What is cervical cancer?
The cervix is the lower end of the uterus, connecting it to the vagina (birth canal). Cervical cancer typically develops slowly over time. Before cancer appears, cervical cells undergo changes known as dysplasia, where abnormal cells begin to appear in the cervical tissue. Over time, if these abnormal cells are not treated or removed, they may develop into cancerous cells and begin to grow and spread deeper into the cervix and surrounding areas.
Each year in Israel, about 250 women are diagnosed with cervical cancer.
Cervical cancer mostly affects younger women (ages 35-45), but it can also occur in older age.
Symptoms of cervical cancer:
In early stages - there may be bleeding or spotting after sexual intercourse, or irregular bleeding between periods.
In more advanced stages - fatigue, loss of appetite, weight loss, pelvic pain, back pain, or pain during intercourse may occur.
Risk factors:
Infection with the human papillomavirus (HPV). Two strains of the virus pose a high risk for developing cancer: HPV 16 and HPV 18, which account for 70% of cervical cancer cases worldwide. Other strains can also lead to cancer but are less common.
Prevention of cervical cancer:
Cervical cancer can be prevented by HPV vaccination - the vaccine is now administered as part of routine vaccinations for school-aged children.
Routine screening for cervical cancer: Two widely used screening tests are HPV testing and cytology (also known as Pap smear). These tests can detect high-risk HPV infections and abnormal changes in cells, which are precancerous conditions that can be treated before they develop into cancer.
Diagnosis of cervical cancer:
- Colposcopy: A procedure in which a doctor uses a device called a colposcope to gently open the vagina and examine the cervix.
- Biopsy: A procedure in which a tissue sample is taken from the cervix for pathological diagnosis
.
Upon diagnosis of cervical cancer, the stage of the disease is determined by PET-CT and MRI scans.
Stages of the disease:
The disease may be limited to the cervix alone, locally advanced, or spread to distant areas of the body.
Treatment:
For precancerous conditions - local excision is performed, followed by long-term monitoring.
Treatment for localized disease involves surgery.
If surgery does not allow complete excision, the preferred treatment is a combination of chemotherapy and radiation.
For advanced disease, treatment involves a combination of chemotherapy with biological therapies (including immunotherapy).
The most important aspect is prevention of the disease - either through vaccination or through monitoring and early detection of precancerous lesions.
