Cervical cancer starts in the cervix, which is the opening between the vagina and the uterus. It occurs when normal
cells transform into precancerous cells. So, it is important to detect these precancerous cells before they develop
into cancer cells.
Cervical cancer is one of the most common cancers among
women in Malaysia and it is most prevalent among women aged
between 14 and 44.
Causes of cervical cancer
Cervical cancer is caused by healthy cells that begin to develop mutations (changes in the DNA structure), causing
these cells to multiply uncontrollably and resulting in tumour mass.
The occurrence of cervical cancer is increased by HPV infection, particularly HPV types 16 and 18. HPV infection is
the most common sexually transmitted infection (STI). Most cases of HPV infection are caused by sexual activity,
both penetrative sexual
intercourse and non-penetrative sexual activity.
Most HPV infections do not cause physical symptoms; however, in some people, these infections may cause pre-malignant
lesions that may become cancers of the cervix, anus, vulva and vagina in females if not detected and treated. The
immune system clears
the HPV infection within 2 years for a majority of people, but this is not always the case. HIV and sexually
transmitted infections can also increase the risk of cervical cancer.
Risk factors of cervical cancer
The following factors increase the risk of developing cervical cancer:
- Human Papillomavirus (HPV) infection
- Human immunodeficiency virus (HIV) infection
- Women aged 30 years and above
- Sexually transmitted infections
- Multiple sexual partners
- Long-term usage of oral contraceptives
- Family history of cervical cancer
- Previously diagnosed with cancer in other parts of your body
- Multiple children
- Weakened immune system
Signs and symptoms of cervical cancer
Most symptoms are not noticeable in the early stages of cancer and develops over time.
Symptoms of cervical cancer include:
- Unusual vaginal bleeding
- Pain at the lower back or lower abdomen/pelvis
- Pain or discomfort during sexual intercourse
- Watery, bloody, and foul-smelling vaginal discharge
These symptoms can be caused by numerous other conditions, which are more common than cervical cancer. Therefore, you
should consult a gynaecologist if you notice one or more of these symptoms.
Stages of cervical cancer
Staging describes the location of cancer and the extent of spread to other parts of the body. The Federation
Internationale de Gynecologie et d'Obstetrique (FIGO) classification is used for cervical cancer staging.
Staging is done based on physical examination, scans, and biopsies. It ranges from stage I to IV, where greater
stages indicate the cancer has spread and there is a poorer prognosis of cervical cancer.
Diagnosis of cervical cancer
Your doctor would first question your general health and symptoms and conduct a thorough physical and gynaecological
examinations. Blood and urine tests may also be requested.
Other diagnostic tests are:
- Colposcopy is the main test for cervical cancer. It is used to examine the cervix in detail. A
colposcope is a large magnifying glass used by a doctor to examine the skin-like covering of the cervix. It can
also detect changes that
are too minute to be seen with the naked eye. If an abnormal region is noticed during colposcopy, a biopsy may
be done whereby a small tissue sample would be taken and sent to the laboratory for evaluation.
- Imaging tests and scans such as X-ray, computed tomography (CT) scan, magnetic resonance
Learn more about the different types of Screening and diagnostic procedures performed to diagnose cervical cancer.
Treatment options for cervical cancer
The treatment of choice for cervical cancer depends on the type and stage of cancer. The key therapies used are
surgery, radiotherapy, and chemotherapy.
Surgery is the primary choice of treatment if cancer is detected early. There are various surgeries to treat
cervical cancer, including:
- Conization: Removal of a cone-shaped part of the cervix. Conization can be either used to
treat or diagnose cervical cancer.
- Trachelectomy: Removal of the cervix and upper part of the vagina, leaving the uterus in
place, so pregnancy may still be possible.
- Hysterectomy: This surgery is done when cancer has spread and requires the removal of the
entire uterus and cervix. Women will not be able to become pregnant after this.
- Pelvic exenteration: Removal of the uterus, ovaries, fallopian tubes, bladder, vagina,
rectum, and part of the colon if the cancer has spread and other treatment options are not possible.
Radiotherapy uses high-energy radiation to shrink tumours and destroy cancer cells. It is performed to relieve
symptoms associated with advanced cancer. Radiotherapy can be given as the main mode of therapy if the tumour is
large or has spread and
after surgery to kill the remaining cancer cells.
The two types of radiation therapy are:
- External beam radiation (EBRT): Directs a radiation beam at the affected area externally.
- Brachytherapy: Places a device with radioactive material inside or near the vagina for a
Chemotherapy is a cancer treatment that employs potent cancer-killing medications. It can be given in combination
with radiotherapy, before surgery to reduce the size of the tumour or after surgery to kill the remaining cancer
cells to reduce the
rate of spread of cancer.
Learn more about the different types of treatment technologies to treat cervical cancer.
Prevention of cervical cancer
The best way to prevent cervical cancer is by getting vaccinated and having frequent screening tests.
- HPV vaccination: Vaccines can only prevent certain types of HPV infections and not treat an
existing HPV infection. Typically, the vaccine should be taken before a person is sexually active. Other
preventive measures include limiting
the number of sexual partners, usage of condoms, and avoid smoking.
- Screening test: Pap test that collects a small sample of cells from the cervix to detect
precancerous and cancerous conditions of the cervix. It is considered a primary screening tool for cervical
cancer. Regular screenings for HPV
by getting a Pap test done may help prevent cervical cancers.
Detect to Protect!
Almost half of all cervical cancer cases are diagnosed early, making it highly treatable. Thus, most women should
have regular cervical cancer screenings which include a Pap test, HPV test or a combination of both tests. Routine
screening tests are recommended
for women at 21 years of age and should be repeated once every few years.
Discuss with your doctor to understand if you would benefit from screening for cervical cancer.
Make an appointment at Gleneagles Hospitals
If you are experiencing any of the symptoms of cervical cancer, get in touch with us to find out more about
our Oncology Services at your nearest Gleneagles
Gleneagles Hospital works with oncologists to assist patients through cancer treatment. The caring and
multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.