The cervix is the lower part of the uterus (womb). It is sometimes called the uterine cervix. The body (upper part) of the uterus is where a foetus grows. The cervix connects the body of the uterus to the vagina (birth canal).

The part of the cervix closest to the body of the uterus is called the endocervix. The part next to the vagina is the exocervix. The place where these two parts meet is called the transformation zone. Most cervical cancers start in the transformation zone.

Dr. Celestin Kanimba works in the gynaecology department of the National University of Rwanda medical teaching hospital of Butare. He says that about 85% of cervical cancers are squamous cell carcinomas, which develop in the scaly, flat, skin like cells covering the cervix.

He adds that most other cervical cancers are adenocarcinomas, which develop from gland cells or adenosquamous carcinomas, which develop from a combination of cell types.

Dr. Celestin highlighted that the retrospective and descriptive study that was carried out in the past six years at the obstetrics and gynaecology department of the university teaching hospital in Butare was on 92 cases of cervical lesions that were suspected of malignancy that were admitted for consultation.

The doctor also points out that the considered parameters for analysis are hospital prevalence, annual distribution, age, occupation, residence, symptoms, previous treatment, diagnostic procedure, histopathology results and prognosis.

Cervical cancer is the second most common type of cancer in women worldwide after breast cancer, and also the leading cause of cancer related death rates among women in developing countries.

The disease can be diagnosed in girls as young as 20 years old. Its highest incidence is observed among 40-50 year olds. Risk factors are early and frequent sexual intercourses, multiple sexual partners, high fertility, poor socio-economic status, sexually transmitted diseases, immuno suppression and in particular Human Papilloma Virus (HPV).

The cancer develops through various pre-malignant degrees. It is screened and discovered by special examinations like paper smear, schiller test, colposcopy and biopsy. The treatment of the dysplasia of the disease is performed following the degree of infection.

Symptoms and Treatment

Symptoms usually don’t appear until abnormal cervical cells become cancerous and invade nearby tissue. When this happens, the most common symptom is abnormal bleeding, which may start and stop between regular menstruations.

Treatment involves cryotherapy, carbon dioxide laser, loop electrosurgical procedure, and cold knife conization. As for micro invasive cervical cancer, therapies such as conization, radical trachelectomy, hysterectomy, radical hysterectomy and therapeutic lymphadectomy may be applied. 

The affected cells of the cervix are removed from the body and also the doctor takes measures to prevent the occurrence of the disease.

As the cancer is characterized by the presence of tumour cells, these cells have to be completely destroyed to ensure normal functioning again of the affected area. Usually surgery takes place after chemotherapy and radiotherapy treatments.

Surgery is done in order to remove all the cancerous cells that are still present even after the procedure of radiotherapy and chemotherapy. The treatment of cancer begins only after an analytical study is conducted by the doctor.

This study is carried out through conducting biopsy and other tests. If only the outer layer of the cervix is affected, then the treatment becomes easier for the doctor. In case the infection has spread internally then the doctor must take extra care.

Before treatment, the doctor must consider the metastatic level of the cancer that is the extent it has spread. The factor of metastasis is known to the doctors by conducting tests and diagnosis.

When the cervix has been affected, then the precancerous lesions develop. The disease can only be treated during this phase because later it becomes complicated.

Ends