A permanent cure is possible, and the sooner the cancer is detected the better the results.
One woman in five will develop cancer during her life. Twenty percent of these cancers will be in the breast, and 10 percent in the cervix or neck of the womb.
Both these sites can be inspected easily, and a third of the cancers could be found at an early stage if women would present themselves for regular examination. The earlier a cancer is detected, the better the results of treatment.
Chronic irritation to the cervix is regarded as the main cause of a cancer developing in this area. It appears to be caused by different things and to behave differently from cancer of the body of the womb.
Cancer of the cervix can occur in teenagers but is not common at this age. It reaches its peak in the late 30s and is then common for the rest of the life span.
The younger a girl starts having sexual intercourse and the more partners she has the more risk she runs of developing this type of cancer. Virgins rarely develop this cancer. So I suppose there is some health advantage to not “sleeping around.”
The more children a woman has, the higher her risk for cervical cancer. In cancer of the breast, the reverse applies – this malignancy is commoner in those who have never had children.
Cervical cancer is also rare in Jewish women.
It has been thought that there is a carcinogenic or cancer-causing chemical in smegma, a thick secretion from under the foreskin. This is not present in those men who have been circumcised. However, there is also some conflicting evidence about circumcision and the incidence of cancer of the cervix.
The herpes virus which causes cold sores is divided into two sub-types. Herpes sub-type 2 virus or herpes genitalis can cause infection in both men and women and is spread from person to person by sexual contact – it is one of the venereal diseases.
It is thought that infection of the cervix with this virus can lead to irritation and then to cancer.
Chronic cervicitis or inflammation of the cervix is so common as to be almost normal in women who have had children. It also occurs in many women who have never been pregnant.
Sometimes this inflammation produces no symptoms and is found only when the woman has an examination. In others, it causes a discharge which may be smelly or large enough to take the woman to her doctor for treatment.
Routine screening examinations can pick up cancer of the cervix at an early stage and so lead to more effective treatment. Once they become sexually active, all women should have regular pelvic examinations and the Papanicolaou smear test.
With this test, a wooden spatula is used to take a scraping from the cervix.
The cells are then examined under the microscope. The test does not hurt, it is easy to do and takes little time.
The slide containing the cells is sent to a laboratory for the examination. If the doctor uses a private laboratory the patient has to bear the cost, but most of this is recoverable through a medical fund. If the doctor uses the State Cytology Service there is no charge to the patient beyond her doctor’s normal fee.
Sometimes when the report comes back it may state that there are abnormal cells present. This may worry the woman but it does not mean cancer. It is evidence of inflammation, and usually, the doctor will repeat the test just to be sure.
Cancer can start in the cervix and be confined to the thin layer of superficial cells, with no local spread. This is called carcinoma in situ, which means the cancer is confined to the layer of tissue in which it has formed.
It is believed that carcinoma in situ may be present for up to 10 years before becoming active and spreading through the tissues locally or through the blood or lymph vessels to elsewhere in the body.
In its early stages, cancer of the cervix may not show any symptoms, and if it is small or in its beginning stage the doctor may not recognize it on examination. But if a smear test is taken, the cancer cells will be recognized under the microscope.
Once the cancer is active, it usually shows itself by abnormal bleeding. A woman may notice bleeding between her periods, or bleeding may follow intercourse. In those women whose periods have stopped, any bleeding should be investigated.
None of these symptoms means that there must be a cancer, but they all require an examination to make sure.
If the smear report is suspicious, the doctor may take a small punch biopsy from the cervix. This tissue is then examined.
Sometimes a cone biopsy is needed. In this, a cone of tissue is taken from around the cervix opening which leads inside to the body of the uterus.
The treatment of the cancer depends on how far it has developed and spread. Carcinoma in situ may not require any more treatment than the cone biopsy.
In a young woman who wants further children, this may be allowed as long as regular and frequent smears are taken. When she has had the desired number of children the womb is removed to prevent the cancer coming back.
There are two forms of treatment for cancer – surgery and radiotherapy. Which is chosen in a particular case depends on the stage of development of the cancer and the choice and experience of the doctor.
Chemotherapy or using chemicals to kill the cancer cells may be used in the initial treatment with operation or radiation, or it may be saved for use should the cancer recur or spread.
Cancer of the cervix can be cured permanently if it is found early enough. And it could be found in time if only women would make use of the facilities available.
All women, including young girls if they are sexually active, should have an internal examination and a smear test every two years or more often if their doctor recommends it.