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Gynecology and Obstetrics
Cervical Cancer
Cervical cancer develops in the cells of the cervix (the lower part of the uterus that opens into the vagina). It occurs almost entirely as a result of persistent infection with high-risk HPV types. It is preventable through screening methods and vaccines.
ℹWhat is Cervical Cancer?
Cervical cancer is most commonly squamous cell carcinoma; adenocarcinoma is less frequent. The cervix has two main cell types: squamous cells lining the outer portion and glandular cells in the inner canal. The "Transformation Zone" where these two regions meet is where cancer and precancerous changes most commonly originate.
If a high-risk HPV infection (HPV16, HPV18, HPV33) persists in the cervical cells for a long time, it can disrupt DNA control mechanisms and lead to cancer.
Common Symptoms
Abnormal Vaginal Bleeding
Bleeding occurring outside of menstrual periods, after sexual intercourse (post-coital bleeding), or during the post-menopausal period.
Vaginal Discharge
Foul-smelling, watery, or blood-tinged pink/brown discharge.
Pelvic Pain
Pain during sexual intercourse (dyspareunia) or persistent pelvic pain.
Advanced Stage Symptoms
Leg swelling (lymphedema), urinary difficulty, rectal bleeding, or weight loss.
Diagnosis Methods
PAP Smear
Cells are collected from the cervix to screen for precancerous or cancerous changes.
HPV Test
Performed to detect high-risk HPV types.
Colposcopy
Magnified examination of the cervix to identify abnormal areas.
Biopsy
Tissue sampling via punch biopsy, endocervical curettage (ECC), or LEEP.
Radiological Imaging
MRI, CT, or FDG PET-CT to evaluate disease extent.
Treatments
Conization
Removal of only a small part of the cervix in very early stages if fertility is desired.
Trachelectomy
Removal of only the cervix while preserving the uterus (to maintain fertility in young patients).
Radical Hysterectomy
Surgical removal of the uterus, cervix, upper vagina, and parametrial tissue. Combined with pelvic lymphadenectomy.
Radiotherapy
External beam radiotherapy and brachytherapy (radioactive source placed directly at the cervix).
Chemotherapy
Used in advanced stages or to enhance radiotherapy efficacy (chemoradiotherapy). Cisplatin-based agents are most commonly used.
Immunotherapy and Targeted Therapy
Bevacizumab or Pembrolizumab can be highly effective in metastatic or recurrent cases.
Prevention
HPV Vaccination
The most effective method for preventing cervical cancer.
Regular Screening
Regular screening with PAP smear and HPV tests effectively detects preinvasive and early-stage disease.