Comprehending Cervical Cancer

For decades, cervical cancer was one of the most common causes of cancer death among women in America. Thanks to better standards and more consistent guidelines regarding women’s health, survival rates have improved. However, it’s still the third most common cancer of the female reproductive organs. The American Cancer Society estimates nearly 12,000 new cases of invasive cervical cancer are diagnosed each year, and more than 4,000 women die annually from the disease. But as the adage goes, the best defense is a good offense, so equip yourself with knowledge that can help eliminate cervical cancer once and for all.

It’s caused by HPV.

“About 99% of all cervical cancer cases are caused by human papillomavirus, or HPV, the most common sexually transmitted infection in the United States,” says Dr. Stephen DePasquale, a gynecologic oncologist with Chattanooga’s Program in Women’s Oncology.

Fortunately, most HPV infections go away on their own within two years. It’s when your body doesn’t naturally rid itself of the infection that there is cause for concern. HPV is composed of somewhere between 100 and 200 related viruses. Each strain within this collection is assigned a number to identify it, known as its HPV type. Around a dozen HPV strains have been identified as “high-risk,” meaning they can cause several types of cancer, including cervical cancer. What’s more, just two strains, HPV16 and HPV18, are responsible for nearly 70% of all HPV-induced cervical cancer cases.

Dr. Shevonda Sherrow, an OB-GYN with Innovative Women’s Health Specialists, explains, “HPV reaches the cells on the surface of the cervix and causes them to grow abnormally. It rewrites the chromosomal makeup of the cells, so they don’t go through their normal lifecycle.”

Smoking can increase your risk.

It’s no surprise smoking is bad for you. But it may be for more reasons than you’d expect. Studies show women who smoke are twice as likely – if not more – to develop cervical cancer. Dr. DePasquale explains, “Cigarette smoking lowers our immune response, thereby increasing the risk for cervical cancer or any HPV-mediated cancer, which would also include vaginal, vulvar, anal, and head and neck cancers.”

Not only is your immune system more vulnerable, the carcinogens and other harmful substances from cigarettes can partner with and even enhance the effects of an HPV infection. Smoking damages your DNA and can make your cervical cells much more susceptible to cancer.

“In addition to smoking,” says Dr. John Adams, an OB-GYN with Women’s Health Services, “other risk factors for cervical cancer include having multiple sexual partners, having intercourse at a young age, giving birth to multiple babies, and lower socioeconomic status.”

The best way to catch it early is to have regular Pap tests.

The best way to detect cervical cancer early is to get a Pap test, or Pap smear. “About half of all cervical cancer cases occur in women who have never had a Pap test,” shares Dr. Sherrow.

Named after its inventor Dr. George Papanicolaou, the Pap test is a routine procedure during which your doctor takes a sample of cells from your cervix. These will be examined to determine if they’re abnormal or pre-cancerous. If they are, you can be treated before they turn into cervical cancer, which can take 10 to 15 years.

According to Dr. Adams, “The guidelines for Pap testing are as follows: the first test is recommended at age 21; between ages 21 and 29, women need a Pap test every three years; between the ages of 30 and 65, a Pap test combined with an HPV test (to test for the virus, which is widespread by this age) can be done every five years, or a Pap test alone every three; after age 65, unless you have a significant history of abnormal results, Pap tests are no longer recommended.” If results are abnormal, testing at least annually is recommended.

Speaking of annually, just because you only need a Pap test every three years doesn’t mean you can skip your annual checkup with your gynecologist. There are numerous aspects of your gynecological health that need monitoring, and once a year remains the recommendation.

Inconsistent periods might signal a problem..

“Unfortunately, symptoms of cervical cancer typically don’t appear until the late stages,” says Dr. DePasquale. “Early stage cervical cancer rarely has symptoms. That’s why Pap testing is so important – it can help diagnose pre-malignant conditions of the cervix prior to becoming cancer.”

When symptoms do arise, they can look like the warning signs of other reproductive system infections, diseases, or disorders. You should visit a medical professional if you’re experiencing pelvic pain, abnormal bleeding, painful urination, unusual discharge, abnormal menstrual cycles, pain or bleeding after intercourse, or urinary incontinence.

As a general rule of thumb, if you’re experiencing anything out of the norm regarding your pelvic region or menstrual cycle, get it checked out by a doctor.

Most cases are preventable.

The most definitive way to avoid cervical cancer caused by HPV is to remain abstinent, but HPV vaccines are proven preventative tools as well.

Since HPV is so difficult to detect – often not presenting symptoms until too late, if at all – it’s important for young girls and boys to receive protection against the infection before being exposed to sexual activity and while their immune systems are at their strongest.

In the United States, there are three HPV vaccines approved to protect against HPV: Gardasil, Gardasil 9, and Cervarix.

The Advisory Committee on Immunization Practices (ACIP) recommends vaccinating children at age 11 or 12, though the vaccines are approved for females as young as 9 up to age 26 and males 9 to 21. Those who begin the series between the ages of 9 and 14 receive a two-dose schedule six to 12 months apart. For those between the ages of 15 and 26, a three-dose schedule is recommended over the course of six months.

It’s treatable.

The earlier cervical cancer is caught, the more successful your treatment is likely to be. Dr. Adams explains, “Treatment for cervical cancer depends on the diagnosed stage. If the cancer is confined to the cervix, a radical hysterectomy (removal of cervix and uterus) can be curative. If it has spread beyond the cervix, a woman often needs a combination of radiation and chemotherapy.”

Radiation therapy, which uses high-powered energy beams, can be pursued alone or in conjunction with chemotherapy to shrink a tumor by destroying cancer cells. Chemotherapy, which uses medications to kill cancer cells, can enhance the effects of radiation, which is why they are sometimes used together.

Depending on the stage of your cervical cancer, it may be possible to preserve your ability to conceive. If you desire to have children, speak to your doctor. Pregnancy is not always possible, but it’s important for your doctor to know when creating your treatment plan.

“Ultimately, minimizing your risk of cervical cancer is all about prevention,” Dr. Sherrow shares. “Get the HPV vaccine, limit your sexual exposure, eat healthier, stop smoking, and never skip your routine Pap test or gynecological appointment. When your health is taken care of, your immune system can clear up the issue before it advances.” As one of the few preventable cancers, there’s no reason it should be fatal. Be responsible and be vigilant!

Picture of Dr. Stephen DePasquale

Dr. Stephen DePasquale

Gynecologic Oncologist, Chattanooga's Program in Women's Oncology

Picture of Dr. Shevonda Sherrow

Dr. Shevonda Sherrow

OB-GYN, Innovative Women's Health Specialists

Picture of Dr. John Adams

Dr. John Adams

OB-GYN, Women's Health Services

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