Cervical Cancer
  • Nearly all cases of cervical cancer can be attributed to human papillomavirus (HPV) infection which is the most common sexually-transmitted viral infection.
  • Prevention of HPV (using condoms, receiving the HPV vaccine, male medical circumcision, delay sexual debut, avoid multiple sexual partners) is one of the best methods to prevent cervical cancer.
  • Symptoms of cervical cancer do not appear until the late stage of cancer, so frequent screening is important to catch detect cervical cancer early so it can be effectively treated.
  • Pre-cancerous stage does not have symptoms. Cervical cancer screening is very important for detection of precancerous lesions. Encourage the caller if she has not gone for any or her screening is not up to date.

Symptoms of Cervical Cancer
Early Symptoms

  • Vaginal discharge (can be foul-smelling)
  • Irregular bleeding in women of reproductive age
  • Bleeding after sex
  • Bleeding or spotting in post-menopausal women

Advanced Symptoms (late-stage cancer)

  • Urinary frequency and urgency
  • Backache
  • Lower abdominal pain
  • Severe back pain
  • Weight loss
  • Decreased urine output (due to renal failure or obstruction)
  • Leaking of urine or feces through the vagina (formation of a vaginal fistula)
  • Swelling of the lower limbs
  • Difficulty breathing or rapid breathing (even at rest. Due to anemia or metastatic cancer to the lungs)

Symptoms of late-stage cervical cancer include:

  • Bleeding between periods, or after sex
  • Low back pain, or pelvic pain
  • Fatigue, weight loss and loss of appetite
  • Odorous discharge from the vagina
  • Swelling of one leg

Risk factors for cervical cancer:

  • Early first sexual encounter (young age of first sexual intercourse)
  • Multiple sexual partners
  • Tobacco use
  • Immune suppression (like HIV infection)

Screening for cervical cancer:

  • HPV testing for high-risk HPV strains
  • Pap test and cytology
  • Visual exam with inspection for acetic acid

Starting at age 25, women who are sexually active should screen for cervical cancer. If tests are normal they should receive re-testing every 3 years for those who are HIV negative and yearly for those HIV positive

Prevention of Cervical Cancer:

  • There are currently 2 vaccines which protect against the strains of HPV that cause 70% of cervical cancers. These vaccines work best if administered prior to exposure to HPV, or early is best. WHO recommends vaccination for girls between age 9-13 before they become sexually active, to prevent HPV and cervical cancer.
  • Both boys and girls should be counselled to use condoms if they are sexually active, and to delay the age of sexual initiation. Male circumcision may also reduce transmission of HPV and thereby serve to reduce cervical cancer in women.

Treatment of Cervical Cancer:
If diagnosis of cervical cancer occurs early, it can usually be cured with effective treatment. Diagnosis is usually made by a biopsy of cells from the cervix.

Treatments include:

  • Surgery
  • Radiotherapy/radiation
  • Chemotherapy

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