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Cervical Cancer
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The mortality of cervical cancer has declined over the past 40 years, probably as
a result of early detection and treatment. The common denominator for increased risk of
developing cervical cancer is early, frequent sexual intercourse. The incidence is highest
in patients with a history of intercourse before the age of 16, early first pregnancy,
multiple sexual partners, and venereal disease.
Symptoms
Symptoms include vaginal discharge, bleeding, and particularly, spotting after sexual
intercourse. More advanced stages often present with a vaginal discharge with foul odor,
or weight loss.
Diagnosis
A. Findings on pelvic examination include the appearance of obvious masses on the cervix;
gray, discolored areas; and bleeding or evidence of inflammation of the cervix. If a tumor
is present, the extent should be noted.
B. Most patients with cervical cancer are asymptomatic, and cases are detected by routine
Pap smear screening. Biopsy specimens should be taken of all visibly abnormal areas,
regardless of the findings on the Pap smear.
C. Patients with a positive Pap smear and no visible lesion generally undergo colposcopy,
which can detect 90 percent of dysplastic lesions. The colposcope is a magnifying
instrument that helps in the detection of lesions. Biopsy specimens are taken from
areas that appear abnormal by colposcopy.
D. Endocervical curettage (ECC) is required if colposcopy does not reveal a lesion. If the
ECC reveals highly suspicious cells, patients should undergo cervical conization with
consists in removing a cone-shaped portion of the cervix for examination.
Prevention
Prevention and early detection can considerably improve chances of survival. Yearly done
Pap smears and gynecological examinations can be very helpful in detection.
Treatment
1. Treatment modalities include superficial ablative therapies (including cryosurgery,
carbon dioxide laser therapy, and electrocoagulation diathermy), loop electrocoagulation
diathermy excision procedure (LEEP), cone biopsy, and hysterectomy.
2. Pelvic irradiation may also be employed.
3. Chemotherapy.
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