Reviewed by: Zhu Jianqing (Zhejiang Provincial Cancer Hospital), Zheng Dayong (Southern Medical University Hospital of Integrated Traditional Chinese and Western Medicine)
Cervical cancer is one of the most easily preventable cancers in women and can be prevented through screening and immunization. And if detected early, the disease is curable. In addition to routine screening, there are other ways to detect precancerous cells early.
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1. Screening for cervical cancer
The most important measure to detect cervical precancerous cells is screening. Screening can detect changes in cervical cells before they become cancerous.
Most women aged 21 to 29 years need to be screened for cervical cancer using a cervical smear every 3 years. Women aged 30 to 64 years usually need to be checked every 3 to 5 years. If you are over 64 years of age, you can stop screening.
Obstetricians and gynecologists can perform a cervical smear examination during a routine pelvic examination, which has the advantage of being quick and painless. The patient lies flat on the examination table, and the doctor uses a peepometer to keep the vagina open so that the cervix can be observed. The doctor then uses a small brush to remove some cells from the cervix and send them to a laboratory for examination.
After the age of 30, human papillomavirus (HPV) should also be tested. HPV is one of the most common pathogens that cause sexually transmitted diseases, and almost all cervical cancers are caused by HPV infection. A positive HPV test does not necessarily mean that you have cervical cancer, but if you have cervical cancer, you will almost certainly have AN HPV infection.
Second, the symptoms of cervical cancer
Most women with early-stage cervical cancer do not have any symptoms. This also shows that cervical smear and HPV screening are very important. If symptoms of cervical cancer occur, there may be:
1. Abnormal vaginal bleeding (occurs between menstruations, after sexual intercourse or after menopause).
2. Menstrual volume is greater than normal.
3. Abnormal vaginal discharge containing blood may occur.
These symptoms do not necessarily indicate having cancer, and other diseases or infections may also cause the above symptoms. Patients should seek immediate medical attention to confirm the diagnosis.
3. Suspected cervical cancer
If the cervical smear is abnormal and other symptoms of cervical cancer appear, the gynecologist will ask the patient about the medical history and family history, and perform more tests to see if there are cancer cells in the cervical area, check the lymph nodes, and see if the cancer has spread.
4. Biopsy methods
1. Colposcopy: In this examination, the doctor will use the colposcope to look closely at the cervix. The doctor will let the patient lie flat on the examination table, use the voulometer to keep the vagina open, use a cotton swab to lightly dip the vinegar solution, wipe the cervix and vagina, the whole process the patient may have a slight burning sensation, but this can help the doctor to observe the presence of abnormal cells.
2. Cervical biopsy: During colposcopy, the doctor will remove small pieces of tissue examination. This is called a colposcopic biopsy.
Other types of biopsies include:
1. Biopsy forceps biopsy: Use a special biopsy forceps tool to remove the tissue.
2. Cervical ring electroresection (LEEP): Use an electrically heated wire ring to excise part of the cervical tissue.
3. Conical biopsy: an invasive biopsy method that facilitates doctors to collect tissue samples, usually implemented in hospitals. This approach can also treat some of the early stages of cervical cancer. Doctors use LEEP, a scalpel, or a laser to remove cervical tissue.
The cervical cells removed from the biopsy method described above are sent to a laboratory to check for cancer cells under a microscope. After the biopsy, the patient may have bleeding.
5. Cancer cell spread examination
If a biopsy shows cervical cancer, the next step is to determine whether the cancer has spread and where it has spread. Doctors may perform one or more of the following tests:
1. Cystoscopy and Rectoscopy: These tests use a luminescent catheter to see if the cancer has spread to the bladder and rectum.
2. Electronic computed tomography (CT): CT scans can show whether the cancer has spread to the lymph nodes, liver, lungs, or other parts of the body.
3. Magnetic resonance imaging (MRI): Doctors may use MRI to obtain clear images of the patient's body. MRI may detect cancer cells that have spread to the pelvic cavity, brain, or spinal cord.
4. Chest x-ray.
5. Positron Emission Computed Tomography (PET): Pet scans may be performed if doctors believe that cancer cells have spread, but are unsure of the location of spread. PET uses a type of radioactive sugar that cancer cells can absorb, and uses a special camera to detect cells that absorb sugar.
Sixth, cervical cancer staging
After obtaining all the test results, the doctor can determine whether the cancer cells have spread according to the results, as well as the extent of the spread, and finally determine the stage of the cancer. Staging is the classification of cancer based on the size of the cancer tissue and the site of spread at the time of diagnosis, and knowing the staging can help doctors plan the best treatment plan.
Stages of cervical cancer include:
Stage I: The cancer is confined to the cervix and has not yet spread to the lymph nodes or other organs.
Stage II: The cancer has spread to the cervix and outside the uterus and may have reached the upper vagina.
Stage III: The cancer has spread to the lower vagina or pelvic wall and has not yet spread to the peripheral lymph nodes.
Stage IV: This is the most advanced stage when the cancer has spread to other parts of the body, such as the bladder, rectum, lungs, or liver.
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