Cervical Cancer - Signs, Symptoms, Prevention

Do you know that in India, cervical cancer is the second most common cancer after breast cancer?
According to the government data, almost 1,22,844 women are diagnosed with cervical cancer every year in India.
Every year almost 67,477 women die because of cervical cancer in India.

So, the statistics are alarming and they make us wonder what we can do to prevent the development of cervical cancer. Well, knowledge is the first step towards victory and we bring you full facts regarding the disease. 
Keep reading to get detailed information about the signs, symptoms, and prevention steps that you can take for cervical cancer.

What is cervical cancer?

As the name suggests, cervical cancer is a condition in which the cervix, which is the lower end of the uterus & opens at the top of the vagina, is affected by cancer.
Most cervical cancers are caused by different strains of a sexually transmitted virus - the Human Papilloma Virus (HPV).

Usually, when a woman is exposed to the human Papillomavirus, the body's immune system does not let the virus do any significant damage to the body and clears off the HPV in a few months. However, in some women, this virus can sustain for years, which damages the cells of the cervix & leads to the development of cancer.
In the past, cervical cancer was one of the major reasons for the death of women worldwide. But this has changed tremendously because of the regular screening tests and preventive strategies which are now available.

Symptoms of cervical cancer

Cervical cancer may not cause any significant symptoms in the early stages. Even if a woman is experiencing some symptoms, there is a high chance that it will be mistaken for common situations like a pelvic infection, irregular menstrual cycle or UTIs (urinary tract infections).

The common symptoms associated with cervical cancer include

• Unusual vaginal bleeding (between menstrual cycle, after sexual intercourse, after reaching the age of menopause).
• Vaginal discharge that is stinky or has a different colour than usual.
• Heavy and painful menstrual periods that last longer than usual.
• Pain in the pelvic region.
• Urge to urinate more often than usual.
• Painful urination.

If cervical cancer has also spread to nearby organs adjacent to the uterus & cervix, you can experience some symptoms like

• Presence of blood in the urine.
• Difficulty in urination.
• Frequent diarrhoea.
• Presence of blood in your poop.
• Hard and painful bowel movements.
• Unexplained and sudden loss in weight.
• Disturbed appetite.
• Excess fatigue. 
• Experiencing general illness on a regular basis. 
• Swelling in the lower part of your body.
• Sharp backache.

If you are experiencing these symptoms, then consult your doctor or a gynaecologist. They will perform some tests and diagnose cervical cancer, providing you with the best treatment for the disease.

Who is at risk of getting cervical cancer?

Though anyone can get cervical cancer, there are some women who are more prone to getting the disease. Factors that increase the risk of cervical cancer include

• Multiple sexual partners - If you have many sexual partners, and are not sure about their sexual history, there is a high risk of you getting HPV and other STDs which may predispose you to cervical cancer.
• Indulging in sexual activity at an early age – Initiating sexual activity at an early age ( before 18 years of age) increases the risk of getting HPV infection & cervical cancer.
• Sexually transmitted disease - If you are suffering from any other sexually transmitted disease(STD) like HIV or AIDS, syphilis, chlamydia, etc., then the risk of cervical cancer increases.
• Weak immune system – A decreased immunity reflects a decreased ability to fight off any infection or disease – this includes HPV infection & also cervical cancer.
• Smoking – Smoking releases many chemicals & cancer-producing substances (carcinogens) in your blood which increase your risk of cervical cancer.
• Multiple childbirths- Women who have had more than 3 deliveries are at an increased risk of developing cervical cancer.
• Early first pregnancy- Women who have their first full term pregnancy at an age less than 20 years are at an increased risk of cervical cancer.
• Oral Contraceptive Pills- Prolonged use of oral contraceptive pills increases the chances of developing cervical cancer.
• Inadequate screening or healthcare access- Women who belong to lower socio-economic status or those who have inadequate access to screening tests or vaccination/treatment for early precancerous stages of cervical cancer are at a high risk of developing cancer of the cervix.
• Factors that cannot be changed -  Use of certain medications like DES (Di-ethyl-stilbesterol) during pregnancy predisposes the developing female fetus to cervical cancer. So, when you were in your mother‘s womb, and she took a drug called DES, then you are at high risk of getting a certain type of cervical cancer. Additionally, there is some evidence that certain hereditary factors may influence your ability to fight HPV infection & thus the high risk of cervical cancers may run in families. 

So, there are some factors that you cannot control but which increase your risk of cervical cancer. However, there are a number of things that you CAN control & which can go a long way to prevent cervical cancer. Read on to find out more about these.

How can cervical cancer be prevented?

You must have heard the popular saying, ‘Prevention is better than cure’. The saying is correct, and every doctor around the globe agrees with it. And so, it is better to take steps to prevent cervical cancer because although there are treatments available to manage the disease, very often they fail to cure it completely and one ends up losing the quality of life, precious time & money in the process.

Here we discuss some simple measures which can help you to reduce the risk of getting cervical cancer.

• Get the HPV vaccine - As we have discussed above, infection by HPV is the commonest cause of cervical cancer. The HPV vaccine protects against the variants which are considered as High-risk variants of the virus and significantly increase your risk of developing cervical cancer. The ideal age for this vaccine is between the age of 9-15 years but it can be given up to 26 years also if you have not initiated sexual activity by then. Read more about the HPV vaccine in our next article.
• Get pap tests on a regular basis – Pap’s smear test is a screening test that detects any pre-cancerous or cancerous changes in the cells of the cervix and can actually predict the possibility of cancer about 15 years prior to its development. It is recommended once every three years after the age of 21 years. Talk to your gynaecologist about the Pap’s test and get it done regularly every 3 years to assess your risk of developing cervical cancer in the future.
• Co-testing with Pap’s smear & HPV DNA- Co-testing with Pap’s smear & HPV DNA is recommended once every 5 years between the age of 30 yr to 65 yr. This is preferable to doing Pap’s test alone as it diagnoses any High-risk HPV-DNA in the cervical smear. Presence of High-risk variants of HPV- Type 16,18 and also Types 31,33, 45, 52, 58 & others is a major risk factor for ~90% of cervical cancers. However, if HPV-DNA testing is not available, a Pap’s smear every 3 years is the best option.
• Practice safe sex - HPV is transferred during sexual contact, and to prevent the risk of getting cervical cancer, practice safe sex. Always use a condom as a barrier method and limit the number of your sexual partners. Also, make sure that you are aware of the sexual history of your partner to ensure that he does not have any such STD which can increase your risk of developing cervical cancer.
• Quit smoking - If you are someone who has never smoked, do not start or try. If you are someone who smokes, take recommendations from your doctor about the techniques to quit. In any case, make an effort to stay away from smoking. Smoking is known to increase the risk of cervical cancer significantly.

For more information on Menstrual Health & Hygiene, please check our other videos.