What is Cervical Cancer?
Cancer arises from the uncontrollable cell growth of cells in the body. Cervical cancer, which arises from the cervix of the uterus, is the third most common cancer in women in Malaysia.
Who Are at Risk for Cervical Cancer?
All women who are or who have been sexually active are at risk for cervical cancer.
What Causes Cervical Cancer?
Cancer of the cervix is caused by infection by a virus called human papilloma virus (HPV). 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 (i.e. oral sex, anal sex and hand-to-genital contact).
Most HPV infections do not cause physical symptoms; however, in some people these infections may cause pre-malignant lesions that may go on to become cancers of the cervix, anus, vulva and vagina in females if not detected and treated.
There are over 170 types of HPV, of these about 10 types of HPV are high risk types that increase the risk of developing cancer. Persistent infections with the "high-risk" HPV types progress to pre-cancerous lesions and invasive cancer. High-risk HPV infection is a cause of nearly all cases of cervical cancer. It is estimated that 10% of the Malaysian female population have HPV infection at any one time.
HPV16 and HPV18 are known to cause around 70% of cervical cancer cases and HPV 31, 33, 45, 52 and 58 cause another 20% of cervical cancer cases.
What Are the Symptoms of Cervical Cancer?
- Pain at the lower abdomen
- Pain during sexual intercourse
- Vaginal bleeding after sexual intercourse
- Irregular vaginal bleeding between periods or after menopause
- Watery, bloody and foul-smelling vaginal discharge
Is Cervical Cancer Preventable?
Cervical cancer is preventable by vaccination. In addition, screening methods are available to detect early signs of developing cervical cancer.
Early detection of pre-malignant lesions by pap smear prevents at least 70% of potential cervical cancers.
The pap smear test is a simple procedure where gentle sampling of the cells from the cervix is used to detect abnormalities. This procedure is effective in detecting changes in the cervix before cancer develops as well as detecting cancer thus improving chances of survival.
Human Papillomavirus (HPV) vaccines can dramatically reduce the risk of cervical cancer by preventing HPV infections. The vaccine however does not protect women who have already contracted HPV. Vaccines are available against the common types of HPV that cause cervical cancer.
Pre-cancer of the cervix can be effectively treated with Loop Electrosurgical Excision Procedure (LEEP), which is a simple procedure under local anaesthesia. LEEP is performed by using a small electrical wire loop to remove the pre-cancerous tissue, thereby preventing the patient from developing cervical cancer. Some patients may require a surgical procedure called cone biopsy to treat pre-cancer as well as help in the diagnosis of early cervical cancer.
How Is Cervical Cancer Diagnosed?
- Pap smear
- Cystoscopy (using a small scope to visualise the inside of the bladder)
- CT scan
- MRI scan
What Are the Treatment Options for Cervical Cancer?
Patients diagnosed with cervical cancer may be treated with:
- Radical surgery
For patients diagnosed with early cervical cancer, an operation called radical hysterectomy and pelvic lymph node dissection (PLND) can have a cure rate of nearly 90%. More advanced cancer is treated with radiotherapy together with low dose chemotherapy (concurrent chemo-radiation), or chemotherapy.