Cervical cancer is the most common cancer of the female reproductive organs. In most cases, different strains of HPV (Human Papilloma Virus) are responsible. HPV is a sexually transmitted virus. The immune system of a woman who is infected with HPV normally destroys it. However, in some women the virus lives for years and eventually turns the cells in the cervix into cancer cells. Half of all cervical cancers occur in women between the ages of 35 and 55. Fortunately, the Pap smear test has significantly reduced the mortality rate from this cancer.
Symptoms and Signs
In the early stages, there are usually no signs and symptoms. As the cancer progresses, the following signs and symptoms will appear.
– Vaginal bleeding after sexual intercourse
– Bloody and foul-smelling vaginal discharge
– Pain in the groin or pain during sexual intercourse
Risk Factors
– Having many sexual partners: The more partners you have, the higher the risk. Because this increases your risk of getting HPV.
– Early sexual debut:The risk of HPV infection increases with sexual debut before the age of 18. Moreover, cells that are not yet fully developed are susceptible to cancerous changes when exposed to HPV.
– Presence of other sexually transmitted diseases : If other sexually transmitted diseases such as AIDS and gonorrhea are present, HPV is also highly likely.
– A weak immune system: Most women infected with HPV never develop cervical cancer. However, if you are infected with HPV and your immune system is weakened by another health problem, you are more likely to develop cervical cancer.
– Smoking: Although the relationship between smoking and cancer is not fully understood, it is known to increase the risk of cervical cancer.
Diagnosis
There is not yet any test that can identify which women’s immune systems are more susceptible to cervical cancer. This is why the simple and inexpensive Pap smear test is so important. In the Pap smear test, cells taken from the cervix with a brush are smeared on a slide and sent to the laboratory. The pathologist examines the cells for abnormal changes.
Treatment
If cervical cancer is caught before it has spread, i.e. only in the outer layer of the cervix, the following can be done;
– Konization : It is the cone-shaped removal of the area of the cervix where the abnormal structure is located.
– Laser treatment: It is the burning of cancerous cells with laser light.
– Cryotherapy : In this technique, cancer cells are frozen.
– Removal of the uterus : With this surgery, the cervix and uterus are completely removed, along with the cancerous cells.
If the cancer has spread;
Women whose cervical cancer has spread can also be completely cured. If the cancer is confined to the cervix, the 5-year survival rate is over 90%. Treatment may include the following;
– Removal of the uterus. This operation is mostly performed on young women. Because by leaving one or two ovaries, estrogen production is maintained. This is important to prevent early menopause and osteoporosis.
– Removal of the ovary, part of the vagina and lymph nodes along with the uterus.
– Radiotherapy Radiation can kill cancer cells and stop their reproduction. However, women who do not go through menopause may develop menopausal symptoms because ovarian function may stop.
– Chemotherapy. The cancer drugs used here work through the bloodstream. They also make the effect of radiotherapy stronger.
Protection
Since HPV is transmitted by direct skin-to-skin contact, the most important form of protection is to use condoms. In addition, there are things that can be done;
– Not starting sexual intercourse at an early age
– Low number of sexual partners
– No smoking.
Pap Smear Test Guidelines
It is important to have a Pap smear test to catch cervical cancer early. However, you need to know when and how often it should be done. The first test should be done 3 years after the first sexual intercourse or when you turn 21. It should be done every year between the ages of 21-29.
Between the ages of 30 and 69, if the test has been normal three times, it should be done every two years. Over 70 years of age, if you have three or more normal tests and no abnormal tests in the last 10 years, you no longer need a Pap smear test. If you are at high risk of cervical cancer, Pap smear tests may be performed more frequently.
Cervical Cancer Vaccine
There is a vaccine developed against the most common types of HPV. It was approved by the FDA (Food and Drug Administration) in July 2006. It is recommended for all girls from the age of 11-12. Between the ages of 13 and 55, it can be administered to women who have not been vaccinated before. The protection rate of the vaccine is around 90%. It is more effective to administer the vaccine before sexual activity begins. However, since this vaccine is not effective against all viruses that cause cervical cancer, Pap smear test is still very important.