer, feel free to reach out to Thomson Medical. Our team is here to assist you with any questions and provide the support you need.