Cervical Cancer

 

 

OVERVIEW

Cervical cancer is a gynecologic cancer that affects the cervix, the lower, narrow end of the uterus that leads to the vagina. The American Cancer Society estimates that in 2007 there will be about 11,000 new cases of cervical cancer diagnosed in the United States. But the good news is that cervical cancer is highly preventable and can be detected and treated quite successfully. The five-year survival rate for localized cervical cancer is 92 percent. The five-year rate for all stages combined is 72 percent.

Cervical cancer begins in the lining of the cervix, with cells first changing from normal to a pre-cancerous condition and then to cancer. For some women, pre-cancerous changes may disappear without treatment, although treatment is usually necessary to prevent the progression to cancer.

The Cancer Center at Hackensack University Medical Center features many unique and innovative services to treat cervical cancer. So if you are diagnosed with cervical cancer, you can feel comfortable with the following:

  • a full-time board-certified gynecologic oncologist on site, who leads the Division of Gynecologic Oncology and is highly experienced in all medical and surgical treatments for cervical cancer
  • minimally invasive laparoscopic surgical procedures, laser surgery, and cryosurgery to treat pre-cancerous conditions and cervical cancer
  • a twice-monthly gynecologic oncology clinic
  • sophisticated diagnostic testing and imaging studies
  • clinical trials to investigate new medications and treatment methods
  • monthly meetings of the Gynecologic Tumor Board, where cases are discussed and treatment plans are developed by a multidisciplinary team of cancer specialists
  • a full range of support services

 

RISK FACTORS

Half of all newly diagnosed cases of cervical cancer are in women over age 47. Virtually all cervical cancers are related to infections by the human papillomavirus (HPV), which is spread from person to person through sex. HPV infection is more common in women who have had unprotected sex, those who have had many sexual partners, and those who have had sex with men who have had many sexual partners. Other risk factors include: being HIV positive, smoking, and age. African-American women, Hispanic, and Native American women experience above-average death rates from cervical cancer.

Prevention

Cervical cancer screenings with the Pap test and liquid-based cervical cytology tests have greatly reduced the incidence of the disease in the United States. Since the introduction of the Pap test in 1949, cervical cancer incidence rates have decreased by 75 percent and mortality rates by 74 percent. Routine Pap smears or liquid-based tests that evaluate cells taken from the cervix will help reduce your risk of developing cervical cancer. Your doctor will advise you as to how often you should undergo a Pap or liquid-based test. Two vaccines, Gardasil and Cervarix, are now available to prevent infection with the human papillomavirus (HPV), the most important risk factor for cervical cancer. The American Cancer Society recommends routine HPV vaccinations for girls aged 11 to 12 years and those aged 13 to 18 who may have missed vaccines. If you are between the ages of 19 and 26, check with your doctor for his/her advice. Generally, the HPV vaccine is not recommended for women over age 26.

SYMPTOMS

Cervical cancer often has no symptoms until it has progressed. Symptoms may include an unusual vaginal discharge, blood spotting or light bleeding aside from a normal menstrual period, and bleeding or pain during sex.

 

TREATMENT SERVICES

The three main methods to treat cervical cancer are surgery, radiation therapy, and chemotherapy. Your doctor may suggest a combination of methods.

Surgery

Your physician will decide which surgical approach is the best for you depending on the size of the tumor, any spread of cancer, your overall health, your age, and other factors:

  • cryosurgery for pre-invasive cancer (using liquid nitrogen to kill abnormal cells by freezing them)
  • laser surgery for pre-invasive cancer (using a laser beam to vaporize abnormal cells)
  • cone biopsy (a cone-shaped piece of tissue is removed using a surgical or laser knife or a thin wire heated by electricity - called the LEEP or LEETZ procedure)
  • simple hysterectomy (removal of just the uterus, either abdominally or vaginally)
  • radical hysterectomy and pelvic lymph node dissection (removal of the uterus, parametria and uterosacral ligaments, upper part of the vagina next to the cervix, and pelvic lymph nodes)
  • pelvic exenteration (in addition to what is removed during a radical hysterectomy and pelvic lymph node dissection, the bladder, entire vagina, rectum, and part of the colon may be removed)

Radiation Therapy

External beam radiation therapy or brachytherapy (radiation placed in a capsule in the vagina near the tumor or in thin needles inserted directly into the tumor) may be used.

Chemotherapy

A combination of chemotherapeutic drugs may be used to treat cervical cancer.