The connection between lifestyle choices and cervical cancer

Cervical cancer, a slow-growing cancer affecting the cervix—the lower part of the uterus that connects to the vagina—is a significant health concern for women in India. Caused primarily by the human papillomavirus (HPV), a common sexually transmitted infection, cervical cancer often develops over years following precancerous changes in cervical cells. India, home to over 511 million women aged 15 and above, faces an alarming burden of this disease . Annually, approximately 123,907 women are diagnosed with cervical cancer, and 77,348 succumb to it, making it the second most common cancer among Indian women .


Common Symptoms and Warning Signs of Cervical Cancer

Cervical cancer is often difficult to detect in its early stages as it may not show any noticeable symptoms. When symptoms do appear, they can be subtle and may resemble those of other conditions. Common early signs include abnormal bleeding between menstrual periods or after menopause, heavier or longer menstrual periods, pelvic or lower back pain, and pain during sex. Women may also experience vaginal bleeding after intercourse, douching, or pelvic exams, along with changes in vaginal discharge, such as a stronger odour or a colour change. As the cancer progresses, more severe symptoms may develop, including blood in the urine, bone fractures, difficulty with urination or bowel movements, fatigue, leg swelling and pain, severe back pain, and unexplained weight loss.




Lifestyle Changes to Prevent Cervical Cancer

To reduce the risk of cervical cancer, several lifestyle changes can make a significant difference. Key recommendations include:


1. Get Vaccinated against HPV: The HPV vaccine can prevent infection with high-risk strains of the virus that cause cervical cancer. It is most effective when administered before exposure to the virus, ideally before sexual activity begins.
2. Practice Safe Sex: Using condoms can reduce the risk of HPV transmission, although they do not eliminate the risk entirely. Limiting the number of sexual partners also lowers the chances of HPV exposure.
3. Quit Smoking: Smoking weakens the immune system and makes it harder for the body to clear HPV infections, increasing the risk of cervical cancer. Quitting smoking reduces this risk significantly.
4. Maintain Regular Screenings: Regular Pap smears and HPV tests help detect abnormal cervical cells early, allowing for prompt treatment before cancer develops.
5. Promote a Healthy Immune System: A balanced diet, regular exercise, and managing stress can help maintain a strong immune system, which plays a key role in preventing HPV infections from progressing into cervical cancer.
6. Avoid Douching: Douching can disrupt the natural balance of bacteria in the vagina, increasing the risk of infections, including HPV.


Treatment Options for Cervical Cancer

Treatment for cervical cancer depends on the stage of the disease, the patient's overall health, and other individual factors. In the early stages, surgery is often the first treatment option, which may involve removing the cervix (hysterectomy) or, in some cases, just the tumour or part of the cervix (conization). Radiation therapy, which uses high-energy beams to target and destroy cancer cells, may be used in combination with surgery or as a primary treatment for more advanced stages. In some cases, platinum-containing chemotherapy, which uses drugs to kill or stop the growth of cancer cells, is combined with radiation therapy for enhanced effectiveness, particularly for locally advanced or advanced stage cervical cancers. Immunotherapy helps the immune system recognize and attack cancer cells and may be used for locally advanced cervical cancers in combination with chemotherapy and radiation therapy. In advanced/recurrent cervical cancers, chemotherapy ± targeted therapy bevacizumab focuses on specific abnormalities in cancer cells ± immunotherapy may be utilized. For patients with advanced disease for who are not eligible for chemotherapy and have PD-L1 positive cervical cancer, immunotherapy as a monotherapy can also be utilized. Other treatment options for patients with advanced or metastatic cervical cancer include Tisotumab vedotin. For patients whose tumors are HER2-positive (IHC 3+ or 2+), trastuzumab deruxtecan may also be considered. When a cure or disease control is not possible, palliative care is provided to manage symptoms and improve the patient's quality of life. Treatment plans are typically personalized, often involving a combination of these therapies.


As we continue to raise awareness about the connection between lifestyle choices and cervical cancer, it is important to remember that prevention is within reach. With informed decisions and consistent efforts, we can empower women to lead healthier, cancer-free lives and pave the way for a future where cervical cancer is no longer a significant public health threat.

(Dr. Vicky Makker, MD, Gynecologic Medical Oncologist, Memorial Sloan Kettering Cancer Center, New York, US)