What Is Cervical Cancer?


Pray to people have cancer in the world. Cervical cancer is a cancer that appears in the cervix of women. The cervix itself serves as the entrance to the uterus from the vagina. All women of all ages
are at risk for cervical cancer. But, this disease tends to affect women who are sexually active. In the early stages, cervical cancer usually has no symptoms. The most common symptoms of cervical caner are vaginal bleeding, does not mean you have cervical cancer. To ascertain the cause of your condition, immediately ask your doctor. If cervical cancer is suspected, referral to a specialist will be given.

Human Papillomavirus as the Main Cause of Cervical Cancer
Almost all cases of cervical cancer are caused by human papillomavirus or HPV. HPV is a collection of virus types that cause warts in the hands, feet, and genitals. There are many types of HPV, most of which are harmless viruses. But there are several types of HPV that interfere with cervical cells to function normally and can eventually trigger cancer. HPV is very commonly transmitted through sex and can be a cause of cervical cancer .

Of the many types of HPV, there are two types of HPV virus is the most dangerous, namely HPV 16 and HPV 18. Both types of this virus that causes 70 percent of cases of cervical cancer. Many women are unaware of being infected, because this type of HPV does not cause symptoms. It is important to realize that this infection often occurs, although many infected women do not have cancer.

Condoms can protect you from HPV during sex, but not always perfect in preventing infection. When infected with HPV, the female immune system prevents the virus from injuring the uterus, but in some women, the HPV virus can last for years. This results in cells that are on the surface of the cervix turned into cancer cells.

Vaccines to prevent HPV infection at risk of causing cancer are readily available. Current HPV vaccination is a bivalent vaccine for HPV 16 and 18; quadrivalent vaccine for HPV 6, 11, 16 and 18; or nonavalent vaccine for 9 HPV types ie 4 types plus 31,33, 45, 52, and 58.

The Importance of Screening Steps for Detecting Cervical Cancer
For years, cells on the surface of the cervix have undergone many changes. These cells can slowly turn into cancer, but actually cell changes in the cervix can be detected early on. Treatment when the cells are still in the pre-cancer stage can be done so that the risk of cervical cancer can be reduced.

Screening for cervical cancer is also known as pap smear or smear test. Pap smears are useful for detecting if there are abnormal cells that potentially turn into cancer cells. When performing pap smears, cell samples are taken from the cervix and examined under a microscope .

Cervical screening is not a test for diagnosing cervical cancer . This test is useful to check the health of cells in the cervix and to detect if any cells are abnormal. With the detection and removal of abnormal cells, cervical cancer can be prevented optimally. In most women, the test will show normal results. But about 5 percent of tests show abnormal changes in cervical cells.

These changes mostly do not lead to cancer, and abnormal cells may still return to normal by themselves. But, in some cases, cells that are abnormal need to be removed because of the potential to turn into cancer.

An abnormal smear test result does not mean a person has cervical cancer. Most abnormal results are caused by infection or the presence of cancer-risk cells that can be handled easily. It is recommended that women who are sexually active and aged 25-49 years are examined every three years. While women aged 50-64 years can be checked every five years. Call your doctor to find out more about this checkup.

Stadium Level Determines Cervical Cancer Treatment
Treatment of cervical cancer depends on several factors. Cervical cancer can be treated by surgery if the diagnosis is done at an early stage. In some cases, only the cervix is ​​removed and the uterus can be left alone. In more serious conditions, the uterus needs to be completely removed. The surgical process for removal of the uterus is called a hysterectomy.

While the radiotherapy procedure is an alternative step for early stage cervical cancer. In certain cases, radiotherapy can also be run side by side with surgery. For advanced cases of cervical cancer, usually treated with a combination of chemotherapy and radiotherapy. Some treatments can have severe and long-term side effects, including early menopause and sterility.

Complications Due to Cervical Cancer
Complications often occur in women with cervical cancer. Complications can arise as a direct result of cancer or the side effects of the treatment performed. For example because of radiotherapy, surgery, or chemotherapy. Complications of cervical cancer are:
  • Complications are minor : small bleeding in the vagina and / or frequent urination.
  • Severe complications : severe bleeding and even renal failure.

Life Expectancy of Cervical Cancer Patients
The future of cervical cancer is determined by the diagnosis of the stage of cervical cancer received. Stage of gradual cervical cancer from one to four, where it describes the extent and development of cancer. The survival rate is at least five years after the diagnosis of cervical cancer, grouped into staging status:
  • Stadium 1 - 80-99 percent
  • Stage 2 - 60-90 percent
  • Stage 3 - 30-50 percent
  • Stage 4 - 20 percent
There is no one special way to prevent cervical cancer . But there are still some ways to reduce the risk of this cancer.


Symptoms Of Cervical Cancer

Symptoms of cervical cancer can not always be seen clearly, even there is the possibility of symptoms do not appear at all. Often, the appearance of symptoms occurs when the cancer has entered the late stages. Therefore, regular pap smears are essential to 'capture' pre-cancerous cells and prevent the development of cervical cancer.

Bleeding In Vagina
Unusual bleeding from the vagina, including spots is a common symptom of cervical cancer. Bleeding usually occurs after sex, outside of menstruation, or after menopause. Immediately see a doctor to check if an abnormal bleeding occurs more than once.

Other Symptoms That May Come Up
In addition to abnormal bleeding, other symptoms that may arise are:
  • The fluid that comes out without stopping from the vagina with a strange or different smell from the usual, pink, pale, brown, or contain blood.
  • Pain every time sexual intercourse.
  • Menstrual cycles change unnoticed, eg menstruation over 7 days for 3 months or more, or massive amounts of bleeding.

Symptoms In End Stage Cervical Cancer
Cervical cancer in the late stages will spread outward from the cervix to the tissues and organs around it. At this stage, the symptoms will be different, among others:
  • Occurrence of hematuria or blood in the urine.
  • Problematic when urinating due to kidney or ureter blockage.
  • Changes in bowel habits and small.
  • Weight loss.
  • Swelling on one leg.
  • Bone pain.
  • Loss of appetite.
  • Pain in the lower abdomen and also pelvis.
  • Pain in the back or waist, this is due to swelling of the kidneys. This condition is referred to as hydronephrosis.
If you experience symptoms as mentioned above, you should see your doctor immediately. Especially about abnormal bleeding in the vagina that can be caused by many things. But, these symptoms should be examined by the doctor to understand the cause.


Causes Of Cervical Cancer

Cervical cancer begins when healthy cells undergo genetic mutations or changes in DNA. This genetic mutation then converts normal cells into abnormal cells. Healthy cells will grow and multiply at a certain speed, while cancer cells grow and multiply uncontrollably.

The number of abnormal cells that continue to grow will form a tumor . Cancer cells that appear then attack the surrounding tissue. This cell can escape from the initial location and spread to other body areas, this process is referred to as metastasis.

Cervical Cancer Due to HPV or Human papillomavirus
There are several risk factors that cause women with cervical cancer. But the study found that even 99.7 percent of cervical cancers are caused by HPV . HPV is a class of viruses, in which there are more than 100 types of HPV.

HPV virus is generally spread through sexual contact, where there is direct contact between the genital skin, mucous membranes, or exchange of body fluids, and through oral sex. After starting sexual intercourse, an estimated 33 percent of women will be infected with HPV. Some types of HPV cause no obvious symptoms, and the infection may disappear without medical treatment.

But there are other types of HPV that can cause genital warts . The type of HPV that causes genital warts does not cause cervical cancer. There are about 15 types of HPV that potentially cause cervical cancer. The two most common types are HPV 16 and HPV 18. This type causes cervical cancer in 70 percent of women.

High-risk HPV types are thought to contain genetic material that can be transferred from viral cells into cervical cells. This material will begin to interfere with the performance of the cell, until the cervical cells finally reproduce uncontrollably. This process causes the appearance of the tumor and then turns into cancer.

There is no known cure for HPV infection. The virus itself can remain in the body with or without treatment. However, most HPV infections disappear without special treatment within a period of about two years. However, as a precaution, every woman is advised to receive HPV vaccination to prevent contracting the type of virus that causes cancer.

Status of Prakanker - Cervical Intraepithelial Neoplasia
Cervical cancer takes years to grow from healthy cells to precancerous cells and eventually cancer cells. Abnormal changes in the cells before the cancer is known as cervical intraepithelial neoplasia (CIN) or precancerous cells. Cellular changes due to HPV infection to CIN, until eventually become very slow cancer. This process can occur within 10-20 years.

CIN is a condition of abnormal cell growth before cancer. These conditions generally do not threaten a person's health directly, but potentially turn into cancer. Although the risk of CIN cells turned into cancer relatively small, doctors will monitor or handle it as a preventive measure of cervical cancer. The purpose of the pap smear is to identify this stage in order for CIN to be treated before it completely turns to cancer.

The rate of abnormal cell changes can be divided according to its severity, namely:
  • CIN 1 - This condition occurs when the changes in cervical cells are small or not very significant. Can be treated or monitored regularly because cells at the CIN 1 stage can turn back to normal without medical treatment.
  • CIN 2 - There are more changes than CIN 2; generally abnormal cells are removed by the doctor.
  • CIN 3 - At this stage, cell changes are very abnormal but not yet cancerous. The CIN 3 cells will be removed by the doctor.
Factors That Can Increase Cervical Cancer Risk
There are several factors that can increase the risk of cervical cancer, among others:
  • Sexual activity too early : Having sex at an early age will increase the risk of HPV infection.
  • Multiple sexual partners : Having multiple sexual partners increases the risk of HPV infection.
  • Smoking : Women who smoke double the risk. This may be caused by harmful chemicals from tobacco that appear in the cervix.
  • Weak immune system: This condition may be due to taking certain medications such as immunosuppressants. This drug is used so that the body does not reject organ donations from others or because of HIV / AIDS .
  • Childbirth: The more children a woman is born, the higher the risk of cervical cancer. Women who have three children, three times more likely to develop cervical cancer than women who have no children at all. It is thought that hormonal changes during pregnancy make the cervix more vulnerable to HPV.
  • Drinking contraceptive pills or family planning for more than five years : Taking birth control pills for a long time will increase the risk of doubling cervical cancer. Although this is still not clear why.
How To Spread Cervical Cancer
If cervical cancer is not diagnosed and not treated, slowly the cancer cells will come out of the cervix and spread to surrounding organs and tissues. Cancer can spread to the vagina and the muscles that support the pelvic bone. Cancer cells can also spread to the upper body. This condition will block the channels that flow from the kidney to the bladder or often referred to as the ureter.

Cancer can spread to the bladder, rectum, and finally to the liver, bones, and lungs. This cancer cell can also spread to the lymphatic system. The lymphatic system consists of a series of nodes and channels that radiate throughout the body in the same way as the circulatory system.

The lymph nodes produce many specialized cells that the immune system needs. If you are infected, the nodes in the neck or under the armpit will swell. In some early-stage cervical cancers, the lymph nodes close to the cervix contain cancer cells. And in some end-stage cervical cancers, the lymph nodes in the chest and abdomen can also be infected with cancer.


Diagnosis Of Cervical Cancer

If cervical cancer is detected early, the success rate of treatment becomes higher. Referral to a gynecologist or female reproductive system specialist doctor will be given if the pap smear results show abnormal cells in the cervix. In most cases, the presence of these abnormal cells does not mean uterine cancer . References to gynecologists are also given in case of abnormal bleeding in the vagina to see if there are abnormal changes in the cervix.
  • Colposcopy Procedure. Colposcopy is a cervical examination to look for abnormalities. The doctor will use a special magnifying glass to see the vulva, vagina, and cervix. This process uses a microscope with a small lamp at the end. If visible abnormalities in the colposcopy process, small samples of tissue will be taken from the cervix and examined under a microscope, to see if there are cancer cells in it. The whole process will be done by a gynecologist.
  • Cone Biopsy . A small surgical procedure called cone biopsy may be necessary. The term conical biopsy is used from conical tissue taken from the cervix. The cells of this tissue will be examined by a microscope to check whether there are cancer cells. This procedure is performed in hospitals with local anesthetic use. The side effect is bleeding that may occur up to one month after surgery. In addition, menstruation may also be painful. If the cervix contains cancer cells or potentially cancerous cells, further treatment is needed to ensure that all abnormal cells are removed.
  • Circular electric wire. This procedure will use thin-wire thin-emitting electrical wires to collect tissue samples for further inspection.
Benefits of Further Examination
With a biopsy examination, the patient can tell if it has cervical cancer and whether it has spread. If there is cervical cancer, further examination is needed to determine the extent of the spread of cancer, among others:
  • Blood tests : performed to check the condition of the liver, kidneys, and bone marrow.
  • Examination of pelvic organs : uterus, vagina, rectum, and bladder will be checked for cancer.
  • CT scan : scanning interior body condition with computer to get three-dimensional image. Useful to see which cancer grows and whether the cancer has spread to other body parts.
  • Chest X-rays : to see if the cancer has spread to the lungs.
  • MRI scan : scanning uses a strong magnetic field and radio waves produce images from within the body. Useful to see if the cancer has spread and how far the spread.
  • PET scan : if combined with CT scan, this procedure can see the spread of cancer and also check the response of a person to the treatment performed.
Cervical Cancer Stage
Stage of cancer suffered can be determined after all tests completed. Staging is used to explain how far the cancer has spread. If the stage of cancer is higher, then the spread is more widespread. Here is a cervical cancer stage based on its spread:
  • Stage 0 : pre-cancerous stage. There are no cancer cells in the cervix, but there are biological changes that can potentially become cancerous. This stage is often referred to as cervical intraepithelial neoplasia (CIN) or carcinoma in situ (CIS).
  • Stage 1 : Cancer is still inside the cervix and there is no spread.
  • Stage 2 : The cancer has spread beyond the cervix and in the surrounding tissue. But it has not reached the pelvic wall or the bottom of the vagina.
  • Stage 3 : The cancer has spread to the wall of the stage and / or to the bottom of the vagina.
  • Stage 4 : the cancer has spread to the intestines, bladder, or other organs, such as the lungs.
Type of Cervical Cancer
By detecting the type of cervical cancer that diidap by patients will help the treatment process and proper handling. There are two types of cervical cancer, namely:
  • Squamous cell carcinoma , is a type of cervical cancer that begins in the outer layer of the cervical cells thin and flat (squamous cells) protruding into the vagina. The majority of cases of cervical cancer that arise are of this type.
  • Adenocarcinoma , is a type of cervical cancer that begins in colloidal gland cells in the cervical canal.

Treatment Of Cervical Cancer

Treatment of cervical cancer depends on several factors. For example the stage of cancer, the type of cancer, the age of the patient, the desire to have children, other medical conditions being faced, and the desired treatment options. Deciding how best treatment can be very confusing. Cervical cancer will usually be handled by a team of doctors of various specialties. This team will help choose the best way to continue treatment, but the final decision remains in your hands.

Type of treatment according to cancer stage is divided into two. The first is the treatment of early stage cervical cancer, which is surgical removal of part or all of the uterine organ, radiotherapy, or a combination of both. And the second is the treatment of end-stage cervical cancer, namely radiotherapy and / or chemotherapy, and sometimes surgery also needs to be done.

If the diagnosis of cervical cancer is known from the beginning, the chances of recovering completely are quite good. But if the cancer has spread, the chances of a full recovery will be reduced. In cases of cervical cancer that can not be cured, it may be advisable to do palliative care. This type of treatment works to slow the spread of cancer, prolong the patient's age and reduce symptoms that appear, such as pain and vaginal bleeding.

Procedures for the Appointment of Precancerous Cells
Pap smear results may not indicate the presence of cervical cancer, but can be seen if there is a biological changes that could potentially become cancer in the future. Here are some of the available handling:
  • Conical biopsy: Â is the removal of areas where abnormal tissue through surgical procedures.
  • Laser therapy : the use of lasers to burn abnormal cells.
  • LLETZ or large loop excision of transformation zone : abnormal cells are cut using thin wire and electric current.
Cervical Cancer Removal Operations
There are three main types of surgery for cervical cancer.

Operation radical trachelectomy

This procedure is more suitable for detectable cervical cancer at an early stage and will be offered to women who still want to have children. This operation aims at lifting the cervix, surrounding tissue, and upper part of the vagina, without lifting the uterus.

You are still likely to have children because the uterus is not removed. Post surgery, uterus and vagina take time to recover. It would be advisable to wait six months to a year after surgery before deciding to get pregnant.

Surgery involving removal of the uterus

Hysterectomy is a surgical removal of a woman's uterus. Hysterectomy is performed for various reasons, one of which is for early-stage cervical cancer surgery. In order for the cancer does not come back again, radiotherapy may also need to be done.

There are two types of hysterectomy surgery. First, a simple hysterectomy. This is a procedure in which the cervix and uterus will be removed. In some cases, the ovaries and fallopian tubes may also be removed. This procedure can be done for early-stage cervical cancer.

The second is a radical hysterectomy. The cervix, uterus, surrounding tissue, lymph nodes, ovaries, and fallopian tubes, all will be removed. This surgery is likely to be performed in advanced stage and second stage cervical cancer at an early stage.

Side effects or short-term complications of hysterectomy surgery are:
  • Bleeding
  • Infection
  • Risk of injury to the ureters, bladder, and rectum
  • Blood clotting
Possible long-term complications of hysterectomy surgery are:
  • Inability to hold urine.
  • The vagina becomes shorter and drier, sexual intercourse can be painful.
  • Digestion in the intestine is blocked by the buildup of scars. It may take more surgery to open it.
  • Swelling of the arms and legs due to fluid accumulation or lymphedema.
Although the risk of complications is small, but will be very difficult if it happens. With hysterectomy, pregnancy is unlikely to occur and if the ovary is removed, it can also trigger the occurrence of menopause in patients who have not experienced it.

Pelvic exenteration

Pelvic exenteration is a major surgery that is only recommended if cervical cancer reappears after being treated and recovered. This operation is performed if the cancer returns to the pelvic area, but has not spread to other regions.

After surgery, the vagina can be reconstructed using skin and tissue taken from other body parts. You can still have sex a few months after this surgery.

There are two stages of pelvic exenteration that must be passed. The first stage, the cancer will be removed along with the bladder, rectum, vagina, and the lower part of the intestine. Then the second stage, two holes called stoma will be made in the stomach to remove urine and dirt from the body. Disposable waste is inserted into a storage bag, called a colostomy sac.

Treatment of Cervical Cancer with Radiotherapy
For the treatment of early-stage cervical cancer, radiotherapy can be done alone or in combination with surgery. While in end-stage cervical cancer, radiotherapy will be combined with chemotherapy to control bleeding and pain.

Radiotherapy can be given in two ways:
  • External . The radiotherapy machine will fire high energy waves to the patient's pelvis to destroy cancer cells.
  • Internal. Radioactive implants will be inserted inside the patient's vagina and cervix.
The process of radiotherapy usually runs about one to two months. However, radiotherapy not only destroys cancer cells, sometimes, radiotherapy also destroys healthy tissue. Side effects can last for months or even years. In some cases, these side effects can be permanent. But, most side effects will disappear within two months after completing treatment.

The benefits of radiotherapy are often greater than the risks and side effects. For some, radiotherapy offers the only hope to destroy cancer. Side effects of radiotherapy are:
  • Pain while urinating.
  • Bleeding from the vagina and rectum.
  • Diarrhea .
  • Fatigue.
  • Nausea .
  • Damage the bladder and intestines to lose control of urinary and small disposal.
  • Narrowing the vagina so sex becomes painful.
  • Skin irritation in the pelvic area.
  • Infertility.
  • Damaging the ovaries, resulting in early menopause.
The egg can be removed by surgery from the ovary before radiotherapy, if you are concerned about fertility. This egg can be implanted back in the womb. To prevent menopause, the ovaries may be removed outside the pelvic area that is not affected by radiation. This process is better known as ovarian transposition .

Treat Cervical Cancer with Chemotherapy
To treat cervical cancer, chemotherapy can be combined with radiotherapy. For end-stage cancer. Chemotherapy is done to slow the spread and reduce the symptoms that appear. This treatment is often referred to as palliative chemotherapy.

Chemotherapy uses drugs to destroy cancer cells. Unlike radiotherapy or surgery that affects only certain parts, chemotherapy affects the whole body. These drugs target cells that grow and multiply rapidly, especially cancer cells. But healthy cells that multiply rapidly can also be affected.

Chemotherapy can use one specific drug to kill cancer cells. One type of this drug is usually called cisplatin . But a combination of chemotherapy drugs can also be applied. Chemotherapy treatment is given by intravenous inpatients. Patient is allowed to go home after receiving treatment according to dose.

You should frequently perform a blood test while undergoing chemotherapy treatment. Blood tests aim to check your kidney health, as some chemotherapy drugs can damage the kidneys.

This treatment can also damage healthy tissue. The most common side effects are:
  • Experiencing thrush .
  • Loss of appetite.
  • Feel the fatigue.
  • Nausea and vomiting.
  • Hair loss : Hair can grow back within three to six months after chemotherapy is complete. But not all chemotherapy causes hair loss.
  • Red blood cell counts are reduced: this can lead to fatigue and shortness of breath. You will be susceptible to infection due to a lack of white blood cells.
Treatment During Pregnancy
Treatment of cervical cancer during pregnancy depends on the stage of the cancer and also the age of your pregnancy. Suppose you have early stage cervical cancer and are at nine months of gestation. Treatment will be delayed until you give birth to a baby. Cancer treatment can lead to premature birth or even a miscarriage .

Advanced Post-Treatment Actions
After treatment of cervical cancer, it is important to receive follow-up examination. Especially necessary in the vagina and cervix if the cancer has not been removed. This examination aims to find a sign because of the risk of cancer can reappear. Biopsy will be done again if there is anything suspicious. The reappearance of this cancer usually occurs about one and a half years after completion of treatment.

Advanced treatment is done every four months, this is for the first two years after treatment is completed. Then, every six months to one year for the next three years.


Complications Of Cervical Cancer

Complications can arise as a result of treatment or because of the stage of cervical cancer that has entered the final stage.

Side Effects of Cervical Cancer Treatment
Treatment of cervical cancer risks causing some side effects faced by the patient.

Experiencing early menopause

Menopause is a condition when the ovaries stop producing estrogen and progesterone hormones. This condition usually occurs in women around the age of 50 years. Early menopause can occur if the ovaries are removed by surgery or it could be because the ovaries are damaged by radiotherapy side effects. Some of the symptoms that can arise due to this condition are:
  • The vagina is dry.
  • Menstruation is stopped or irregular.
  • Loss of sexual appetite.
  • Sensation of heat and sweat ( hot flushes ).
  • Excessive sweating, even at night.
  • Loss of urine retention ability, so it can cause accidental urination when coughing or sneezing; This condition is known as urinary incontinence.
  • Bone thinning may cause osteoporosis or brittle bones.
There are several drugs that can overcome this symptom with the effect of stimulating estrogen and progesterone production. This treatment is referred to as hormone replacement therapy.

Occurrence of vaginal narrowing

Treatment with radiotherapy in cervical cancer often leads to vaginal narrowing. Sex can be very painful and difficult. There are two treatment options for this. First, apply a vaginal hormone cream to increase the vaginal moisture. And finally, sex can get easier.

The second is by wearing a vaginal dilator . The vaginal dilator can be made of plastics, rubber, or fine glass. Shaped like a tube of different sizes and weights. This tool serves to restore the flexibility of the vagina. This tool will make the vaginal tissue becomes elastic and sex will feel more comfortable. It is recommended to use a vaginal dilator for five to 10 minutes on a regular basis for six months to a year.

Many women are embarrassed to talk about this tool. But this method of treatment is well known for the problem of vaginal narrowing. You can ask your doctor about the advantages and disadvantages of this tool.

The emergence of lymphedema or accumulation of body fluids

Lymphoedema is a swelling that commonly occurs in the hands or feet due to the obstructed lymphatic system. The lymphatic system is an essential part of the immune system and the body's circulatory system.

The lymphatic system may not work normally if the lymph nodes are removed from your pelvis. One function of the lymphatic system is to remove excess fluid from within body tissues. Disturbance in this system can cause the accumulation of fluids in organs. This hoarding causes swelling.

In patients with cervical cancer, lymphedema usually occurs in the legs. To reduce the swelling that occurs, you can do special massage exercises and techniques. Bandages or special dressing pads can also help to overcome them.

Emotionally, being diagnosed with cervical cancer or feeling the side effects of treatment can be very tiring. In fact, people can be depressed. Consult your doctor about how to deal with the emotional impact. You can also find information about cervical cancer support groups both at the hospital and at the Indonesian Cancer Foundation.

Impact of Advanced Cervical Cancer Stage
Pain due to cancer spread

Severe pain will occur when the cancer has spread to nerves, bones, or muscles. But some painkillers can usually be used to control the pain. Medications taken from paracetamol , non-steroidal anti-inflammatory drugs or NSAIDs, to morphine . All depends on the level of pain that is felt.

If painkillers do not help much, ask your doctor about medications that may have a stronger effect. Short-term radiotherapy is also effective for controlling pain.

Excessive bleeding

Excessive bleeding can occur if the cancer spreads to the vagina, intestines, or bladder. Bleeding can appear in the rectum or in the vagina. Can also occur bleeding while urinating. Excessive bleeding can be treated with a combination of drugs to lower blood pressure. This drug can inhibit blood flow.

Small bleeding can be treated with a drug called tranexamic acid . This drug will make the blood clot, so it can stop the bleeding that occurs. Radiotherapy is also effective in stopping bleeding due to cancer.

Blood clots after treatment

Like other cancers, cervical cancer can make the blood more 'sticky' or 'thick' and tend to form clots. The risk of blood clots also increases after chemotherapy and postoperative rest. The appearance of a large tumor can suppress the blood vessels in the pelvis. This is what slows the flow of blood and ultimately results in agglomeration in the legs. Symptoms of blood clots in the feet include:

  • Pain that feels very deep in the area of ​​the associated foot.
  • Pain and swelling in one of the legs, usually on the calf.
  • The skin is flushed, especially on the back of the foot below the knee.
  • In the part that occurs clumping, the skin will feel warm.

The most worrying is the occurrence of pulmonary embolism or pulmonary embolism. The impact of this condition can be very fatal. Pulmonary embolism is a blood clot from the blood vessels in the legs moving into the lungs and blocking the blood supply to the lungs. Blood clots in these legs can be treated with a combination of blood-thinning drugs, such as heparin or warfarin -type drugs. A kind of stocking will also be wrapped into the legs as it can help smooth the blood circulation throughout the body.

Kidney failure

Kidney function to remove waste material from the body. This waste is discharged through the urine through a channel called the ureter. A simple blood test can be performed to monitor kidney performance. This blood test is usually referred to as the serum creatinine level.

In some cases of advanced cervical cancer, the cancer can suppress the ureter. This causes obstruction of the flow of urine to get out of the kidney. The accumulation of urine in the kidney is better known as hydronephrosis. This condition can cause the kidneys to swell and stretch. Severe hypnonophrosis can damage the kidneys and thus lose all of its functions. This condition is referred to as kidney failure .

Treatment for kidney failure is to remove all urine collected in the kidneys. The pipe will be inserted through the skin and into each kidney, known as percutaneous nephrostomy. Another treatment option is to widen the two ureteral channels. This is done by inserting a small iron pipe or stent into the ureter.

Some of the symptoms that arise from kidney failure can vary greatly:
  • Hard to breathe.
  • Fatigue.
  • Nausea .
  • Swelling of the wrist, hands or feet due to fluid accumulation.
  • Blood in the urine.
The production of abnormal vaginal fluids

Vaginal fluid can smell strange and unpleasant because of advanced cervical cancer. Exit fluid can appear for several reasons, namely:
  • Damage to tissue cells.
  • Damage to the bladder or intestine resulting in leakage of the contents of these organs that come out through the vagina.
  • Because of bacterial infections of the vaginal organs.

Treatment for this vaginal discharge uses antibacterial gel containing metronidazole . Can also by wearing clothes that contain carbon (carbon). Carbon is a very effective chemical compound to absorb unpleasant odors.

Fistula

Fistula is the formation of a connection or abnormal tract between two parts of the body. In the case of cervical cancer, fistulas can form between the bladder and the vagina. This can lead to the relentless discharge of fluids from the vagina. Occasionally, fistula may occur between the vagina and the rectum. Fistulas include unusual complications. This condition occurs only in 2 percent of cases of advanced cervical cancer.

To improve the fistula, surgical procedures are usually necessary. But this is often not possible in women with advanced cervical cancer, because of their already very weak condition. If surgery is not possible, creams and moisturizers may be used to reduce discharge. It also aims to protect the vagina and surrounding tissue to avoid damage and irritation.


Prevention Of Cervical Cancer

The main way in preventing cervical cancer is to prevent contracting HPV virus. It is estimated that about 99 percent of cases of cervical cancer are caused by this virus. Measures that can be done to reduce the risk of cervical cancer include sex safely, loyal to the couple, routine screening on the cervix, vaccinations, and quit smoking.

Most cases of cervical cancer are associated with certain types of HPV infections. The spread of this virus occurs through unsafe sex, then use condoms when having sex to reduce the risk of contracting HPV.

The risk of contracting HPV also increases with the number of sexual partners a person has. Women who have only one partner can also be infected with this virus if the partner has many other sexual partners.

Screening or pap smears for cervical cancer  is a method to detect cells that are potentially cancerous. Pap smears  The cervix is ​​not a test for cancer. This test only checks the health of cells in the cervix. Most test results in women show normal results. Do a pap smear regularly. Women who have had sex and are primarily 25-49 years old are advised to take the test every three years. For women aged 50-64 years, it is recommended to test every five years.

HPV or human papillomavirus vaccination protects women from the major viral infection that causes cervical cancer. The vaccine will be more effective if given to the girl before sexually active. Although HPV vaccine can reduce the risk of cervical cancer, but this vaccine does not guarantee you free from this disease. You are still advised to undergo regular pap smears despite getting vaccinated.

The risk of cervical cancer can also be reduced by steering clear of cigarettes. People who smoke are more difficult to eliminate HPV infection from the body. These infections are potentially cancerous.


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