Authored by Jyoti Shah in Diseases, Women’s Health 
Published on 05-13-2009

Cervical cancer is a silent killer, as symptoms generally show up only when the disease is at an advanced stage This is reason enough for women to be more alert about any changes, however slight, that they notice in their menstrual cycle or body chemistry. Early detection means better chances of recovery. Unfortunately the symptoms of cervical cancer often remain unnoticed because those that are apparent may mimic other common ailments and therefore, tend to get trivialized. Symptoms may also get overlooked because of the belief that they may be related to PMS or pains during ovulation. Certain risk factors increase vulnerability of some women to it.

Causes and Risk Factors

The cervix connects the uterus to the vagina and is composed of squamous cells. These are flat, scaly skin-like cells covering the cervix. 85% of the cervical cancers attack squamous cells and generally occur in the area called the transformation zone, where the endocervix and the exocervix meet. Other cancers that may develop may be adenocarcinomas or adenosquamous carcinomas that develop from a combination of various types of cells.

Human Papilloma Viruses (HPV) are viruses that can affect the cervix directly and are generally transmitted by sexual contact, though is not unusual for adults to be infected by these viruses at sometime or the other.

There are over 50 kinds of HP viruses. Some of these may cause genital warts. Type, 16, 18, 31 and 33 may cause carcinomas. The cancer causing HP viruses can affect body cells and causes changes in them that may eventually result in cervical cancer.

It is also believed that women working on farms and those exposed to pesticides and chemicals because of their jobs are at higher risk.

Women affected by the HIV virus who are under heavy medication are at greater risk because of lower immunity levels. They require monitoring and regular cervical examination for early detection of any pre-cancerous changes that may occur in the cervix. Certain genetic material found in this virus shows up in cervical tissues, which may exhibit cancerous or pre-cancerous changes.

Over use of oral contraceptives, unprotected, licentious sexual contact, being overweight and multiple pregnancies can also increase risk. A diet that is low on vegetables and fruits is low on anti-oxidants and increases pre-disposition to the disease.

Symptoms

Most women tend to fight shy of medical attention because they believe that the absence of pain is not serious enough to warrant a thorough examination, but this is not true of cervical cancer as it may manifest symptoms that are not accompanied by pain till probably it has spread to other parts, or when the disease has reached a fairly advanced stage. They also do not occur till cells in the cervix begin to invade neighboring, normal, healthy tissue. It is then that the symptoms begin to manifest. Some of the symptoms are:

• Vaginal bleeding that is abnormal, in the sense that bleeding occurs at a time when it is not supposed to occur, like in between periods, or after intercourse or sometimes even after menopause is long over and done with.
• Menstrual periods that are abnormally heavy as compared to what is the normal pattern.
• Vaginal discharge that is abnormal or tinged with blood.
• Inexplicable changes in the menstrual cycle.
• Bleeding that occurs after douching or after a pelvic examination.
• Pain that occurs during urination or bladder pain are generally symptoms that manifest when the disease has reached an advanced stage and may suggest that the bladder has also been attacked.

Detection

A PAP smear test can detect cervical cancer and must be undertaken at the slightest doubt so that treatment can begin immediately and the disease can be arrested before it is too late.