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What is cancer?

Cervical Cancer is Cancer that affects the “mouth” of the uterus

Cancer….. normally gone berserk:

Normal mechanisms can be disturbed by many factors (ex: viruses, chemicals in Tobacco, repeated damage)

Cancer cells are abnormal cells which multiply too fast. Old cells refuse to die. New cells don’t mature but keep growing — become a bulk called a “tumour”. They cannot function normally and start competing with normal cells. They can spread and grow anywhere else in the body and choke off the normal cells (ex: brain, lungs, liver)

What does Cervical Cancer look like?

What does Cervical Cancer look like?

Why is Cervical Cancer important to you?

Cervical Cancer is the commonest cancer in Indian Women, 200 women die every day in India, 8 women die every hour, and 1 woman every 7 minutes. India makes up only 16% of the world’s population but has 27% of the world’s total cervical cancer cases and deaths every year

New cervical cancer cases diagnosed annually -India: 1,32,082 — World: 4,93,243. Deaths due to cervical cancer annually -India: 74,118 — World: 2,73,505. Cervical cancer usually has no signs and symptoms in its early stages. There is low awareness of cervical cancer

Who is at risk of Cervical cancer?

Anyone with a cervix is at risk for cervical cancer. It occurs most often in people over age 30. All sexually active women are potentially at risk of cervical cancer as they could have been infected by HPV

Though the risk begins early, cervical cancer is most commonly found in women in their 40’s and 50’s. Long-lasting infection with certain types of human papillomavirus (HPV) is the main cause of cervical cancer. HPV is a common virus that is passed from one person to another during sex.

Who Is at Risk for HPV?

HPV is so common that most people who have ever had sex — both women and men — will get the virus at some point in life. Because HPV can linger quietly, it’s possible to carry the infection even if it has been years since you had sex. Condoms can lower your risk of getting HPV, but they do not fully protect against the virus. HPV is also linked to cancers of the vulva, vagina, and penis, and to anal and oral cancers in both sexes.

Top Cause of Cervical Cancer: HPV Infection

The human papillomavirus (HPV) is a large group of viruses. About 40 types can infect the genital areas, and some have a high risk for cervical cancer.

HPV is a group of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex. Sexually transmitted HPV types fall into two groups, low-risk and high-risk.

Low-risk HPVs mostly cause no disease. However, a few low-risk HPV types can cause warts on or around the genitals, anus, mouth, or throat.

High-risk HPVs can cause several types of cancer. There are about 14 high-risk HPV types including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68. Two of these, HPV16 and HPV18, are responsible for most HPV-related cancers.

How Does HPV Cause Cervical Cancer?

If one of the high-risk strains of HPV lingers in the body, it can cause abnormal cells to develop in the cervix. These precancerous changes do not mean that you have cervical cancer. But over time, the abnormal cells may give way to cancer cells. Once cancer appears, it tends to spread in the cervix and surrounding areas.

Genital HPV infections usually clear up on their own. If one becomes chronic, it can cause changes in the cells of the cervix. And it’s these changes that may lead to cancer. Worldwide, over 90% of cervical cancers are caused by an HPV infection.

The 4 most important types of HPV

HPV 16 & HPV 18 →75% of Cervical Ca., >50% of Vaginal & Vulvar Cancer

HPV 6 & HPV 11 & HPV 16 — — 90% of Anogenital warts

How does HPV spread?

Sexual activity spreads the virus, It’s one of the most common sexually transmitted diseases(STD). About half of those with HPV are aged 15 to 24.

How HPV Causes Cervical Cancer

When you’re exposed to genital human papillomavirus (HPV), your immune system usually prevents the virus from doing serious harm. But sometimes, the virus survives for years.

Eventually, the virus can lead to the conversion of normal cells on the surface of the cervix into cancerous cells.

At first, cells may only show signs of a viral infection. Eventually, the cells may develop precancerous changes.

This is known as cervical intraepithelial neoplasia, which usually resolves spontaneously, but in some cases, it may progress to invasive cervical cancer.

HPV infections — what you should know

A Large number of women get HPV infection sometime during their lifetime (80% by the age of 50). your immune system usually prevents the virus from doing serious harm.

The dangerous types of HPV can stay in the body for years without causing any symptoms — you may not know you have it.

The majority would clear the infection without developing any disease. Few women develop precancerous lesions, cervical intraepithelial Neoplasia, which resolves spontaneously but in some cases, it may progress to invasive cervical cancer and tends to spread to surrounding areas.

Other risk factors for cervical cancer

Early marriage and starting sexual life at an early age.
Early Childbirth, Multiple Child births and unsafe abortions
Unprotected sex
Multiple Sex Partners, Casual sex
Smoking
Family History/Hereditary
Oral Contraceptive pills

What are the Symptoms of Cervical Cancer?

Usually no symptoms in the early stage
When advanced, there can be the following symptoms:
A little bleeding between periods
Bleeding after sexual intercourse
Abnormal vaginal discharge
Sometimes — pain during intercourse
Continuous low back-ache
Unexplained loss of weight
Pale face and nails (anaemia)

How to prevent Cervical Cancer?

Awareness

Awareness about all aspects of cervical cancer, especially the importance and mode of its prevention is very crucial.

Vaccination

What you should know about vaccination?

Vaccination is the only true form of “prevention” — stops the disease from happening in the first place

There are two vaccines available today:

Quadrivalent (“four types”)-Protects from 6,11,16,18
Partial protection from 33, 35, 41 and 7 other types
Bivalent (“two types”)Protects from 16, 18
Partial protection from 33, 35 and 41

How does the vaccine work?

It gets your body to produce antibodies against the HPV virus. These antibodies protect your body from an HPV infection by fighting the virus when it tries to attack the cervix.

Who should take the vaccine and when?

Ideally, the vaccine should be taken as early as possible after the age of 9 years, but girls and women of any age up to 45 can benefit from this vaccine. Expectant mothers should not take the vaccine during their pregnancy.

What is the dosing schedule of the vaccine?

The quadrivalent vaccine is given in three doses as follows:

0, 2 and 6 months
The bivalent is given in a similar schedule at 0,1 and 6 months.

How soon will the protection work?

Usually, the full protection comes into effect usually within a month of the last dose. It is important to complete the schedule.

How long will the protection last?

So far the data has shown that vaccinated women have been significantly protected from the disease since they got the vaccine (5 yrs according to published data).

There is a good chance of life-long protection as well. Only time will tell.

This is being tracked worldwide till we know for sure when people would need a booster, if at all.

How long will the protection last?

So far the data has shown that vaccinated women have been significantly protected from the disease since they got the vaccine (5 yrs according to published data).

There is a good chance of life-long protection as well. Only time will tell.

This is being tracked worldwide till we know for sure when people would need a booster, if at all.

What about side effects?

The vaccines have been studied and is safe and well tolerated.

How to prevent cervical cancer?

Early Detection: Screening with Pap Test

PAP’s smear test is a Simple, quick, painless procedure — takes 5 minutes

If the Test is Abnormal,

Scheduling Colposcopy — an exam with a lighted magnifying device — may be necessary to get a better look at any changes in the cervical tissue and also take a sample to be examined under a microscope.

If abnormal cells are precancerous, they can then be removed or destroyed.

Treatments are highly successful in preventing precancerous cells from developing into cancer.

Early Detection: HPV DNA Test:

In some cases, doctors may offer the option of the HPV DNA test in addition to a Pap test.

This test checks for the presence of high-risk forms of HPV. It may be used in combination with a Pap test to screen for cervical cancer in women over 30 years of age.

Conservative treatment (save the uterus and part of the cervix)

Burn the abnormal part of the cervix with electric current (electro-cautery)

Destroy the abnormal area by freezing it (cold coagulation)

Symptoms of cervical cancer usually don’t show up till it’s too late. Can often be mistaken for something less serious

It is never too early to Guard Yourself against it !!

Cervical Cancer is the most common cancer affecting Indian women. It is a preventable disease.

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