Cervical cancer is the malignancy that starts in the cervix. Cervical cancer instigate from the cells located on the surface of the cervix. Cervical cancer occurs in several forms. The most common is squamous cell carcinoma, which accounts for 85 to 90 percent of cervical cancers.

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Cervical cancer is the malignancy that starts in the cervix.
Cervical cancer instigate from the cells located on the surface of
the cervix. Cervical cancer occurs in several forms. The most
common is squamous cell carcinoma, which accounts for 85 to
90 percent of cervical cancers. Other forms include
adenocarcinomas and combination cancers such as
adenosquamous carcinoma. Some strains of the human
papillomavirus (HPV), a virus transmitted during sex, play a
role in causing most cases of cervical cancer. The type of
cervical cancer is determined by the type of cell where the early
genetic mutation occurred. The type also helps in determining
the specific treatment for a patient. There are two main types of
cervical cancer that include –
 Adenocarcinomas: This type takes place in the glandular
cells lining the cervical canal. Adenocarcinomas accounts for a
smaller portion of all cervical cancers.

2.  Squamous Cell Carcinomas: This type starts in the flat
and thin cells lining the bottom of the cervix. Squamous cell
carcinomas make up for a large majority of cervical cancers.
Abnormal cervical cell changes rarely cause
symptoms. But you may have symptoms if those cell
changes grow into cervical cancer. Symptoms of
cervical cancer may include:
 Bleeding from the vagina that is not normal or a change
in your menstrual cycle.
 Bleeding when something comes in contact with your
cervix, such as during sex
 Pain during sex
 Vaginal discharge that is tinged with blood
 Leakage of urine or feces from vagina
 Swelling in legs.
 Loss of weight
Causes
Cervical cancer stands as the third most common type of cancer
in women. The main cause is HPV (Human Papilloma Virus), a
common virus that spreads through sexual intercourse.
Risk factors
* Having premature sex
* Having more than one sexual partner
* Poor socioeconomic status
* Weakened immune system
Symptoms of advanced cervical cancer
* Low backache
* Pain in the pelvis
* Exhaustion
* Excretion of urine or feces through the vagina
* Single swollen leg
* Loss of appetite
* Weight loss

3. Investigations
Screening tests
* For pre-cancer and cancer, Pap smear screens are effective,
though not for final diagnosis.
* Colposcopy is carried out if abnormal changes are discovered.
In this procedure, pieces of tissue are surgically removed
(biopsy) and sent to a laboratory for examination under
magnification.
The role of the Pap smear is to screen for cervical cancers and
cervical pre-cancers. In its early stages, cervical cancer usually
has no symptoms.
To diagnose cervical cancer, Gyneconcologist first
performs the following procedures:
Pap smear : In this test, Gyneconcologist collects cells from
the cervix during a vaginal exam to look for abnormal, or
precancerous, changes in the lining of the cervix
Colposcopy : If the Pap smear results are abnormal,
Gyneconcologist may check the cervix using a magnifying lens
(colposcopy) and collects and examines cells (biopsy) to
determine whether cancer is present.
Some other tests are also ordered when cervical cancer is
diagnosed. The spread of the cancer can be easily determined
with the help of these tests. The different tests include :-
 MRI of the pelvis
 Chest x-ray
 Intravenous pyelogram (IVP)
 CT scan of the pelvis
 MRI of the pelvis

4. Treatment plan
The treatment of cervical cancer depends on:
* Stage
* Size and shape of the tumour
* The woman's desire to have children in the future
* The woman's age and general health
Treatment of early cervical cancers
* To ensure that a woman can bear children in the future,
removing the precancerous or cancerous tissue without
removing the uterus or harming the cervix, can cure early
cervical cancer.
* Pre-cancerous conditions are curable when followed up and
administered proper treatment.
Treatment of advanced cervical cancers
* Radical hysterectomy: The uterus and much of the
surrounding tissues are removed, including lymph nodes and
the upper part of the vagina.
*Radiation therapy: It is used in cases where the cancer has
spread beyond the pelvis, or cancer that has returned.
Radiation therapy is of two types:
* External radiation therapy is like an X-ray and delivers
radiation from a large
machine onto the part of the body where the cancer is located.
* Internal radiation therapy or brachytherapy entails placing a
device filled with radioactive material inside the woman's
vagina.
* Intensity Modulated Radiation Therapy (IMRT) and Image
Guided Radiotherapy (IGRT) help deliver radiation to the
tumour and adjacent tissues sparing nearby normal structures
like urinary bladder, rectum and intestines and thus preventing
long term complications.

5. * Chemotherapy uses drugs such as carboplatin, paclitaxel, 5-
FU and cisplatin to destroy cervical cancer. It is generally used
along with radiation to sensitize the tumour. Radiation and
chemotherapy may be used before or after surgery.
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