Hyderabad: In a tragic turn of events, Sherika De Armas, the former Miss World contestant who represented Uruguay in the 2015 pageant held in China, lost her battle with cervical cancer at the young age of 26. Cervical cancer, the fourth most common cancer among women worldwide, claimed the life of this promising young woman, shedding light on the critical need for greater awareness, prevention, and early detection of this disease.
Cervical cancer is a formidable adversary that begins its insidious journey in the cells of the cervix, the lower part of the uterus connecting to the vagina. It typically progresses slowly, often preceded by precancerous changes known as dysplasia, which serve as a warning sign before the onset of cancer. Alarmingly, nearly all cases of cervical cancer (99%) are attributed to high-risk human papillomaviruses (HPV), the most common viral infection of the reproductive tract, primarily transmitted through sexual contact.
Understanding the Cervix:
To comprehend the gravity of cervical cancer, it is imperative to grasp the intricacies of the cervix. This vital organ is a muscular, tunnel-like structure situated in the lower part of the uterus, bridging the gap between the uterus and the vagina. The cervix consists of two main components:
The Ectocervix (Exocervix): This is the outermost part of the cervix, visible during gynecological examinations, and it is covered with thin, flat cells called squamous cells.
The Endocervix: This is the inner portion of the cervix, forming a canal connecting the vagina to the uterus. It is lined with column-shaped glandular cells that produce mucus.
The critical juncture where the endocervix and ectocervix meet is referred to as the squamocolumnar junction or the transformation zone, where the majority of cervical cancers originate.
Types of Cervical Cancer:
Cervical cancer manifests in various forms, but the two primary types are:
Squamous Cell Carcinoma: This is the most prevalent form, accounting for up to 90% of all cervical cancers. Squamous cell carcinomas develop from cells in the ectocervix.
Adenocarcinoma: These cancers arise in the glandular cells of the endocervix. A rare subtype of adenocarcinoma is clear cell adenocarcinoma, also known as clear cell carcinoma or mesonephroma.
In some cases, cervical cancer can exhibit features of both squamous cell carcinoma and adenocarcinoma, termed mixed carcinoma or adenosquamous carcinoma. Although rare, cancer can also originate from other cells in the cervix.
The Elusive Symptoms:
One of the most insidious aspects of cervical cancer is its tendency to remain asymptomatic in its early stages. However, as the disease progresses within the body, a series of distressing symptoms may emerge. These include:
- Vaginal bleeding after intercourse and menopause.
- Increased menstrual bleeding, often accompanied by heightened pain.
- Watery vaginal discharge.
- Pelvic pain, which can be indicative of advanced stages of the disease.
These symptoms serve as red flags and underscore the importance of regular screenings and check-ups to detect cervical cancer at its earliest, most treatable stage.
Treatment Modalities:
Cervical cancer treatment varies based on the type of cancer and its stage of development. Common treatment options include:
- Surgery: Surgeons remove cancerous tissue through various surgical procedures aimed at eradicating the malignancy.
- Chemotherapy: Specially designed medications are employed to shrink or eliminate the cancer. These drugs can be administered orally or through intravenous injections, or a combination of both.
- Radiation Therapy: High-energy rays, akin to X-rays, are utilized to target and destroy cancer cells, often complementing surgery or chemotherapy.
The Power of HPV Vaccination:
A ray of hope in the fight against cervical cancer comes in the form of HPV vaccination. The World Health Organization (WHO) has prequalified four vaccines that offer protection against HPV types 16 and 18, responsible for causing at least 70% of cervical cancers. One of these vaccines even extends protection against five additional oncogenic HPV types, which contribute to an additional 20% of cervical cancer cases. Notably, two of these vaccines also safeguard against HPV types 6 and 11, which are responsible for anogenital warts.
