Welcome to the Rare Classroom, a new series from Patient Worthy. Rare Classroom is designed for the curious reader who wants to get informed on some of the rarest, most mysterious diseases and conditions. There are thousands of rare diseases out there, but only a very small number of them have viable treatments and regularly make the news. This series is an opportunity to learn the basics about some of the diseases that almost no one hears much about or that we otherwise haven’t been able to report on very often.

Eyes front and ears open. Class is now in session.

The disease that we will be learning about today is:

Cervical Cancer

What is Cervical Cancer?

• Cervical cancer is a form of cancer which originates from the cervix, the lower area of the uterus in the female reproductive system
• In early stages, generally no symptoms are present
• Cervical cancer typically develops gradually from precancerous changes to cervical tissue, called cervical intraepithelial neoplasia
• 90% of cases are classified as squamous cell carcinoma, while the remaining 10% are adenocarcinoma, with a very small percentage of other types
• Though generally uncommon, cervical cancer is the fourth most common cancer type in women and the fourth most common cause of cancer-related death in women
• The most famous immortalized cell line in scientific research, called HeLa, was developed from cancer cells from cervical cancer patient Henrietta Lacks

How Do You Get It?

• Infection with the human papillomavirus (HPV) is the most common cause of cervical cancer and the greatest risk factor, being directly linked to up to 90% of cases
  • HPV type 16 and 18 are linked to 75% of cases; types 31 and 45 contribute to around 10%
• Other risk factors for cervical cancer include beginning sexual activity at a young age, having a large number of sexual partners, immunodeficiency, having many pregnancies, smoking cigarettes, and the use of oral contraceptives
  • However, these risk factors are generally much less important than infection with HPV

What Are the Symptoms?

• Symptoms of cervical cancer are typically slow to appear
• In the early stages, cervical cancer often inflicts no symptoms
• As the disease progresses, symptoms can include:
  • Bleeding after sex
  • Vaginal bleeding
  • Vaginal mass (less common)
  • Vaginal discharge
  • Moderate pain during sex
• Indicators of advanced disease, particularly metastatic disease, include:
  • Fatigue
  • Weight loss
  • Appetite loss
  • Pelvic pain
  • Swollen legs
  • Back pain
  • Leg pain
  • Severe vaginal bleeding
  • Bone fractures
  • Discharge of urine or feces from the vagina (uncommon)

How Is It Treated?

• Surgery and radiation therapy are common approaches to the treatment of cervical cancer
• In recent years, options that leave a patient’s fertility intact have become more widely available
  • These are typically more feasible if the disease is detected and diagnosed at an early stage
• Chemotherapy is also used, typically alongside radiation, and this combination is generally regarded as more effective than radiation alone, improving overall survival and reducing the chance of recurrence
• If identified, the precancerous condition cervical intraepithelial neoplasia can also be treated effectively with various surgical approaches
• Microinvasive cancer may be treated with hysterectomy or trachelectomy; the lymph nodes may be removed as well
• Rates of survival in cervical cancer vary greatly and generally depend on the stage of cancer
  • Overall the five-year survival rate is 66%

Where Can I Learn More???

• Check out our cornerstone on this disease here.
• Learn more from the National Cervical Cancer Coalition.