Human Papillomavirus (HPV) and Cervical Cancer: A Pathophysiology Case

This case study provides a detailed analysis of cervical cancer, focusing on the pathophysiology and various risk factors associated with the disease. It examines the case of Adina, diagnosed with cervical cancer and HPV, with a history of asthma. The study elucidates the link between risk factors like HPV infection, smoking, age, ethnicity, and oral contraceptive use, and how these contribute to the development of cervical cancer. It further explains the symptoms of cervical cancer at various stages, correlating Adina's symptoms with the advanced stage of her disease, including vaginal bleeding, fatigue, weight loss, and pelvic pain. The analysis references several research articles to support the understanding of cervical cancer's etiology and progression. Desklib provides access to similar case studies and solved assignments for students.

Human Pathophysiology
and Pharmacology
(concept map)

Stopping ovulation
Infection in epithelial lining of
anogenital area
Pathophysiology
Risk Factors
Aetiology
Clinical
manifestations
Diagnostic tests
Treatment
Human
papilloma
virus (HPV)
Oral
contraceptives
Vaginal bleeding
after intercourse
HPV
Fatigue
Infection is spread through
skin- associated virus
Pelvic pain
smoking
Radiation
Surgery
Loss of appetite
PAP test, cervuical
biopsies,
Key
Age – over
40 years
Infects the keratinocyte of
the epidermis
Epidermal cells differentiate and migrate to
the surface, virus replicates
Virus replication alters the
character of epidermis
Sexual
intercourse
during early
teen years
Medication such
as Aspirin
Ferrous sulphate
as iron
supplement
Nutrient
supplementation
Vinegar solution
test
DNA tests

1.
As per the given case, Adina is diagnosed with cervical cancer and human papilloma virus. She also has medical history of
long standing asthma. The link between the risk factors and aetiology can be explained to account for the pathophysiology
of the disease.
The following are the factors that increase the risk of a woman developing cervical cancer:
Human papilloma virus (HPV) infection- This is considered to be the most important risk factor for cervical cancer. Further,
the most common way through which a person can contract HPV is through sexual activity with an infected person.
Smoking- The risk of cervical cancer increases with smoking. The women who smoke are two to three times more risk of
developing cervical cancer as compared to non- smoking women.
Age- the risk of cervical cancer is more among the women aged over 40 years of age.
Race/ ethnicity- Cervical cancer is more prevalent among women of Hispanic origin, black women and American Indian
women.
Oral contraceptives- Birth control pills are associated with an increased risk of cervical cancer.
The pathophysiology of the disease indicates that human papilloma virus needs to be present for cervical cancer to occur.
However, only a small fraction of HPV progress to develop into cervical cancer. This indicates that there needs to be
presence of other factors that make HPV infections progress to cervical cancer. As per the case of Adina, her lifestyle
choices exposed her to a number of risk factors for cervical cancer. She had the habit of smoking and engaged in sexual
activity at a very early age of 14 years. Moreover, she has had six sexual partners which strengthens the fact that she may
have contracted HPV from an infected partner. Furthermore, Adina often consumed an oral contraceptive pill to prevent
pregnancy. Her age may also have increased the possibility of development of the disease as she is 43 years of age.
2.
Cervical cancer does not manifest any signs and symptoms during early years. The presence of malignancy is indicated by
the symptoms such as vaginal bleeding, bleeding after sexual intercourse (contact bleeding) or a vaginal mass. Other
symptoms of cervical cancer are presence of moderate pain during sexual intercourse and discharge from the vagina. The
advanced stages of the disease are indicated by presence of metastases in the lungs, abdomen and elsewhere.
In advanced stages, cervical cancer is marked by fatigue, appetite loss, back pain, weight loss and leg pain. Other
symptoms in advanced stages are heavy vaginal bleeding, swollen legs and bone fractures. The signs and symptoms
exhibited by Adina indicate that the disease is in its advanced stage. She reported vaginal bleeding following sexual
intercourse. She also suffer from fatigue, weight loss and pelvic pain from the past 2 to 3 months. This suggests that HPV
has progressed to develop into cervical cancer and the disease has reached its advanced stages.

Reference list
Colombo, N., & et.al. (2012). Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-
up. Annals of Oncology, 23(7), pp.27-32.
Song, S., & et.al., (2012). 20year experience of postoperative radiotherapy in IB-IIA cervical cancer patients with
intermediate risk factors: Impact of treatment period and concurrent chemotherapy. Gynecologic oncology, 124(1), 63-67.
Massad, L. S., & et.al., (2013). 2012 updated consensus guidelines for the management of abnormal cervical cancer
screening tests and cancer precursors. Obstetrics & Gynecology, 121(4), 829-846.
Chelimo, C., & et.al., (2013). Risk factors for and prevention of human papillomaviruses (HPV), genital warts and cervical
cancer. Journal of Infection, 66(3), 207-217.
Katanyoo, K., Sanguanrungsirikul, S., & Manusirivithaya, S. (2012). Comparison of treatment outcomes between squamous
cell carcinoma and adenocarcinoma in locally advanced cervical cancer. Gynecologic oncology, 125(2), 292-296.
Saslow, D., & et.al., (2012). American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American
Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA: a cancer journal
for clinicians, 62(3), 147-172.
Herfs, M. & et.al., (2012). A discrete population of squamocolumnar junction cells implicated in the pathogenesis of cervical
cancer. Proceedings of the National Academy of Sciences, 109(26), 10516-10521.
Darragh, T. M. & et.al., (2012). The lower anogenital squamous terminology standardization project for HPV-associated lesions: background and
consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical
Pathology. Archives of pathology & laboratory medicine, 136(10), 1266-1297.