Cervical Cancer
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Cervical Cancer
What is Cervical Cancer?
Cervical cancer develops in the cells of the cervix—the lower part of the uterus that connects to the vagina. It is one of the most preventable and treatable cancers when detected early through regular screening.
The leading cause of cervical cancer is persistent infection with high-risk types of Human Papillomavirus (HPV), a common sexually transmitted infection.
Cervical cancer progresses slowly over several years, typically starting with pre-cancerous changes called Cervical Intraepithelial Neoplasia (CIN).
Anatomy of the Cervix
The cervix has two parts:
- Endocervix – The inner part that leads into the uterus
- Ectocervix (Exocervix) – The outer part that doctors can see during a pelvic exam
Most cervical cancers start in the transformation zone, where these two parts meets.
Types of Cervical Cancer
- Squamous Cell Carcinoma – Arises in the outer part of the cervix; accounts for ~80% of cases.
- Adenocarcinoma – Begins in the glandular cells of the endocervix.
- Aden squamous / Mixed Carcinoma – Contains both cell types; less common.
Early Symptoms of Cervical Cancer
Early cervical cancer usually has no symptoms, which is why regular screening is crucial. As the disease progresses, symptoms may include:
- Abnormal vaginal bleeding (after intercourse, between periods, or post-menopause)
- Unusual vaginal discharge (foul-smelling or watery)
- Pain during intercourse
- Pelvic or lower back pain
- Bleeding after douching or pelvic exams
- Pain during urination or bowel movement (in advanced stages)
- Swelling in the legs (in very advanced cases)
Important: These symptoms can be caused by other health problems, but always consult a gynaecologist if they persist.
- Screening Tests
- Pap Smear (Pap Test) – Detects precancerous or cancerous cells
- HPV DNA Test – Identifies high-risk HPV strains (e.g., HPV-16 and HPV-18)
- Colposcopy
- A magnified visual examination of the cervix using a colposcope
- Biopsy
- A small sample of cervical tissue is taken for histopathological analysis
- Imaging for Staging
- Pelvic Ultrasound
- MRI or CT Scan
- PET-CT Scan (available at Onco-Life) to evaluate spread to lymph nodes or distant organs
Stages of Cervical Cancer
- Stage 0 (CIN III or Carcinoma in situ): Pre-cancer; confined to surface cells
- Stage I: Cancer limited to the cervix
- Stage II: Cancer has spread beyond the cervix but not to the pelvic wall
- Stage III: Cancer has spread to pelvic wall or lower vagina
- Stage IV: Cancer has spread to nearby organs (bladder, rectum) or distant sites (lungs, liver)
Treatment Options at Onco-Life Cancer Centre
Treatment depends on the stage, patient’s age, fertility desires, and general health. Our multidisciplinary team creates personalized treatment plans.
- Surgery
- LEEP or Cold Knife Conization – For pre-cancer or early microinvasive cancer
- Hysterectomy – Removal of the uterus (may be simple or radical)
- Trachelectomy – Preserves fertility by removing cervix but keeping uterus intact (for select early cases)
- Pelvic Exenteration – For very advanced or recurrent cancer
- Radiation Therapy
- Often combined with chemotherapy (called chemoradiation)
- External Beam Radiation + Internal Brachytherapy
- Onco-Life offers Tomotherapy for targeted, high-precision treatment
- Chemotherapy
- Typically, cisplatin-based
- Given in combination with radiation or for advanced/recurrent cancer
- Targeted Therapy & Immunotherapy
- Drugs like Bevacizumab (Avastin) used in advanced stages
- Immunotherapy for recurrent/metastatic cases (e.g., Pembrolizumab for PD-L1-positive tumours)
- Supportive Care
- Pain and symptom management
- Nutritional support
- Psychological counselling
- Fertility counselling (when needed)
Prevention of Cervical Cancer
- HPV Vaccination
- Protects against high-risk HPV types
- Recommended for girls and boys aged 9–26
- Now available under the Universal Immunization Programme (UIP) in India
- Regular Screening
- Pap test every 3 years (ages 21–65)
- Pap + HPV co-testing every 5 years
- Safe Sexual Practices
- Limit number of sexual partners
- Use condoms to reduce HPV transmission
- Quit Smoking
- Smoking increases the risk of cervical and other HPV-related cancers
Cervical Cancer in India: A Public Health Priority
- Cervical cancer is the second most common cancer in Indian women
- Majority of cases occur in women between ages 30–60
- 70% of deaths are due to late-stage diagnosis — stressing the importance of awareness and early screening
Most Popular Questions
Cervical Cancer
1. Can cervical cancer be prevented?
Yes. HPV vaccination and regular screening are the best ways to prevent it.
2. What causes cervical cancer?
Persistent infection with high-risk strains of HPV, especially HPV-16 and HPV-18.
3. Is the HPV vaccine safe?
Yes. It is proven safe and effective. Side effects are usually mild (e.g., fever, pain at injection site).
4. Can I get cervical cancer without being sexually active?
It’s rare. HPV is sexually transmitted, so risk is low in those never sexually active.
5. How often should I get a Pap smear?
Every 3 years from age 21–65, or as recommended by your gynaecologist.
6. Can I have children after cervical cancer treatment?
Yes, in early stages, fertility-sparing surgeries like trachelectomy are possible. Discuss options with your oncologist.
7. Is cervical cancer hereditary?
Not directly. It's more linked to HPV infection than to genetics.
8. What is CIN?
Cervical Intraepithelial Neoplasia (CIN) is a precancerous condition where abnormal cells grow on the cervix.
9. Can men get HPV?
Yes, men can carry and transmit HPV. Some HPV types also cause penile, anal, and throat cancers.
10. Will I need chemotherapy for early-stage cervical cancer?
Not always. Surgery or localized radiation may be enough in early stages.
11. Is there a cure for cervical cancer?
Yes, especially when caught early. Even advanced cases can be treated effectively.
12. Can cervical cancer recur?
Yes. Regular follow-ups are crucial after treatment to detect recurrence early.
13. What are the side effects of radiation therapy?
Fatigue, skin irritation, vaginal dryness, diarrhoea, and bladder issues. Most are temporary.
14. Does HPV always lead to cancer?
No. Most HPV infections clear on their own. Only persistent infections cause cancer risk.
15. What does a positive HPV test mean?
You have a high-risk HPV strain. It doesn’t mean you have cancer but requires monitoring.
16. Can cervical cancer be detected without symptoms?
Yes, through Pap smear or HPV test, which detect precancerous changes.
17. What is brachytherapy?
It is internal radiation where a small device delivers radiation directly inside the cervix.
18. Can I get screened during menstruation?
It’s best to avoid screening during periods. Wait a few days after bleeding stops.
19. What should I avoid during cervical cancer treatment?
Avoid smoking, alcohol, and spicy foods. Follow the diet and medication plan given by your doctor.
20. Where can I find support?
Onco-Life provides counselling, peer groups, and survivor programs to support you emotionally and mentally.
