Cervical Cancer: Risk Factors, Pathophysiology, Symptoms, Staging, Diagnosis, Treatment & Prevention

Summary

This video provides an in-depth look at cervical cancer, covering its stages, diagnosis, treatment options, and prevention strategies. The progression from precancerous lesions to advanced cancer stages is explained, with insights into colposcopy and FIGO staging. Treatment methods range from minor procedures for precancerous cells to surgery, radiation, and chemotherapy for later stages. The video emphasizes the importance of prevention through HPV vaccination and regular Pap smears, aiming to stop the virus before it causes cancer and detect precancerous changes early.

Takeaways

• 😀 Cervical cancer can be classified into different stages, starting with precancerous lesions (CIN1, CIN2, CIN3) and advancing to invasive cancer that may metastasize to other parts of the body, including lymph nodes, liver, lungs, and bones.
• 😀 Colposcopy is an important diagnostic tool used to visualize and evaluate the cervix for precancerous changes, often aided by applying acetic acid to highlight acetyl-white lesions.
• 😀 LEEP (Loop Electrosurgical Excision Procedure) and cone biopsy are common treatments to remove precancerous lesions and prevent progression to cancer.
• 😀 Potential complications of LEEP include shortened cervix, which can lead to pregnancy complications like preterm labor and infertility.
• 😀 Figo staging is used to classify cervical cancer, ranging from Stage 1 (localized) to Stage 4 (distant metastasis), with Stage 2 and beyond involving spread to adjacent structures.
• 😀 Stage 3 cervical cancer may involve the pelvic wall and lower third of the vagina, leading to complications like hydronephrosis due to ureter obstruction.
• 😀 Stage 4 cervical cancer indicates metastasis to distant organs, such as the bladder, rectum, liver, lungs, or bones.
• 😀 Treatment options for cervical cancer include surgery (hysterectomy, radical hysterectomy, lymph node dissection), radiation therapy, and chemotherapy, with the goal of reducing symptoms in later stages.
• 😀 In early-stage cervical cancer (Stage 0, CIN2-3), treatments like cryosurgery, conization, and radiation therapy are commonly used to treat pre-cancerous changes.
• 😀 HPV vaccination is a key method for primary prevention of cervical cancer, with vaccines like Gardasil protecting against high-risk HPV strains that cause most cervical cancers.
• 😀 Secondary prevention involves regular screenings (e.g., Pap smear) to detect precancerous lesions or early-stage cancer, with HPV testing helping to identify infections before cancer develops.

Q & A

What is the primary cause of cervical cancer?

Cervical cancer is primarily caused by persistent infection with high-risk strains of the human papillomavirus (HPV), especially types 16 and 18, which can lead to precancerous changes in the cervix.

What does CIN stand for, and how is it classified?

CIN stands for Cervical Intraepithelial Neoplasia, which refers to the presence of abnormal cells on the cervix. It is classified into CIN1 (mild dysplasia), CIN2 (moderate dysplasia), and CIN3 (severe dysplasia or carcinoma in situ), with CIN2 and CIN3 being more likely to progress to cervical cancer.

How is a colposcopy used in diagnosing cervical cancer?

A colposcopy is a procedure where a clinician uses a colposcope to closely examine the cervix, especially after applying a 3% acetic acid solution to reveal acetowhite lesions. These lesions indicate abnormal cells with higher nucleus-to-cytoplasm ratios, which are signs of potential precancerous changes.

What are the stages of cervical cancer, and how is it categorized?

Cervical cancer is staged using the FIGO system. Stage 1 is confined to the cervix and uterus, Stage 2 extends beyond the uterus to the upper two-thirds of the vagina or parametrium, Stage 3 involves the pelvic wall and lower vagina, and Stage 4 indicates distant metastasis to other organs such as the liver or lungs.

What is the difference between Stage 1a and Stage 1b cervical cancer?

Stage 1a cervical cancer is micro-invasive, meaning it is too small to be seen clinically, while Stage 1b is clinically visible and the lesion can be seen on examination.

What are the potential complications of LEEP (Loop Electrosurgical Excision Procedure)?

While LEEP can help remove precancerous lesions, it can cause complications such as a shortened cervix, which may lead to issues like pre-term premature rupture of membranes (PPROM), pre-term labor, and infertility, especially if performed in younger patients or those wishing to maintain fertility.

What are the primary methods used to treat advanced stages of cervical cancer?

Treatment for advanced cervical cancer (Stage 3 and Stage 4) often involves a combination of radiation therapy and chemotherapy for symptom management, as surgery is less likely to be effective at these stages. Surgery may still be considered in some cases for palliative care.

How does chemotherapy help in treating cervical cancer?

Chemotherapy is used to treat cervical cancer, especially in more advanced stages, to shrink tumors, prevent cancer from spreading, and manage symptoms. It may also be used in combination with radiation therapy to increase the effectiveness of treatment.

What are the two types of HPV vaccines mentioned, and what do they protect against?

The two types of HPV vaccines mentioned are **Gardasil** and **Cervarix**. Gardasil protects against HPV types 6, 11, 16, and 18, while Cervarix protects against HPV types 16 and 18, both of which are associated with a higher risk of developing cervical cancer.

What is the role of Pap smears in cervical cancer prevention?

Pap smears are used in secondary prevention to detect precancerous changes (dysplasia) in the cervix. While they are effective at identifying precancerous lesions, they may not always detect overt cervical cancer, so visual examination of the cervix is also important during the procedure.