Cervical Cancer

Overview

Cervical cancer is the third most common type of cancer affecting women. This type of cancer starts in the cervix, the lower part of the uterus (womb) that opens at the top of the vagina. This cancer develops very slowly and begins as a pre-cancerous condition called dysplasia.  

Almost all cervical cancers are caused by HPV (Human Papilloma Virus), which is a common virus that spreads through sexual intercourse. All women should begin cervical cancer screening when they are 21 years old.

This is the easiest female cancer that can be prevented with regular Pap smears and follow-up. Screening should be done every 3 years in women with no history of abnormal Pap smear.  Depending on the stage of cervical cancer, treatment such as surgery, radiotherapy and chemotherapy are available.

Signs and Symptoms

In its initial stage, there are no symptoms of cervical cancer. However, its symptoms include:

• Abnormal vaginal bleeding between periods and after intercourse
• Post-menopausal bleeding, if you are not on HRT or have stopped it for six weeks
• Continuous vaginal discharge
• Unusual and/or unpleasant vaginal discharge
• Back pain
• Fatigue
• Leg pain
• Pelvic pain
• Single swollen leg
• Weight loss
• Heavier periods that usual

Causes:

This type of cancer starts in the cells on the surface of the cervix. Its major causes are:

• Not getting the HPV vaccine
• Poor economic status
• Weakened immune system
• Unhealthy sexual intercourse
• Multiple sexual partners
• Intercourse with people involved in high-risk sexual activities

Treatment

The treatment of cervical cancer generally depends on various factors – cancer stage, size and shape of the tumour, woman's age and general health. In earlier days, cervical cancer would be cured by the removal of cancerous tissues. However, nowadays, with surgeries having undergone heavy advancements, different types of treatment options are available presently. Some of the options available nowadays are:

• Loop Electrosurgical Excision Procedure (LEEP): This procedure employs electricity to remove abnormal tissue.
• Cryotherapy: The procedure involves freezing abnormal cells.
• Laser therapy: This therapy uses light to destroy cancerous tissue.
• Radical hysterectomy: It involves removal of the uterus and much of the surrounding tissues, including lymph nodes and the upper part of the vagina.
• Pelvic exenteration: A rare type of surgery in which all of the organs of the pelvis, including the bladder and rectum, are removed.
• Radiation therapy: Internal or external radiation may be used to treat cancer that has spread beyond the pelvis, or cancer that has returned.
• Chemotherapy: It involves the use of certain drugs that kill cancer tissues.

Bone Marrow Transplant

Bone marrow transplantation (BMT) is a procedure wherein stem cells from the bone marrow (that produce various blood cells like red blood cells, white blood cells and platelets) are injected into the recipient after a short course of chemotherapy (called conditioning).

What are the various types of BMT?

An interesting observation here is that the type of bone marrow used for transplant is different from the different types of BMT. There are two types of BMT:

Allogenic BMT: Donor and recipient are two separate individuals and BMT is done using the stem cells of donor. It may be:

• Matched Related: where donor is HLA matched relative usually a sibling.
• Matched Unrelated: where donor is not a relative of patient and usually found from one of the various national or international registries.
• Partially Matched Related: where donor is from a patient’s family but partially matched (haploidentocal).

Autologous BMT:  In this case, the donor and recipient are the same individuals. BMT is done using the patient’s own stem cells. The procedure involves giving high dose chemotherapy to patient in order to remove the primary disease. Thereafter, an autologous transplant is conducted to rescue damaged bone marrow. This type of transplant has minimal complications and is preferred for diseases like multiple myeloma. 

Who requires BMT?

BMT is required for conditions mentioned below:

Blood cancers

• Multiple Myeloma
• Hodgkin Lymphoma
• Non-Hodgkin Lymphoma
• Acute Lymphoblastic Leukemia (ALL)
• Acute Myeloid Leukemia (AML)
• Chronic Myeloid Leukemia (CML)
• Myelodysplastic syndrome

Non Cancerous Conditions

• Thalassemia, sickle cell anaemia, transfusion dependent anaemia
• Aplastic anaemia
• Fanconi anaemia, pure red cell aplasia
• Metabolic disorders
• Immunodeficiency states