Know the Causes of Cervical Cancer and How to Treat It

According to WHO data, this one disease is claimed to be the fourth most common cancer in women. Nevertheless, the symptoms of cervical cancer actually cannot be felt clearly.

Cervical cancer is known to start showing characteristics when the initial cells have turned into cancer. Furthermore, cervical cancer can also be examined until it is detected using a pap smear test.

1. Definition

Cervical Cancer is a malignancy that occurs in the neck of the uterus / cervix which 95% of cases are caused by HPV. Human Papilloma Virus (HPV) infection is common in women of reproductive age. This infection can persist, develop into dysplasia or heal completely. There are two classes of HPV, namely high-risk HPV or so-called oncogenic HPV, namely mainly types 16, 18, and 31, 33, 45, 52, 58; while low-risk HPV or non-oncogenic HPV, namely types 6, 11, 32, etc.

2. Risk Factors

Factors that expose women to HPV (as the etiology of cervical cancer) are: 

1. Married / starting sexual activity at a young age (less than 20 years). 
2. Changing sexual partners. 
3. Having sex with men who frequently change partners. 
4. History of infection in the genital area or pelvic inflammation. 
5. Women who have given birth to many children. 
6. Female smokers have a two and a half times greater risk of developing cervical cancer than non-smokers. 
7. Women who become passive smokers (who live with families who have a habit of smoking) will increase their risk 1.4 (one point four) times compared to women who live with free air. 
8. Women who have had screening examinations (Papsmear or IVA) will reduce the risk of developing uterine neck cancer.

3.   Early Detection

There are several known methods for screening for cervical cancer. The purpose of screening is to find precancerous lesions. Some of these methods include: 

1. Visual Inspection with Acetic Acid Application (VIA) Examination by observing using a speculum, looking at the cervix that has been smeared with acetic acid or vinegar (3-5%). Precancerous lesions will display a white spot color called acetowhite epithelium. 
2. Cytologic Examination (Papanicolaou/Papsmear) Is a simple examination procedure through cytopathologic examination, which is carried out with the aim of finding morphological changes in cervical epithelial cells found in precancerous and cancerous states.

4. Clinical Symptoms

Pre-cancerous lesions and early cancers are usually asymptomatic and can only be detected by cytologic examination. Boon and Suurmeijer reported that as many as 76% of cases are asymptomatic. If cancer has occurred, symptoms will arise according to the disease, which can be localized or scattered. Symptoms may include post-coital bleeding or bleeding outside the menstrual period or post-menopause. If the tumor is large, infection may occur and cause smelly discharge (duh) flowing out of the vagina. If the disease is advanced, there will be pelvic pain, symptoms related to the bladder and colon. Other symptoms may include disorders of the affected organs such as the brain (headache, loss of consciousness), lungs (congestion or coughing up blood), bones (pain or fracture), liver (right upper abdominal pain, jaundice, or swelling, etc.).

5. Therapy

In lesions with mild dysplasia, most lesions can heal on their own or spontaneously regress, while for moderate and severe dysplasia, the following treatment alternatives can be carried out: - Freezing/cryotherapy - Excision therapy: Loop Electrosurgical Excision Procedure (LEEP) - Large Loop Excision of the Transformation Zone (LLETZ) - Cone biopsy/conization - Hysterectomy, can be done in NIS III if the patient has enough children.

Sumber : PERATURAN MENTERI KESEHATAN REPUBLIK INDONESIA NOMOR 34 TAHUN 2015 TENTANG PENANGGULANGAN KANKER PAYUDARA DAN KANKER LEHER RAHIM