Cervical Cancer amongst Middle Age Women

 

            Cervical cancer is a type of cancer associated with women since it affects women only.  Cervical cancer is a malignant growth at the most lower part of the uterus which is the cervix. According to statistics pertaining to cervical cancer in America, there was a time when cervical cancer was among the most death-causing cancerous-related disease where most of the women who suffered from the disease were between the ages of 45 to 65. Cervical cancer is still a death-causing disease today since the American Cancer Society approximates that in the current year 2021 new cases amounting to 14,480 will be diagnosed and also it will cause death to women amounting to 4,290. According to World Health Organization 2018 cancer data, 570,000 women were estimated to be diagnosed with cervical cancer worldwide were 311,000 women passed away as a result of the disease. Despite the disease being this dangerous and infectious to women, cervical cancer is treatable when detected at an early age and this will prevent many cancer cases in the world. Therefore, this research paper will focus on the signs and symptoms of cervical cancer among mid-aged women, its causes, interventions, comparison of the interventions, and the outcome of the interventions.

Signs and symptoms of cervical cancer among mid-age women

Cervical Cancer is mostly and frequently diagnosed in women who are in the middle age with an average age of women diagnosed being 50 years. Cervical Cancer hardly ever develops or affects women who are below 20 years old. Among the cervical cases recorded every year, more than 20% are of the cases are recorded from women above the age of 65. However, there are very rare cases of this cancer among women who used to go for regular cervical cancer screening tests when they were below the age of 65. Nevertheless, many of the old women do not understand there is still a risk of Cervical Cancer development at their age. It is difficult to identify Cervical Cancer during its early stage because it might not show any signs or symptoms. Cervical Cancer signs and symptoms will be seen when cancer has progressed to a stage where it is dangerous. Therefore, for one to notice whether she has cancer or Cervical Cancer infections, she should show some or all of the signs and symptoms discussed below.

When present, the most common symptom or sign of the growth that grows at the cervix might include irregular vaginal bleeding. The vaginal bleed can occur after sex or between menstrual periods (Pretorius, et al, 1991, P. 50). Other times it shows as blood splotch vaginal discharge which frequently gets released as spotting. Some women with invasive cervical cancer symptoms may experience vaginal bleeding during their post-menopause period. Menopause is a period when monthly periods among women become less regular in a few months or years before they completely stop bleeding. When a woman reaches menopause, she can no longer have periods and she can never ever get pregnant in the future unlike the biblical story about Sarah the wife to Abraham who was able to get pregnant far much beyond menopause age. Therefore, women who experience and who may experience vaginal bleeding in this manner should see a doctor because this is normal and it might be a notifying symptom of cervical cancer or some other serious problems.

The other symptom pertaining to cervical cancer among the middle age women is vaginal discharge. Vaginal discharge plays a very significant role in the housekeeping responsibility in the reproductive system of the female. Dead cells and bacteria’s in the vagina are carried away by a fluid produced by the glands inside the cervix and the vagina. This fluid helps in keeping the vagina clean and also helps in preventing vaginal infection. The Vaginal discharge is usually normal most of the time but the amount of discharge, odor, and color may vary and range from being clear to a whitish milky substance confined by your menstrual cycle time. For instance, high amount of discharge will be experienced during ovulation, when one is sexually aroused or when breastfeeding. Also, the odor of the discharge may be different when one fail to observe personal hygiene or when a woman is pregnant. Meanwhile, changes during these instances are is should not be alarming since it is a normal happening. However, if the odor, color or the regularity is a bit or much different than the usual one, particularly if one has vaginal burning or itching, one could be having an infection or cancer related implications (Pretorius, et al, 1991, P. 51). The cancer related discharge may be watery, clear, foul smelling, white or tinged with blood. Unless keenly observed, this can lead to severe infections sine most of the women may assume it to be normal or an issue that will end within a short period of time. Infact, many women will view it as an occasional thing that happen when one reaches middle age which is not the case and this require serious intervention from the medical practitioners.

Swelling or pain in the legs can be a sign or a symptom among mid aged women that can possibly be caused by cervical cancer. Swelling of legs is not a problem associated with blood circulation or heart problem. Leg or legs of a person can swell for being in active, fluid buildup which is usually as a result of overweight, standing or sitting for prolonged period of time or wearing tight jeans or stockings. Also, another cause of swelling of legs is Cervical Cancer illness or infections. The spread of lymph nodes is pressurized by cancer which at times causes some body parts to swell because of the fluid buildup. The swelling commonly occurs in the ankles, legs and feet.

Pain during sexual intercourse is one of the cervical cancer first signs. Sex is an enjoyable act that fastens partners bond or it is life pleasure source. But to so many people, sex is very hard to enjoy and also very scary due to the pain that comes from the act (Lammerink, et al, 2012, P. 301). This causes many people to avoid sex or even plod through it in spite of the pain that they will experience. This can cause physical and psychological consequences to the said individuals. Among the causes of pain such as vaginal dryness, vulva or vagina injury, vulvodynia, menopause, sexually transmitted diseases, endometriosis vaginismus, wrong position, ruptured ovarian cyst and latex allergy during sex, Cervical Cancer is among them.

According to the Cancer Treatment Centers of America, unclear weight loss is one of the signs originating from the advanced Cervical Cancer. Loss of weight in a way that cannot be explained is an issue of concern on human health. Some loss of weight are caused by stressful event or life changing events and therefore they are not much serious issues to consider. However, unexplained weight loss might be as a result of some medical conditions which include Muscle loss, overactive thyroid, Rheumatoid arthritis, Diabetes, Depression, Inflammatory bowel disease, Chronic obstructive pulmonary disease, Tuberculosis, Endocarditis, Addison’s disease and Congestive heart failure. Among them, cervical cancer is also a cause of unexplained weight loss among middle aged women (Ohno, et al, 2006, P. 95). This issue of weight loss is a common symptom of cancer of different types. If having issues with weight loss, it is very necessary to get a checkup for cervical cancer to avoid severe infections due to delay.

Lower back pain as a cancerous characteristic. Mostly, women raises issue of lower back pain which comes as a result of regulation in their spinal vertebrae, Hormonal changes and issues pertaining to posture. Also, Cervical Cancer is among the diseases in the list of diseases associated with back pain. Signs of Cervical Cancer which is at an advanced level can be identified by feeling pain near the appendix or also in the Pelvis general region in form of pelvic pain (Lahad, et al., 1994, P. 1286-1291).

Loss of appetite is a show of the probability of the presence of Cervical Cancer cells in the body. Loss of appetite is a situation where the desire of an individual to eat is not same as it used to be. Signs associated with decreased or reduced appetite are unintentional loss of weight, not feeling to eat and not feeling hungry. An individual who have loosed her appetite usually have a characteristic which makes her feel like she will vomit after when she thinks of eating food ((Pretorius, et al, 1991, P. 53). Therefore, reduced appetite is classified to be a sign which shows that a woman have Cervical Cancer. If a middle aged woman feels less hungry or eats less frequent than usual, she should seek medical help from a medical profession and get checked of Cervical Cancer.

Risk factors

Division of cells in uncontrolled manner and the growth of abnormal cell results to Cancer. Many cells in human body have a certain lifespan after whereby after it is complete, they die and new cells are generated by the body to replace the dead cells. Abnormal cells have two problems and that is; they cannot die and they keep dividing. This causes the cells to build up too much and therefore they form a tumor. Scientists have not fully understood why the cells results to be cancerous. However, development of cervical cancer can be increased by various risk factors. The risk factors include:

Human papillomavirus (HPV) causes many of the cervical cancer cases. Human papillomavirus is a sexually transmitted virus. Most of the people get infected with the virus through sex and also most people free the virus with no difficulty or complication. This brings up the reason why most cases related to cervical cancer comes from women who are at the mid age, and this is because most women engage in sexual intercourse activity at mid age more than those at the old age and also than those at a younger age. Human papillomavirus is of more than 100 types of different kind but not all of them are connected to cancer. The most associated strain of Human papillomavirus with cervical cancer is the HPV16 and HPV18 (Ngelange, et al., 1998, P. 44).  Beginning to have sex at an early age or having many sex partners makes an individual prone to contract HPV types that are of high risk.

Immune deficiency causes many women who are at the middle age to develop cervical cancer. Women who are at a high risk of getting the cervical cancer are those with lowered or weak immune system. A weak immune system results created by immune vanguishment from other types of cancer treatment, corticosteroid medication, organ transplantation, or from Human Immunodeficiency Virus which gives rise to Acquired Immune deficiency syndrome (Waggoner, 2003) Immune system of the women at the middle age and all other individuals in the world living with HIV gets weak to defend the body from cancer at an early stage.

Factors related to social economic issues. Women who cannot easily access the screening services for cervical cancer have many cases for cervical cancer. Those women who are less advantaged in matters of screening include American Indians, Black women, women who are from low income households and Hispanic women.

Age is another risk factor for this cancerous disease. Development of the cervical cancer rarely develop in young people who are of 20 years old and below. But the risk increase to individuals who are at late teens and those at mid-30s. However, women who are beyond the age of 30s suffer the risk and therefore they need to ensure that they frequently do the cervical cancer screening which may include HPV test or Pap test or they can also do the two.

Oral contraceptives are other risk factors associated with cervical cancer among women at mid age. Some researchers proposes that oral contraceptives which include birth control pills may be linked with the increasing rates of cervical cancer cases among women at mid age since they are connected with a high degree risk of sexual behavior (Waggoner, 2003). However, since it is not clear of how oral contraceptives are related to cervical cancer, an intensive research required to understand the connection between the two.

Diethylstilbestrol exposure to infants. In the years 1940-1970 there many cases of miscarriage and therefore pregnant women in those years were given this drug to prevent miscarriage (Laronda, Unno & Batler, 2012, P. 256). Those women who are currently at the mid age and whose mothers took diethylstilbestrol with the aim of preventing miscarriage are at a high risk of growing cancer of very rare type at the vagina or at the cervix.

Herpes among women. There is a high risk of cervical cancer development to women who are genital herpes. Herpes simplex virus type 2 is type of a virus that is contracted mainly through sexual contact activity therefore making it to be a risk factor ((Ngelange, et al., 1998, P. 46). Various studies done proposes that Herpes simplex virus type 2 is parallel with extremely high number of incidences pertaining to cervical cancer. This tells us that most of the women at the mid age have the Herpes simplex virus and hence high rate of cervical cancer infections or cases in the age group.

Smoking is another cause or risk factor of cervical cancer development among women at the mid age. The number of women with cervical cancer is twice more than that of women who don’t smoke in any way. Researchers concludes that smoking causes cervical cancer because the mucus from the cervix of the women who do smoke show some by-products originating from tobacco. It is believed that the tobacco substances leads to development of cervical cancer through the damage of the DNA of the cervix.

Sexually transmitted diseases causes development of the cervical cancer. There are over one million transmission of the sexually transmitted disease in the world every according to The World Health Organization. Sexually transmitted diseases like gonorrhoea and others like chlamydia and syphilis are reported to cause inflammatory pelvic disease and also cause infertility in women. This sexually transmitted diseases raises the risk rate of cervical cancer development among women (De Sanjose, et al., 1997, P. 311). The number of this number have increased due to the high rate of use of birth control measures such as family planning in the 21^st century. This birth control measures have made people to be reluctant in using contraceptives such as condoms which reduces the risk of contracting sexually transmitted diseases from one person to another. This have led to the increase in the number of cervical cancers in the world together with the increase in the number of people suffering from sexually transmitted diseases. By use of evidence, 376 were the number of new infections estimated by the World Health Organization with 1 of 4 STIs in 2016. The diseases that accumulated to the total figure were gonorrhoea whose infection was at 87 million in the year, trichomoniasis which was at 156 million, chlamydia was at 127 million and syphilis at 6.3 million in the same year.

Prevention of cervical cancer amongst mid aged women

Factors that cause cervical cancer are still in the study by the researchers. The factors under research include how people can participate their individual risk and also ways in which this type of cancer can be prevented. Ways in which this cancer can be prevented completely have not be discovered but there are interventions on how to reduce the risk of this cancer and various methods to treat the disease.

There are several treatments for cervical cancer which include surgery, chemotherapy and radiotherapy or treatment with the combination of the three. Decision on what treatment to be applied on an individual depends on factors such as age, stage of cancer and the overall health state of the individual.

In the early stage, surgery is used as the method of treatment since cancer have not yet reached to the cervix (Waggoner, 2003). After surgery, radiation therapy is quite necessary if the doctors thinks that there might be cancerous cells still present in the body. Radio therapy also reduces cancer reoccurrence. When the surgeon finds it necessary to reduce the tumor by shrinking so that it can be easier to operate, chemotherapy may be used on the patient although it is not a common approach.

If the cancer stage is beyond the early stage (beyond the cervix), surgery is not used since it’s usually not an option. Cancer beyond the early stage is referred to as invasive or advanced cancer because most of the body parts are invaded. Very extensive treatment is required on this type of cancer. This kind of treatment requires either radio therapy or the mix of both chemotherapy and radio therapy. In the full blown cancer stages, medical practitioners dispense palliative therapy so as to improve the patient’s quality of life and soften or reduce the symptoms.

Radio therapy is used in the treatment of invasive cervical cancer among mid age women. Radio therapy is referred to XRT or radiation oncology by some doctors. Radio therapy encompasses the application of the beams of high energy radiation or x-rays so as to destroy cancer cells in the body (Ohno, et al, 2006, P. 97).

Another way to treat invasive cancer is through the use of chemotherapy which involves the application of chemical medication in disease treatment or generally it involves cancer cells destruction (Long III, 2007). This method is used by doctors to aim and remove cancer cells that were not successfully removed through surgery or to remove the cancer cells that surgery could not remove. It is also used to improve the symptoms of individuals with cervical invasive cancer.

Prevention and Screening of cervical cancer among mid age women

Researchers have come up with various ways which may help and reduce the probability of development of cervical cancer among the middle aged women through prevention and screening. These cervical cancer prevention and screening methods include:

Use of Human papillomavirus vaccine. There is much connection between cervical cancer development and some Human papilloma virus type which include HPV16 and HPV18 (Ngelange, et al., 1998).  Vaccination helps reduce the spread of a virus and also it helps in depletion of a virus. Vaccination is done to every living individual who is prone to get certain kind of a virus for instance women with Human papilloma virus. Cervical cancer frequency can reduce if all females agree or accept to be vaccinated and follow the present Human papilloma virus program.

Encourage and observation of safe sex among partners who don’t know each other health status (Herzog, & Wright, 2007, P. 574). Human papilloma virus protects women from its two strains which are Human papilloma virus 16 and 18 but does not protect individuals against other cervical cancer causing strains. This will also reduce the infection rate of the sexually transmitted diseases which make who are at the mid age be at a high risk of developing cervical cancer.

Cervical cancer screening of women at the mid age helps prevent the development of the cervical cancer in their body. Frequent cancer screening helps women to recognize and handle cancer signs before the spread or development of the conditions (Long III, 2007).  It is necessary to note that screening never identify but it show change of the cervix cells.

Having few sexual partners is a preventative measure of the cervical cancer. Women at the mid age should ensure they have less sexual partners as possible since the more individuals a woman engages with in sexual intercourse, the risk of contracting Human papilloma virus is much high too which is very dangerous for their health. Many sexual partners will lead to a greater risk of cervical cancer development. By reducing sexual partners, the number of cervical cancer cases among the women at mid age will reduce (Herzog, & Wright, 2007, P. 576).

Delaying of the first sexual intercourse is another prevention measure of cervical cancer. Among the causes of cervical cancer, frequency of sexual intercourse engagement was among them. When a woman engage in the first sexual intercourse for the first time while young, the risk probability of her getting Human papilloma virus is much high because she will want to have the pleasure many more time (Herzog, & Wright, 2007, P. 574). On the other hand, when a woman delays to have her sexual intercourse, the less the probability risk of her getting HPV infections hence lower risk of development of cervical cancer. Parents should encourage this preventative measure through advising and counselling their girls so that there will be less cases of cervical cancer in future,

Women at the mid age should be encouraged to Stop and avoid to smoking because tobacco is carcinogenic. By finding traces of tobacco by-products at the mucus of the cervix means that tobacco is among the causes of cervical cancer. Due to the increasing and the common cases of this cancer among the women who are at the mid age, smoking should be stopped by the women at this level of age to reduce the chances of cervical cancer development in their body. The risk among women who have Human papilloma virus and who smoke too to development of cervical cancer is much high than of those women who don’t smoke or have Human papilloma virus.

Cervical smear test is a screening intervention that help control and prevent cervical cancer among women. In 2019, the American Cancer Society had estimated that the health professionals would have diagnosed over 13000 new cases of invasive cervical cancer in the year. However, the American Cancer Society had estimated 4000 fatalities from women who suffer from the disease.  But most death would have been prevented through regular screening. The aim of screening is to find cervical cells which have had abnormal changes and which can develop and become cancer.

HPV DNA testing. This is among the screening interventions that have been discovered to detect cervical cancer at an early stage which can help. This screening test is used to determine any type of HPV which may cause cervical cancer in an individual. In this test, cervical cells are collected for lab testing. High risk HPV strains are detected through this testing in the DNA cells before any abnormalities gets clear in the cervical cells (Eddy, 1990, P. 221). This test will help to detect and helps to detect cervical cancer causing virus at an early stage and therefore this reduces cases of cervical cancer among the mid age women.

The success of cervical cancer treatment depends on the time of diagnosis. Therefore, early diagnosis of cervical cancer increase treatment rate of success. Recommended routine screening by United States Preventative Services are as follows: There is no recommendation made by U.S. Preventative Task Force on screening of females who are below the age of 21 years. It also recommends that women from the age of 21 to the age of 29 should ensure they are screen for cervical cancer every three years. The frequency of screening to women from the age of 30 to the age of 65 varies on the screening type. The United States Preventative Services suggestions include: firstly, cervical cancer screening every three years. Secondly, HPV should be screen every 5 years, and lastly both cervical cancer and Human papilloma virus should be screened every 5 years. The United States Preventative Services still recommends that women who are over 65 years and who had satisfactory screening at the past should not be screened unless high cervical cancer risk is associated with them. Women who had undergone hysterectomy accompanied by cervix removal do not require to be screened unless they had cervical cancer in the past or they had precancerous injury.

Comparison Intervention

By comparing interventions on cervical cancer, prevention and screening measures are the best interventions compared to the treatment intervention. Prevention measures and the screening measures helps in reducing cervical cancer infections by noticing HPV at an early stage and also by failing to engage on activities that can increase the risk factor of getting the HPV infection or development of cervical cancer cells. On the other hand, treatment of cervical cancer is not an assurance that a woman cannot get the cancer again but it solves the cervical cancer issue at hand and at some cases, some cancer cells are not successfully removed and therefore they remain in the cervix and they may multiply and still cause cervical cancer damage in the body. Therefore, women at the middle age should ensure they get screened and also make sure that they observe prevention methods since they are the only ways to keep them safe from the cervical cancer.

Outcome

Considering the above interventions, each intervention has its own outcome. Outcome of some interventions are positive while others have negative outcomes.

Starting with the outcomes from the treatment intervention, the discovery of cervical cancer can raise interest on ways in which treatment might affect ability to have children, and sexual functions. Treatment of cervical cancer is associated or lead to various complications. Cervical cancer complications may occur as a result of invasive cervical cancer or as a result of treatment side effects. Some of the treatment side effects include:

Early menopause. In case there is removal of ovaries surgically or damage of the ovaries during radiotherapy treatment, early menopause may be triggered if you’re not through with it. Naturally, women experience menopause at the age of early fifties. Menopause symptoms include loss of sex drive, hot flushes, mood changes, vaginal dryness, urine leak when one cough or sneeze, night sweats and no monthly periods anymore. This gives a call to the medical professional to ensure they should do surgeries and radiotherapy efficiently to avoid damage of ovaries. Meanwhile, the menopause symptoms can be reduced through medications that enhances hormones such as progesterone and estrogen production through hormonal replacement therapy treatment.

Narrowing of the vagina is another complication caused by treatment of cervical cancer. Narrowing of the vagina is caused by radiotherapy which is a treatment of cervical cancer. The narrowing of the vagina makes it painful and difficult to have sex (Lammerink, et al, 2012, 302). Radiotherapy seems to cause many complications after cervical cancer treatment. Research should be done and solutions and safe ways of performing radiotherapy should be developed to avoid this complications. Other complications associated with treatment of cervical cancer include lymphedema.

The routine recommended by U.S. preventive Service Task Force helps us know the chances of survival of female for at least 5 more years in relation of the diagnosis stage of the cervical cancer.

 

Summary

            This summary shows the flow of the research paper where page two has the introduction, the signs and symptoms are also discussed from page two to page six. Causes or risk factors of cervical cancer among the mid aged women starts from page six to page 9. Treatment of cervical cancer is covered from page 9 to page 10. Page 11 to page 14 contains cervical cancer prevention and screening discussion. Page 14 contains a comparison of the interventions and finally, Outcomes of the interventions are discussed from page 14 to page 16.

In conclusion, women at the mid age have reported most of the cervical cancer cases in the world. To reduce the number of cervical cancer cases they have to be observant with the symptoms they encounter. In case they experience a cancer related symptom, they should seek medical attention. To reduce these increasing number of cervical cancer cases, women at the mid age have get screened regularly, observe the prevention methods discussed such as receiving Human papilloma virus vaccine.

 

 

 

 

 

 

 

 

References List

Pretorius, R., Semrad, N., Watring, W. and Fotheringham, N., 1991. Presentation of cervical cancer. Gynecologic oncology, 42(1), pp.48-53.

Lammerink, E.A., de Bock, G.H., Pras, E., Reyners, A.K. and Mourits, M.J., 2012. Sexual functioning of cervical cancer survivors: a review with a female perspective. Maturitas, 72(4), pp.296-304.

Ohno, T., Kato, S., Wakatsuki, M., Noda, S.E., Murakami, C., Nakamura, M. and Tsujii, H., 2006. Incidence and temporal pattern of anorexia, diarrhea, weight loss, and leukopenia in patients with cervical cancer treated with concurrent radiation therapy and weekly cisplatin: comparison with radiation therapy alone. Gynecologic oncology, 103(1), pp.94-99.

Lahad, A., Malter, A.D., Berg, A.O. and Deyo, R.A., 1994. The effectiveness of four interventions for the prevention of low back pain. Jama, 272(16), pp.1286-1291.

Ngelange, C., Munoz, N., Bosch, F.X., Festin, M.R., Deacon, J., Jacobs, M.V., Santamaria, M., Meijer, C.J. and Walboomers, J.M., 1998. Causes of cervical cancer in the Philippines: a case-control study. JNCI: Journal of the National Cancer Institute, 90(1), pp.43-49.

Waggoner, S. E. (2003). Cervical cancer. The Lancet, 361(9376), 2217-2225.

Laronda, M.M., Unno, K., Butler, L.M. and Kurita, T., 2012. The development of cervical and vaginal adenosis as a result of diethylstilbestrol exposure in utero. Differentiation, 84(3), pp.252-260.

De Sanjose, S., Bosch, F.X., Munoz, N. and Shah, K., 1997. Social differences in sexual behaviour and cervical cancer. IARC scientific publications, (138), pp.309-317.

Long III, H.J., Laack, N.N. and Gostout, B.S., 2007, December. Prevention, diagnosis, and treatment of cervical cancer. In Mayo Clinic Proceedings (Vol. 82, No. 12, pp. 1566-1574). Elsevier.

Herzog, T.J. and Wright, J.D., 2007. The impact of cervical cancer on quality of life—the components and means for management. Gynecologic oncology, 107(3), pp.572-577.

Eddy, D.M., 1990. Screening for cervical cancer. Annals of Internal Medicine, 113(3), pp.214-226.

 

 

 

 

 

 

 

 

 

 

Appendices

Appendix 1: Research strategy

	P	Signs and symptoms and causes of Cervical cancer
	I	Interventions such as treatment, prevention and screening.
	C	Comparison intervention
	O	Intervention outcomes