In the second blog of our mini-series focusing on cervical cancer Dr Tracie Miles looks at how the common Human Papillomavirus (HPV) infection can potentially lead to cervical cancer:
The true cause of cervix cancer is not just a virus. Rather it’s the failure of the numerous protective mechanisms against it – often over many years.
Following a virus skin cells can become infected and enlarged. They look slightly different from normal and we can see this by looking at a skin sample smeared on a microscope slide (a cervical smear). Scientists recognise these changes and call it CIN. (Cervical Intraepithelial Neoplasia). In plain English: new growth of cervix skin.
Over many years, usually decades, the changes can regress or progress. The condition is still called CIN as the changes are only on the very surface of the skin. Some doctors call it pre cancer meaning “before cancer”. Cancer has not yet developed.
Cancer is only diagnosed when further molecular mutations occur and the cell loses control of its growth restraint. It changes and avoids all the body’s natural immune defences. It can also invade nearby tissues.
Even then many skin abnormalities will die at this stage. But those that survive are very early skin cancers with microscopic invasion into nearby tissues. At this stage, the immune system can eliminate them or a doctor could identify the change on a smear and remove this small area of skin to achieve complete cure.
The abnormal cells can leave the cervix or clusters can break off the roots and get into the fluid that surrounds every cell. This fluid travels around the lymph system and the abnormally growing cervix skin cells can be trapped and killed within a lymph filter (lymph gland or node).
So we see that there are many different protective measures that the body can take at all stages between virus and cancer. Cancer represents a cumulative failure of those processes – it is not just a sexually transmitted virus.
So – rather than stigmatising cervix cancer – let’s educate people about the true process. And let’s encourage them to look after their immune system – for example the toxins in cigarettes can make it harder for the immune system to repair problems.
We cannot avoid viruses. But we can promote a good immune system. And we can attend screening to spot unusual changes and take action.
Discussion point: Do tell us your experience with cervix cancer and when it was diagnosed. How can we educate people about the true process?