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Cervix Uteri Cancer

According to the National Cancer Registry report in 2002, cancer of the cervix uteri is the second most common form of cancer that strikes Malaysian women. It is uncommon before the age of 30 years old; the risk of developing it increases with age, with a peak incidence at ages 60 to 69 years, and declining thereafter.

Risk Factors
Sexual intercourse is a major factor in the causation of this cancer, specifically a woman’s age at first intercourse, the number of her sexual partners and parity. It is thought that a transmittable virus is central to the cancer, and herpes and the human papilloma virus have been implicated.

The most common complaints are bleeding after sexual intercourse and bleeding in between periods. Sometimes the bleeding may be severe, leading to anaemia. Other symptoms include difficulty in breathing when exercising, increased tiredness, and occasionally, a foul smelling vaginal discharge.

If the disease progresses it may infiltrate the bladder, causing blood in the urine. It may also spread to the rectum, causing rectal bleeding and pain when passing motion.

If you do have these symptoms, see your gynaecologist for further evaluation.

Examination of the cervix is important to assess the status of the disease. If an abnormality is discovered, a biopsy would be necessary to confirm the diagnosis of cancer of the cervis uteri.

Once this is confirmed, it is important to determine the full extent of the cancer. This may involve an examination under anaesthesia and CT scan of the abdomen and pelvis. Further treatment will depend on the extent of the spread of the cancer.

In early disease, radical surgery and radical chemo-radiotherapy are equal treatment options. Where disease is more advanced, chemo-radiotherapy will be the preferred choice of treatment.
Consult your gynaecologist and oncologist for further evaluation.

The outcome of treatment is dependent on stage of the disease. The probability of curing cancer progressively decreases as the disease advances.

Thus, it is important to detect the disease early and initiate treatment to optimise the chances of cure.

Early Detection
This cancer is the most amenable to early detection by mean of screening. A pap smear and the ThinPrep procedure is widely available.

This should be done regularly and certainly in all sexually active women. The frequency is yearly for 3 years and provided that this is 3 yearly after that for life.

  By Dr Matin Mellor  

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