Cervical cancer and ovarian cancers are both gynecological cancers common to women. In advanced stages both have a poor prognosis and both may not be detected until too late. This article will talk about both Cervical and Ovarian Cancers in detail, and the differences between them, highlighting their clinical features, symptoms, causes, investigation and diagnosis, prognosis, and also the course of treatment they require.
Cervical cancer is the cancer of a uterine cervix. The uterine cervix is covered by a stratified non-keratinized squamous epithelium on the outside and a tall columnar epithelium on the inside. There is a transitional zone in between the two regions. This transitional zone is the most susceptible site for cervical cancers. Early menarche, early menopause, early first sexual contact, talc, and oral contraceptive pill increase the risk of cervical cancer. Human papilloma virus is associated with cervical cancer, as well.
Cervical cancer starts as cervical intraepithelial neoplasia. Cervical intraepithelial neoplasia is a condition where the cancerous changes in the epithelium are restricted to the epithelium only. When the changes are only in the upper one third of the cervix it is called CIN 1. Subsequently, if it affects the upper two thirds, it becomes CIN 2 and CIN 3 if full epithelium is involved. At this stage, the cancer has not spread across the basement membrane and can be cured completely if the uterus is removed. Because cervical cancer is so common, all women above the age 35 are screened at the well woman clinics with a pap smear. If the pap smear shows inflammatory changes, it should be repeated in six months. Cervical intraepithelial neoplasia is almost always asymptomatic, and it definitely progresses into cervical cancer.
Cervical cancers may present as spontaneous vaginal bleeding, post coital bleeding, and offensive smelling vaginal discharge. Digital vaginal examination may reveal a small palpable growth on the cervix in early cases or a destroyed cervix with extensive parametrial spread in advanced cases. MRI and CT may be needed to stage the disease. Hysterectomy removes the tumor bulk and chemotherapy and radiotherapy may also be needed.
Ovarian cancers are a common gynecological cancer. These are mostly found in middle aged women to elderly women. A positive family history of uterine, cervical, bowel and ovarian cancers is associated with ovarian cancers. Polycystic ovarian disease (PCOD) is a complex endocrine disorder which increases the risk of ovarian cancers.
Ovarian cancers may lie unnoticed until it is very advanced. They may present as abdominal masses, fluid in abdomen, irregular cycles and incidentally during routine scans. Ultrasound scan of the pelvis is an easily accessible and reliable way to detect ovarian malignancies. Ovarian masses, which are multiloculated, vascular, septated, hemorrhagic, and enlarging, are more likely to be ovarian cancers. Specific tumor markers like CA125 rises in ovarian epithelial cancers. It can also be used to assess the effectiveness of the treatment. Ovarian cancers spread to local lymph nodes, pelvic wall, lungs, vertebral column, and the peritoneum. Early cancers can be cured by oophorectomy. Chemotherapy and radiotherapy may be needed according to the stage of the condition.
What is the difference between Cervical Cancer and Ovarian Cancer?
• Cervical cancers arise in the uterine cervix while ovarian cancers arise from the ovaries.
• Cervical cancers need a hysterectomy while ovarian cancers need oophorectomy, as well. Both can be cured if detected early.
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