Globally, cervical cancer is a common disease, ranking seventh among all cancers with over 500,000 women diagnosed ever year. In the United States, incidents are fewer–approximately 12,000 new cases diagnosed each year—but African-American women are succumbing to the disease more often than any other minority. January is Cervical Cancer Awareness Month. Dr. Daniela Matei, medical oncologist at the IU Health Simon Cancer Center, answers questions about the disease.
What is cervical cancer?
Cervical cancer begins in the lining of a woman’s cervix, where abnormal cells begin to multiply. The cervix is the lower part of the uterus that connects a woman’s womb to the birth canal. Cervical cancer is often diagnosed early- through regular, preventative screening at regular OB/GYN appointments – and is typically diagnosed in women between the ages of 20-50.
Is cervical cancer hereditary?
There is no known family predisposition to cervical cancer. This type of cancer is typically caused by environmental factors—in particular by the human papillomavirus (HPV), a sexually transmitted disease linked to 80 percent of cervical cancers. Some women are able to fight off HPV through their own immunity, but if the virus is not eliminated, it causes changes in the surface cells. These abnormalities and the associated persistent inflammation can lead to the initiation of cancer.
Is cervical cancer preventable?
Cervical cancer is highly preventable. The approved screening is a regular Pap smear, recommended for all women from age 21 until age 65. This screening detects not only cancer, but importantly, pre-cancerous lesions that have the ability to transform into cancer. If a physician detects these lesions early, they can be treated locally with minimally invasive procedures in order to prevent them from becoming cancerous. The screening is usually provided during routine exams by a woman’s OBGYN or primary care physician. The Pap smear is a painless and relatively inexpensive procedure in which the physician swabs tissue from the cervix and examines the sample under the microscope for abnormal cells. Women typically receive a Pap smear every three years unless an abnormality is detected, in which case more close monitoring or interventions are necessary.
Who is most at risk for cervical cancer?
All women are at risk of cervical cancer, but African-American women have a higher incidence of cervical cancer by about 30 percent compared to the general population. Also, there is an increased rate of death from the disease among African-American women – 4.9 deaths per 100,000 cases versus 2.6 deaths for the general population. In fact, it’s the highest cervical cancer death rate for all ethnicities. This can be reversed with regular checkups and screening with their physicians. Detected at an early stage, most women survive cervical cancer. But once the disease spreads beyond the cervix and the pelvic cavity, it is highly fatal.
What is the treatment for cervical cancer? Can women maintain fertility?
For early stage cervical cancer, surgery is an option for removing the tumor. This can even be accomplished through minimally invasive surgery—just removing the affected portion of the cervix—so women may retain fertility and still have children. In more advanced cases, treatment involves radiation along with chemotherapy. The earlier stage in which the cancer is detected, the higher the chances are of curing the disease.
What is new in the treatment of cervical cancer?
This past year, there was a breakthrough with the approval of the drug Bevacizumab to be used in combination with chemotherapy to treat metastatic cervical cancer. This was an important development, after two decades of no new drugs introduced for cervical cancer. It has changed the standard of care for stage 4 cervical cancer by introducing a combination of chemotherapy and this novel agent, which prevents formation of new blood vessels, leading to “starvation” of the tumor. The combination treatment improves responses to chemotherapy and prolongs the survival of women with advanced cervical cancer.
