Cervical Cancer: Everything you need to know

Author: Dr. Tanaya Narendra, MBBS, MSc (Oxon)

So, you’ve probably heard of cervical cancer – on the TV, at your doctor’s clinic, on Instagram. But do you know what it is? Let’s talk about it!

The cervix is the entrance to the uterus. It’s a thick collection of muscle that looks like a donut and acts as the doorway to the uterus. It connects the main body of the uterus to the vagina. The cells of the cervix can sometimes develop cancer. Cancer is basically an uncontrolled growth of cells – usually this results in a tumour. When this uncontrolled cell growth happens in the cervix, it’s called cervical cancer.  

So, how does it happen? It’s important to know them because according to Globocan 2018, Cervical Cancer is the second most common cancer in Indian women! There are many risk factors for cervical cancer which are largely preventable. 

Cervical Cancer-Risk factors:

• Having a persistent infection with HPV (Human Papilloma Virus)
• Unprotected sex, especially with multiple partners
• Your partner having unprotected sex, especially with multiple partners
• Smoking
• Any conditions that lower your immunity (HIV, Cancer, etc)
• Having a sexually transmitted infection (STI)

So, as you can see, safe sex and not smoking are easy to implement in your life. It’s important to note here that you shouldn’t be under the wrong impression that being young will keep you safe. Jade Goody, a British celebrity, passed away from Cervical Cancer at the age of 27.

So, how do you know whether you or someone you know has it? When is it important that you go to a doctor?

Let’s discuss some symptoms!

• Vaginal bleeding after sex
• Bleeding between periods, or bleeding after menopause
• Unusual discharge, especially if it has a bad smell
• Pain when having sex

It’s important to be mindful of these symptoms, because often people don’t notice them until it’s too late. The symptoms that develop after spread of the disease include:

• Pelvic pain
• Trouble in peeing
• Weakness, lack of energy
• Loss of appetite

Okay, so how do I protect myself?

Aside from taking simple precautions like practising safe sex and not smoking, another great way of taking care of your cervical health is getting regular pap smears. If you’re over the age of 21, and you’ve had any sexual exposure, it’s useful to get examined by your gynaecologist every three years. Your gynaecologist will take some cells from your cervix, using a soft brush. Don’t worry, this is not painful. This can be combined with an HPV test to check for the presence of an infection with the HPV virus. Your gynaecologist will then send these cells to be examined under a microscope. Getting a follow up every three years is the recommendation from the Federation of Obstetric & Gynaecological Societies of India (FOGSI) and is a convenient way of taking care of your cervical health.

Aside from this, we are very lucky, because there is a vaccine available for protecting yourself from cervical cancer! Yes! A vaccine to prevent cervical cancer! This vaccine, called Cervarix, is available at your gynaecologist. It protects you from two strains of HPV that are responsible for 70% of cervical cancer. Another vaccine, called Gardasil, also protects you against two strains of HPV that are responsible for causing genital warts. You can choose whichever fits you best, or whichever is available to get. I personally recommend all my patients to get the vaccine early on, especially before their first sexual experience. 

The vaccine itself is given in two doses or three doses, over a period of six months, depending on the age of the patient. Your doctor will be able to tell you which one fits you best, and anyone with a cervix over the age of nine years of age can get the vaccine. This, however, doesn’t mean that you will have 100% protection against cancer. You will continue having to take basic precautions.

A few years ago we had a 37-year-old lady, Ms. X, come to our center in Allahabad – Abhilasha Hospital & Fertility Center, with a constant vaginal bleed. Having spoken to the patient, we found that she had sex with her boyfriend at the age of 19. At the age of 26, she came out of the closet as a lesbian. Given that she wasn’t having sex with men after her first boyfriend, Ms. X did not get any smears or HPV tests. Dr. Abhilasha Chaturvedi, the director and leading gynaecologist at Abhilasha Hospital & Fertility Center, recommended getting a smear and HPV test to Ms. X. She agreed, and we were surprised to learn that Ms. X had an HPV infection and had developed precancerous changes in her cervical cells! Presumably, she had been infected from her first exposure so many years ago? This was causing her vaginal bleed. 

So, the point is not to scare you. The point is to make sure we are aware and cognizant of our bodies. Don’t smoke, have safe sex, get your smears, and get your vaccine! Stay safe, stay healthy.

Good luck!