Cervical cancer: Squamous cell carcinoma of the cervix

• What is Cervical Cancer (Squamous Cell Carcinoma of the Cervix)
• Statistics on Cervical Cancer (Squamous Cell Carcinoma of the Cervix)
• Risk Factors for Cervical Cancer (Squamous Cell Carcinoma of the Cervix)
• Progression of Cervical Cancer (Squamous Cell Carcinoma of the Cervix)
• Symptoms of Cervical Cancer (Squamous Cell Carcinoma of the Cervix)
• Clinical Examination of Cervical Cancer (Squamous Cell Carcinoma of the Cervix)
• How is Cervical Cancer (Squamous Cell Carcinoma of the Cervix) Diagnosed?
• Prognosis of Cervical Cancer (Squamous Cell Carcinoma of the Cervix)
• How is Cervical Cancer (Squamous Cell Carcinoma of the Cervix) Treated?

What is Cervical Cancer (Squamous Cell Carcinoma of the Cervix)

Cervix cancers may be of the Squamous Cell Carcinoma type and usually arise from the epithelium lining the cervix. 90% of all carcinomas of the cervix are of the squamous cell type. The cervix is the extension of the uterus into the top part of the vagina. A small passage through the middle of the cervix leads into the cavity of the uterus. In a normal situation, squamous epithelium lines the cervix from this opening outwards. The inside of the cervix normally has a more fragile epithelium lining, which under normal circumstances is not exposed to the environment. Certain hormonal changes such as pregnancy and the oral contraceptive pill may cause the inner lining from inside the cervix to migrate outwards to be visible on the outside of the cervix. This is sometimes referred to as an erosion by doctors. For more health information on cervical cancer visit your local doctor.

Statistics on Cervical Cancer (Squamous Cell Carcinoma of the Cervix)

Cervical cancer is common and occurs during child bearing years, usually in the 20’s, 30’s or 40’s with sex incidence being obviously in females. Geographically, the cervical tumour is found worldwide but it is especially common in women in the western world.

Risk Factors for Cervical Cancer (Squamous Cell Carcinoma of the Cervix)

The number one predisposing factor for cervical cancer is infection with the Human Papilloma Virus (HPV). Any factor which increases a woman’s risk of contracting Human Papilloma Virus will increase the risk of cervical cancer. These following factors increase a womans risk of getting Human Papilloma Virus (HPV):

• Intercourse without barrier contraceptives.
• Multiple sexual partners.
• Sex with a partner that has penile warts.
• Cigarette smoking doubles a womans risk of getting cervical cancer.

Progression of Cervical Cancer (Squamous Cell Carcinoma of the Cervix)

This type of cervical tumour spreads by lymphatic spread to local and then regional lymph nodes. Blood borne malignant cells spread to bone and lung.

How is Cervical Cancer (Squamous Cell Carcinoma of the Cervix) Diagnosed?

Cervical cancer general investigations may show no abnormality.

Prognosis of Cervical Cancer (Squamous Cell Carcinoma of the Cervix)

Since the introduction of the PAP Smear as a cervical cancer screening test, the number of people dying from cervical cancer has dramatically fallen. The vast majority of potential cancers of the cervix are picked up in the early dysplasia stage. This allows cervical cancer treatment to take place before cancer has actually developed. When invasive cervical cancer has become established, the vast majority of patients will survive 1 year. About 70% of patients will still be alive at 5 years.

How is Cervical Cancer (Squamous Cell Carcinoma of the Cervix) Treated?

Cervical cancer is usually preventable with regular PAP smear screening for cervical cancer. This allows the very earlier stages of the disease dysplasia to be treated which can then prevent the development of the more aggressive cervical cancer cancer. The abnormal cells can be destroyed with a freezing probe or by powerful laser beams which destroy the abnormal cells. In some parts of the world a technique called “needle and ball diathermy” is used, which heats the abnormal cells and kills them. For more severe forms of dysplasia which are closer to becoming frank cancer or for carcinoma in-situ, the treating doctor will advise on whether a local procedure such as cone biopsy will be best or whether more extensive surgery such as hysterectomy should be carried out. A lot of this will depend upon age and child bearing status. For invasive cervical cancer, the mainstays of treatment are surgery to remove the cervix, uterus, tubes and ovaries together with a small segment of vagina and/or radiotherapy. There are a number of ways of giving radiotherapy: from shining it from externally (external beam radiation) to putting radioactive implants into the top of the vagina which gives local radiotherapy, to the area where it is needed most. Please see our radiotherapy section for further details. Improvement in cervical cancer symptoms is an important measurement. Specific monitoring may be by regular colposcopy to check on the state of the existing cervical cells. In advanced cervical cancer, imaging is useful in measuring the response of metastases to treatment. The cervical cancer symptoms that may require attention are pelvic pain from locally advanced disease. Diarrhoea may be a complication of treatment for this disease. Somatic pain from bone metastases may cause problems as may visceral pain from liver or lung metastases. It must be remembered that CIN, carcinoma in situ and early invasive carcinoma are usually completely asymptomatic (ie. have no symptoms). If discharge is present, it may sometimes be malodorous and this may be improved by the administration of antibiotics with anti-anerobic activity. The chemotherapy protocols are as follows: 1) Cisplatin as a single agent, Cisplatin 100mg/m2 day 1 (repeat every 3 weeks). 2) Ifosfamide 5000 mg/m2 24 hour infusion day 1 with Mesna 5000 mg/m2 3) Combination Therapy: – Cisplatin 50 mg/m2 iv – Ifosfamide 5000 mg/m2 25 hr infusion – Mesna 5000 mg/m2 4) Combined Chemoradiotherapy: – Cisplatin 70 mg/m2 iv – 5-Fluorouracil 1000 mg/m2 iv cont inf 96 hours – With RT repeat every 3 weeks For more health information on cervical cancer visit your local doctor.