Cervical cancer or cervical carcinoma is a malignant change of the cervical tissue. Provided the cancer is diagnosed in time, the disease is almost 100 percent curable.
What is cervical cancer?
Cervical cancer, also known as cervical carcinoma in medical terminology, is a collective term for all malignant changes in the area of the cervix. The cervix is the area of the female body that connects the vagina to the uterus. The disease occurs more frequently between the ages of 35 and 55 and after the age of 65. In Germany, about 6,000 women contract this disease every year. The most common cause of cervical cancer is infection by the papilloma virus (HPV) during unprotected sexual intercourse.
Causes
The main cause of cervical cancer is infection with the human papillomavirus; this usually occurs during unprotected sexual intercourse. These infections are by no means rare – after all, 80 percent of the German population become infected with this virus at least once in their lives. However, most of the affected patients do not notice this infection, especially since it usually does not cause any pain. Only in 20 percent of patients does the virus remain in the body and only in five percent of those affected does it develop into cervical cancer. Of course, other factors also favor this cancer. Among other things, female smokers are affected significantly more often, and the risk of developing cervical cancer is also significantly higher in the case of a weakened immune system, for example an HIV infection. Taking hormonal contraceptives, such as the pill, is also considered by experts to be a risk factor for the onset of the disease cervical cancer. In addition, this virus can trigger other symptoms, including skin or genital warts. Since 2007, the Robert Koch Institute has therefore been recommending that people be vaccinated against these viruses – this applies in particular to young girls between the ages of 12 and 17.
Symptoms, complaints and signs
In the early stages of cervical cancer, there are often no symptoms at all. However, sometimes irregular bleeding and a whitish and foul-smelling discharge are already observed at this stage. Bleeding after sexual intercourse can also occur. Often, however, these symptoms also occur with other much more harmless diseases, so they are non-specific. Only in the advanced stage of the disease do the symptoms become more specific and then give an indication of the cancer. In the early stages, however, almost all patients can still be completely cured. However, the chances of cure decrease as the cancer progresses. If the lymphatic system is already affected, lymphedema develops, which is noticeable by swelling of the legs. In addition, the urine is often red in color due to bleeding from the bladder or urinary tract. Urinary tract infections are also common. If the cancer has spread to the pelvis and spine, deep back pain radiating into the pelvis occurs. Furthermore, severe abdominal pain is possible due to bowel paralysis caused by the cancer affecting the abdominal viscera. At the same time, normal bowel movements are disturbed. Severe and unexplained weight loss represents a clear sign of advanced cancer. Eventually, death occurs after many organs are invaded by the tumor due to multiple organ failure.
Course
Due to the location of the cervix, this type of cancer is usually detectable at an early stage. Those who have regular examinations by their gynecologist have a good chance that this will be detected early. Detected at an early stage, this form of cancer is 100 percent curable. This type of cancer does not cause any symptoms in the early stages, and even if the cancer is already more advanced, most patients hardly complain of any symptoms. Sometimes, however, symptoms such as a foul-smelling or even bloody discharge can occur, as can spotting after sexual intercourse. Pain during urination or defecation is also not uncommon. Swollen legs on one side can also indicate this disease, as can undefinable abdominal, pelvic or back pain.
Complications
In most cases, complications of cervical cancer occur only when treatment begins too late and therefore the cancer is already advanced. If diagnosed early, cervical cancer can be cured relatively well, so there is no further discomfort or complications. Cervical cancer causes various symptoms in the vaginal area. Disturbances of the bleeding cycle and increased bleeding may occur. These also occur outside of the period. Increased vaginal discharge also occurs. The discomfort reduces the quality of life of the affected person. Unfortunately, due to the absence of pain, cervical cancer can be diagnosed at a late stage, which is why it is very important to attend preventive examinations. The cancer can also cause pain in the back or abdomen in some cases. It is not uncommon for the legs to be swollen as well. Usually the cancer can be removed by surgery without complications if it is not advanced. In severe cases, chemotherapy or radiation is necessary. In most cases, however, the cancer can be defeated relatively well, so that there are no further complications. If the course of the disease is positive, there is no reduction in life expectancy.
When should you go to the doctor?
A doctor should be consulted as soon as discomfort in the abdomen develops. If there is irregularity of menstruation, pain or cramps, a medical examination should take place. If menstruation is shortened or greatly prolonged, if intermenstrual bleeding occurs repeatedly, or if bleeding occurs after menopause, it is advisable to consult a doctor. If there is discomfort during sex or if there is swelling of the abdomen, a visit to the doctor is necessary. Basically, you should participate in the annual check-ups at the gynecologist. There, the cervix is palpated and a smear of the vaginal fluid is examined in the laboratory. This cancer screening can detect cancer before the first symptoms appear. If the woman suffers from a general feeling of illness, weakness or exhaustion for several weeks, she should consult a doctor. If there is an altered discharge from the vagina or an unusual odor in the intimate area, these indications should be clarified by a doctor. If irregularities of the cervix can be perceived by your own palpation in the vaginal canal or if complaints occur when using tampons, a visit to the doctor should be made. In case of a feeling of pressure in the lower abdomen, inner restlessness as well as reduced performance, it is advisable to consult a doctor for clarification of the cause. Persistent pain in the pelvis, abdomen or back should be examined and treated.
Treatment and therapy
In most cases of cervical cancer, a minor surgical procedure on the cervix called conization is sufficient. Laser surgery can also promise good healing prospects in the early stages. Another advantage of these two treatment methods is that the uterus is completely preserved. It is also still possible to become pregnant after the procedure. If the cervical cancer is already more advanced, however, a major operation or, if necessary, radiation therapy must be performed. In individual cases, this is also combined with chemotherapy. Doctors also distinguish cervical cancer from a preliminary stage of this disease. In this case, the irregularities of the cells often disappear by themselves. If such irregularities have been diagnosed, one should have vaginal smears taken at regular intervals. If these cell changes persist over a longer period of time, the doctor may have to remove the affected area. Thus, treatment depends primarily on how far the cancer has progressed.
Aftercare
Regular follow-up examinations after completion of therapy are necessary to detect early recurrence of cervical cancer and to take countermeasures. Follow-up examinations generally take place every three months for the first three years, then twice a year for two years. After five years of freedom from symptoms, a check-up is only necessary once a year.The individual risk of relapse is strongly dependent on the type and size of the original tumor, the therapy performed and the patient’s general condition: In individual cases, check-ups at much shorter intervals may be advisable. A follow-up examination usually consists of a detailed interview, a comprehensive physical and gynecological examination including cell smear and vaginal ultrasound examination, and blood and urine tests. Ultrasound examinations of the kidneys and a mammogram are performed at longer intervals. X-ray examinations of the lungs, an ultrasound examination of the liver and a computer tomography (CT) or magnetic resonance imaging (MRI) are only performed in exceptional cases with a high risk of relapse. Great importance is attached to the psychological aftercare of the patient. The psychological stress caused by the cancer can be significantly alleviated by talking to a therapist or attending a self-help group. To restore physical performance after chemotherapy or radiotherapy, a medical rehabilitation measure is recommended in many cases: this can take place in an inpatient rehabilitation clinic, as a day patient or as an outpatient.
Outlook and prognosis
The prognosis for cervical cancer depends largely on the time of detection. In the preliminary stages, it can be treated so well that sometimes no aggressive cancer therapy is needed at all. A minor surgical procedure is sufficient; depending on the severity, the woman is still fertile afterwards and can have children. In the initial stages, the chances of survival from cervical cancer are also still very good. In most cases, however, cancer therapy must now be expected so that the cancer can recede completely. However, such early detection means in most cases that the cancer is actually curable. In contrast, if cervical cancer is detected late, more invasive surgical procedures are necessary. Even at this stage, there is often still a chance of complete cure, but this goes hand in hand with partial or complete removal of the uterus. If the cervical cancer has already spread, other (reproductive) organs must also be removed. In addition, the patient must expect to undergo chemotherapy. In the case of advanced cervical cancer, it is unfortunately not uncommon for the woman to become infertile as a result of the treatment or for the cancer itself to have already attacked the uterus to such an extent that pregnancy is no longer possible. In these cases, however, eggs can be retrieved before cancer therapy begins so that a desire to have a child can be fulfilled in an alternative way.
This is what you can do yourself
Cancer must be treated and therapized by a doctor. The ill person can support the well-being and stabilize the psyche with own possibilities. However, a doctor and, in most cases, surgery are needed to relieve physical symptoms. Some sufferers find contact with self-help groups mentally strengthening. There, in a protected environment, women with the disease and those who are already healthy can exchange ideas, help and motivate each other. Relaxation techniques have also proven effective for many patients. Meditation, autogenic training or yoga can develop mental strength, which contributes to new confidence and optimism. A stable social environment and the opportunity to talk about emotional concerns also help immensely in everyday life. As a result, fears can be discussed and reduced. Furthermore, the use of a therapist can be helpful. In addition, a healthy diet and sufficient exercise promote general well-being. A balanced food intake rich in vitamins strengthens the immune system and protects against additional susceptibility to illness. Walks or sporting activities adapted to the possibilities of the sick person improve the quality of life in everyday life. Positive moments in the patient’s life can be created through appealing leisure activities, which contribute to the promotion of joie de vivre.
