| Cervical Cancer
What is cervical cancer?
Cervical cancer is a malignant growth of the cervix. The cervix
is the opening of the uterus that leads into the vaginal canal.
You can feel it with your fingers, inside of the vagina.
It is believed that cervical cancer is caused by a sexually transmitted
virus called (Human Papilloma Virus or HPV). Only a few types of
HPV cause cancer. Most of the cancer caused by HPV is cancer of
the cervix, but HPV may also be responsible for cancer in the vagina,
vulva, ano-rectal area (in men or women) and on the penis.
When the cells of the cervix become abnormal, it is called "Dysplasia".
When dysplasia is diagnosed and treated early, cancer can be prevented.
Cervical cancer starts out in a few cells, but gradually grows in
size. This usually occurs over ten or more years. When the growth
can be seen and felt during a pelvic exam, it is called a tumor.
If the tumor is not treated, it will spread to nearby areas such
as the ovaries, fallopian tubes and vagina. If cervical cancer is
not treated, it will become a life-threatening disease.
Who is at risk for cervical cancer?
In 1993, the Centers for Disease Control (CDC) added invasive cervical
cancer to the list of AIDS diagnoses. This is based on the observation
that HIV-positive women are more likely to have dysplasia than women
without the virus. Many doctors believe that dysplasia may become
cancer more rapidly in HIV infection. High-grade dysplasia seems
to occur more frequently in women with CD4 (T-cells) counts below
400. Other risk factors that may be involved in causing cervical
cancer are smoking cigarettes and an inadequate diet (perhaps lack
of vitamin A).
What are the symptoms of cervical cancer?
A woman may have cervical cancer without having any symptoms at
all. Women with cervical cancer can get pregnant and usually have
normal periods. There are no real clues or symptoms to look for,
especially in the early stages of cancer. In very advanced stages,
a woman may have some pain, some vaginal discharge and may bleed
easily between normal periods.
How is cervical cancer diagnosed?
The Pap smear is a screening test for cervical cancer. Women with
HIV infection should have a Pap smear every six months for one year,
and if these Pap tests are normal, they should get annual Pap smears.
The Pap smear can detect dysplasia. When dysplasia is found, a further
examination is done with a magnifying instrument called a Colposcope.
A colposcope allows abnormal tissue to be seen so a biopsy can be
taken. Most of the time, the problem is dysplasia, but sometimes
it can be cancer. After a colposcopy, spotting and minor discomfort
may occur.
When cervical cancer is found, more tests will be needed before
treatment can be planned. This is called staging the cancer. Staging
is a series of tests and evaluations that tell how far the cancer
has spread.
How is cancer of the cervix treated?
A very small cancer (called a microinvasive cancer) may be totally
removed by a procedure called a cone biopsy. In this type of biopsy,
a larger piece of the cervix is removed and the tissue is examined
very carefully under a microscope to see if all of the cancer cells
have been removed. This can be done in the doctor’s office,
or in the hospital. Because there are three kinds of cone biopsy
procedures, side effects and healing time will vary.
If the cancer cannot be entirely removed by the cone biopsy, the
woman may need to have a hysterectomy (surgical removal of the uterus),
to prevent the further spread of the cancer. Sometimes, the lymph
nodes in the pelvic area are also removed. This is called a radical
hysterectomy. But if the cancer has already spread beyond the cervix,
the treatment will usually be radiation. Chemotherapy is not usually
used to treat cervical cancer.
Can cervical cancer be prevented?
YES! Cervical cancer can be prevented by regular screening and proper
treatment of dysplasia. This makes it very important for HIV-positive
women to get regular Pap smear tests. HIV-positive women who have
had a history of dysplasia should probably have a colposcopic exam
every six months. Be sure to see a practitioner that knows about
HIV.
A word about Human Papilloma Virus (HPV)
HPV does not always cause cancer. In fact, probably one third of
all sexually active women have been exposed to HPV, yet very few
of them have cervical cancer.
HPV is also important because it causes warts. However, some types
of HPV produce no symptoms at all. Recent research has determined
that there are at least 60 different types of HPV. There are at
least twelve types of HPV that are sexually transmitted. Some types
are easily transmitted through all kinds of intimate, sexual or
skin-to-skin contact.
Treatment for HPV will often need to be repeated (usually one to
three times weekly for two to six weeks). Sexual contact is not
advised when genital warts are present, and sexual partners should
also be examined for HPV.
© 2003 Gay Men's Health Crisis |
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