All About Cervical Cancer Dr. Ha Joong-gyu, Professor of Obstetrics and Gynecology at Daejeon Eulji Medical Center, Eulji University

Cervical cancer can occur in any women who have ever had sex. It was typically found in pre- or postmenopausal women in their 40s and 50s, but more recently, it is becoming more common in younger women. Let’s learn more from Dr. Ha Joong-gyu, Professor of Obstetrics and Gynecology at Daejeon Eulji Medical Center, Eulji University.

So let’s learn the facts and myths about diabetes from Dr. Hong Jun-hwa, Professor of Endocrinology at Daejeon Eulji Medical Center, Eulji University.

Q1. Where does cervical cancer occur?

The uterus is a part of the female reproductive system where a fertilized egg gets implanted and grows. It consists of the corpus (body) and the cervix. A malignant tumor occurring in the cervix, which is connected to the vagina, is called “cervical cancer,” which is the second most common type of cancer occurring in women worldwide.

Q2. Why do you think cervical cancer is being diagnosed in younger women?

Due to better nutrition than in the past, the development of secondary sex characteristics is occurring at younger ages. Also, due to the widespread use of the Internet and smartphone, people are having their first sexual intercourse at younger ages, yet proper sex education is not being provided. The transformation zone where cervical cancer develops is located on the outer surface of the cervix in the adolescent years, so it is more susceptible to infection and thus there is a higher risk of developing cervical cancer.

Q3. Are there any particular signs and symptoms prior to onset?

It’s almost asymptomatic in the early stages. Some say they experienced “uterine pain,” but if you experience pain in the pelvic area, you might dismiss it as a type of menstrual cramps. A clear sign of cervical cancer is slight vaginal bleeding after sexual intercourse. However, this symptom, in many cases, appears after the cancer has progressed to a certain extent, rather than in the early stages. When there is secondary infection, there will be an unpleasant odor, difficulty in urination, blood in urine, rectal bleeding, edema in the legs, weight loss, and so on.

Q4. Are the causes of cervical cancer known?

It is probably the one and only cancer, the cause of which is known. Cervical cancer is mainly caused by human papillomavirus (HPV) that is transmitted sexually. It has been reported that in more than 99.7% of cervical cancer patients, high-risk HPV infections were discovered. HPV is common, with around 80% of sexually active women becoming infected at least once in a lifetime. It takes years or decades until it progresses into cancer after infection.

Q5. What are the characteristics of HPV?

There are more than 150 types of HPV, which are divided into low-risk and high-risk types. Two low-risk types of HPV, types 6 and 11, cause genital warts. High-risk types – namely, types 16 and 18 -- lead to cervical cancer. Most of them die within around 5 years, but continuous infection increases the risk of cervical cancer.

Q6. What are the possible treatment methods?

For stage 1 to early stage 2 cervical cancer, both surgery and chemo-radiation are possible. From late stage 2, one of the two options gets chosen. This is because research has shown that there is no significant difference in the survival rate between surgery and chemo-radiation. In most cases, chemo-radiation is chosen over surgery. Possible methods of surgery include laparotomy, laparoscopy, and robot-assisted surgery. Most women do not want visible scarring afterwards, so there is high demand for surgery that leaves behind minimal scarring. So patients are also given the option of single-port access laparoscopic surgery, which involves making just one hole in the body, or surgery through the vagina.

Q7. Since the cause is known, is it preventable?

Cervical cancer is the only cancer where a vaccine is available. So getting vaccinated against HPV is essential. However, the vaccination rate is only around 55 to 60%. There was controversy over adverse effects from HPV vaccines in Japan a few years ago, but according to the Korea Centers for Disease Control and Prevention (KCDC), there have been any cases of serious adverse reactions resulting in a disability or death from HPV vaccines. The reported adverse reactions were either temporary or minor in most cases. The adverse effects were comparable to those of flu shots. Therefore, it is advised that both men and women aged 9 to 29 get vaccinated against HPV. But middle-aged women aged 30 and over can also become newly infected, and getting vaccinated later doesn’t mean it will be ineffective. So it is advised that you speak to a medical specialist and get vaccinated before the age of 45.

Q8. What other ways, aside from vaccination, can women prevent cervical cancer?

Regular checkups are necessary. Having your first sexual intercourse later in life, minimizing your sexual partners, and other safe sex practices will help prevent the disease.

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