Cervical cancer is a type of malignancy that begins on a woman's cervix and can spread to other parts of her body.

The current thinking is that cervical cancer is a slowly developing condition that is initially signalled by the presence of "abnormal" but non-cancerous cells on the cervix. These abnormal cells form lesions on the surface of the cervix - usually, but not always, in women between 25 and 35 - which may go away on their own, or may begin to spread deeper into the tissues of the cervix - usually, but not always, in women between 30 and 40 years of age. If the cells spread deeper into the cervical tissue or into other organs of the body, a woman has cervical cancer. Only then will she begin to have symptoms, usually abnormal bleeding.

As abnormal bleeding is an ambiguous kind of term, and can have many causes, any change in your vaginal discharges - bloody or otherwise - should be the occasion for a trip to the doctor.

That, of course, is the bad news. The good news is that cervical cancer is preventable. The abnormal cells can be easily discovered through routine pelvic examinations and pap smears, which is why women should heed the advice to have these tests every year once they become sexually active. After several years of negative results, a woman can begin to be tested every two years.

Women should also be aware of the risk factors for cervical cancer. These include her becoming sexually active at a young age, or having many sexual partners once she is active. It's thought that cervical cancer is associated with viruses that are transmitted sexually, particularly some forms of the human papillomavirus (HPV), which causes genital warts and possibly also abnormal cell growth. Although the relationship between different forms of HPV and cervical cancer is not clear, recent studies are showing that testing for HPVs may be an effective screening tool for detecting cervical cancer. Genital herpes and chlamydia may also play a role. And smoking is a risk factor for this, as for all, cancers. Women who take the Pill may be at increased risk of cervical cancer, possibly because they are more sexually active, and those with compromised immune systems also have a higher incidence of the disease.

Should a woman have abnormal cells, the physician will run through a number of uncomfortable tests to determine the extent of the abnormality. Colposcopy involves coating the cervix with a solution and viewing it through a colposcope; a biopsy may be done; or a more painful endocervical curettage, which involves dilating the cervix to scrape tissue from inside the cervical opening. These only reveal changes on the surface of the cervix, however, so a cone biopsy or conization may be necessary. Sometimes it's not clear if the abnormality is on the cervix or in the uterus, in which case the dreaded dilation and curettage (D&C) might be performed; the actual curettage (scraping) isn't so bad, but the cervical dilation is a killer, particularly if you've never had children. Accept the drugs.

Dilation and curettage is one treatment for cervical cancer that hasn't spread far. Others involve removing the abnormal areas, for example through cutting off (biopsy), freezing (cryosurgery), burning (cauterization), or through laser surgery. Hysterectomy is an option for women who don't want (more) children. If the disease has spread farther, the gamut of cancer therapies may be offered: surgery followed by radiation and/or chemotherapy are the medical interventions of choice among doctors. There's quite a lot of good information on these interventions at
cancernet.nci.nih.gov/wyntk_pubs/cervix.htm#1

Although all this is frightening, the fact is that pap tests in particular greatly increase every woman's chance of surviving cervical cancer. Although pap tests may give false negative results, regular testing will cause the error to be discovered; about half of American women diagnosed with invasive cervical cancer had not had a pap smear in the last five years.
(rex.nci.nih.gov/massmedia/backgrounders/cervical.html)

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