Cervical Cancer in Singapore
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Cervical cancer is one of the top ten most common cancers among women in Singapore. Often, women who develop cervical cancer are unaware they have it because symptoms do not show until much later. Protect yourself and your young daughters by keeping a lookout of this disease. If possible, get them vaccinated early and for yourself, do a pap smear test regularly for early detection of cervical cancer.
Here’s all you need to know about cervical cancer from its stages, treatment options and ways to lower your risks of getting this cancer.
What is cervical cancer?
Cervical cancer is a cancer that forms in the cervix. The cervix is an organ that connects the uterus and vagina. In Singapore, cervical cancer is the 10th most common cancer among women. While there are different types of cervical cancer, the most common type is squamous cell carcinoma (SCC). It constitutes about 80 – 85% of all cervical cancers and is usually caused by an infection by the human papilloma virus (HPV).
What causes cervical cancer?
A HPV infection is the most common cause of cervical cancer. As cervical cancer arises from the cervix, HPV can infect the cervix too. This is because infection from HPV can persist and cause cells in the cervix to grow in an abnormal way, thus developing into cervical cancer. Specifically, HPV types 16 and 18 cause about 70% of cervical cancer cases.
As such, sexually active women risk a chance of getting infected. Women with multiple sexual partners risk an even higher chance. Finally, women who start having unprotected sexual intercourse from a young age are the most at risk.
Is there a vaccine for cervical cancer?
Yes, however the vaccine only works if it’s administered before infection occurs. Thus, this vaccine is targeted at young females. However, having a vaccine does not mean that you are entirely shielded from cervical cancer; the vaccine only covers certain types of high risk HPV. As such, women are advised to have regular pap smear tests even after vaccination.
What are the symptoms of cervical cancer?
Cervical cancer typically does not carry any symptoms during the early stages. As it progresses, signs and symptoms include:
- Vaginal bleeding after intercourse
- Vaginal bleeding in between periods or after menopause
- Watery, bloody vaginal discharge that carry a foul smell
- Lower abdominal pain or pain during intercourse
- Leaking of urine or faeces
What are the stages of cervical cancer?
Cervical cancer is a slow, developing cancer. It usually begins from abnormal cells in the cervical tissue from HPV infection. Over time, the abnormal cells may develop into cancerous cells and multiply and spread more deeply into the cervix and surrounding areas.
Some women develop cervical intraepithelial neoplasia (CIN), which are basically lesions that do not invade the tissue of the cervix. CIN is at the superficial area of the cervix and graded as mild, moderate or severe. Not all women with HPV infections develop CIN. It’s important to note that not all women with CIN develop cervical cancer too.
- Stage one cervical cancer — the cancer has invaded the cervix, but not outside of the cervix yet.
- Stage two cervical cancer — the cancer has spread to the vagina or the sides of the cervix.
- Stage three cancer — the cancer has spread to the lower part of the vagina, sidewall of the pelvis and caused blockage of the kidney
- Stage four cancer — the cancer has extended to other organs like the liver, lungs, lymph nodes, bowel or bladder
How is cervical cancer diagnosed?
During a cervical cancer screening, the doctor will gently brush cells from the narrow of the cervix to collect samples. The samples will then be sent to a lab for testing.
For women aged 25-29, a Pap test can be done to detect the precancerous stage of cervical cancer. This is when the abnormal cells in the outer layer of the cervix have not spread to the deeper tissues.
For women aged 30 and above, a HPV test is done to detect high-risk cancer-causing strains. A HPV test is more efficient for women aged 30 and above.
What are the treatment options for cervical cancer?
Cervical cancer can be treated effectively if detected early. Treatment is almost 100% effective too and is relatively simple. Early stage cervical cancer treatment options include:
- Cone biopsy (conisation)
- Laser surgery
- Loop electrosurgical excision procedure (LEEP)
For more serious stages of cervical cancer, treatment options include:
- Radical hysterectomy: This is a surgery done to remove the uterus and cervix. Reproductive organs such as the ovaries and fallopian tubes may also be removed, depending on severity of the condition.
- Radiation therapy: High-powered energy is used to kill cancer cells. This high-powered energy can be given externally using external beam radiation or internally by placing devices filled with radioactive material near the cervix.
- Chemotherapy: Cancer cells are killed with strong anti-cancer chemicals.
Are there ways to prevent cervical cancer?
To reduce your risk of cervical cancer, women are encouraged to have regular pap smear tests. Pap smear tests are the most effective way to detect cervical cancer early. Other ways include delaying sexual intercourse and having fewer sexual partners.
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