Semen enhances cervical tumours

Cervical cancer is now one of the most common cancers in women overall. Cancer is a disease in which the cells in the body develop out of control.
 Cory Couillard
Cory Couillard

Cervical cancer is now one of the most common cancers in women overall. Cancer is a disease in which the cells in the body develop out of control. When cancer starts in the cervix, it is called cervical cancer. Cancer of the cervix is often deadly as it metastasizes or spreads to other parts of the body.

Cervical cancers don’t always spread, but those that do most often spread to the lungs, the liver, the bladder, the vagina, and the rectum.

The cervix is the lower, narrow end of the uterus. The cervix connects the vagina (birth canal) to the uterus. The uterus (or womb) is where a baby grows when a woman is pregnant.

Human papillomavirus (HPV) is the main cause of cervical cancer. HPV is a common virus that is passed from one person to another during sex. Unfortunately, at least half of sexually active people will have HPV at some point in their lives. However, not all women will get cervical cancer but all women are at elevated risk.

A hormone-like molecule found in semen called prostaglandin could facilitate the development of cervical cancer. Researchers found that the high concentration of prostaglandin in semen makes other diseases of the female reproductive organs worse as well - including uterine cancers.

Prostaglandins present in semen can influence the progression of cervical and uterine cancers by enhancing tumour growth according to Dr Jabbour, lead researcher at the Medical Research Council’s Human Reproductive Sciences Unit.

The cells that line the female reproductive organs are known to naturally produce prostaglandin. However, the concentration of prostaglandin in semen is 1000 times higher than that normally found in these cells.

Prostaglandin receptors are present on the surface of the cells that make up cervical and uterine cancer tumours. The influx of prostaglandin delivered by semen creates abnormal signaling between cells and can trigger an increase in tumour growth.

Although prostaglandins do not cause cervical cancer directly, this research shows that seminal fluid can contribute to tumour growth when other risk factors are present.

‘‘Sexually active women who are at risk of cervical or uterine cancer should encourage their partners to wear a condom to prevent increased exposure to the prostaglandins that might make their condition worse,” according to Dr Jabbour.

The majority of cases occur in midlife rather than old age and it is one of the most common cancers in women under 35. Preventative cervical screening programmes can cut cervical cancer death rates and provide a means of early detection. When cervical cancer is found early, it is highly treatable and is often associated with long survival and good quality of life outcomes.

Types of cervical cancer

There are two main types of cervical cancers: squamous cell carcinoma and adenocarcinoma. About 80 to 90 per cent of cervical cancers are squamous cell carcinomas. Squamous cell carcinomas starts in the surface of the cells that line the cervix that can rapidly multiply into active cancer.

Cervical adenocarcinomas seem to have become more common in the past 20 to 30 years but still only make up 5 to 10 per cent of cervical cancers. This form is more difficult to detect as it often starts higher up in the cervical canal and is commonly missed by a screening test.

Although most cervical cancers are either squamous cell carcinomas or adenocarcinomas, other types of cancer also can develop in the cervix as well. These types include melanoma, sarcoma, and lymphoma but they are more likely to occur in other parts of the body.

Symptoms of cervical cancer

Cervical cancer is often silent. In the early stages there are usually no symptoms and that’s the purpose of screenings to pick up abnormal cells before it’s too late. Once cancer is established, the most common symptom is bleeding between periods or after sex. Menstrual bleeding may also be heavier or last longer than normal.

Other common symptoms include pain in the pelvic area before, during or after intercourse as well as pain or difficult urination. Another red flag is any sort of unusual or unpleasant smelling discharge from the vagina. However, these symptoms may indicate other problems than cervical cancer as well.

Risk factors for cervical cancer

It’s common to have multiple sexually transmitted infections that may act in combination to complicate and weaken one’s immune system.  The number of sexual partners significantly increases one’s risk of HPV, chlamydia and HIV.  Having sex at a young age and not using barrier contraceptives such as condoms will encourage transmission and cancer development.

Oral contraceptive use is also associated with an increased risk of cervical cancer according to the National Cancer Institute. However, sexually active women using oral contraceptives have a higher risk of becoming infected with human papillomavirus, which is the main cause of cervical cancers.

Pap testing for cervical cancer

The Pap test (or Pap smear) and the human papilloma virus (HPV) test are often used in pre-cancerous screenings. If pre-cancerous lesions are found, they can often be treated thus stopping cervical cancer before it becomes deadly. Pap testing is considered safe and has very few side effects.  The benefits definitely outweigh any risk.

Recommendations may vary but all women should begin cervical cancer screening by age 21. Women aged 21 to 29 are generally recommended to have a Pap test every 3 years. Beginning at age 30, the most common way to screen is with a Pap test combined with an HPV test every 5 years. Consult with your doctor to determine the correct frequency specifically for you.

Even those that have been vaccinated against HPV should still be routinely screened, as any vaccine is not 100 per cent effective.  Women who have abnormal test results may need to have more frequent follow-ups done in 6 months or a year to monitor the situation closely.

Although Pap tests are widely accepted as the most effective screening procedure in the prevention of cancer, it’s still not perfect. Limitations exist as it needs to be examined by humans and humans make mistakes.  Despite technology, hundreds of thousands of cells need accurate examination to properly diagnosis the condition.

Preparing for a Pap test

The best time to obtain the most accurate results from a gynecological examination and Pap test is one or two weeks after one’s period. Try not to schedule the appointment for a time during your menstrual period.

Vaginal douching is generally a good idea due to the risk of infection. If douching is practiced, it is important not to douche for at least two or three days before one’s appointment.

Do not use tampons, birth control foams, jellies or other vaginal type creams, moisturizers or lubricants for at least 48 hours prior to the test. It’s also important to refrain from sexual intercourse for at least a day.

Dr Cory Couillard is an international healthcare speaker and columnist. He works in collaboration with the World Health Organization’s goals of disease prevention and global healthcare education.

Twitter: DrCoryCouillard

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