Cervical Cancer Treatment – Sheba Medical Center
In women, the cervix is the lower part of the uterus, or womb. The upper area of the cervix is known as the endocervix and contains glandular cells, while the lower area, called the exocervix, is covered in squamous cells. These regions abut each other in the transformation zone, a location where many cervical cancers originate.
About 90% of all cervical cancers are squamous cell carcinomas originating in the exocervix. A minority of cervical cancers are adenocarcinomas that form in the endocervix. Other cases of cervical cancer are a mixture of these types, known as mixed carcinomas or adenosquamous carcinomas.
The main risk factor for cervical cancer by far is infection with the human papilloma virus (HPV). HPV is spread by sexual contact and in more rare cases by skin on skin contact. HPV infection may cause warts but sometimes exhibits no symptoms at all. While there is no cure for HPV, there are vaccines currently available. People who are immunosuppressed for various reasons, such as HIV infection, have a higher risk of contracting HPV.
Another risk factor for cervical cancer, and many other types of cancer, is smoking. Additionally, a poor diet, obesity, a positive family history, and the use of oral contraceptive pills and certain intrauterine devices may increase the risk for cervical cancer. Finally, women who are under 17 at the time of their first full-term pregnancy carry twice the normal risk of developing cervical cancer.
There are five main stages of cervical cancer, classified according to the spread of the cancer. These stages are:
Carcinoma in situ. The cancer is only present on the surface of the cervix and has not infiltrated deeper layers or elsewhere in the body
The cancer is now present in the vagina and/or pelvic walls, but has not invaded distant organs. It may or may not have invaded pelvic lymph nodes.
The cancer has invaded the cervix, but not the uterus itself.
The cancer has invaded nearby and/or distant organs and may be blocking urinary flow.
The cancer has traveled beyond the cervix and uterus, but has not invaded the vagina, pelvic walls, or any lymph nodes.
Some signs and symptoms of cervical cancer include:
- Abnormal vaginal bleeding, including unusual vaginal discharge, bleeding after menstruation, or an unusually heavy period
- Pain during sexual intercourse
One of the first clinical signs of cervical cancer is an abnormal Pap smear. A pathologist will see abnormal cells on the Pap smear and alert the patient’s physician. The physician will usually proceed with a colposcopy, a direct examination of the cervix via the vagina.
Additionally, there are several biopsy techniques to confirm cervical cancer, all offered at Sheba Medical Center. These include biopsy during colposcopy, endocervical curettage, which is a scraping of cells from the cervix, and cone biopsy. Cone biopsy, where cone-shaped tissue is removed from the cervix for analysis, may be both a diagnostic and therapeutic procedure since some cervical cancers can be removed in the procedure.
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