Cervical Cancer

Overview

Cancer occurs when some types of cell start to grow abnormally. These abnormal cells grow more quickly than healthy cells, leading to the formation of a lump or mass. Cervical cancer is cancer that occurs in the cells of the cervix, which is the lowest part of the uterus that connects to the vagina. Because this type of cancer develops in the female reproductive system, it can only occur in females.

Cervical cancer causes

Various strains of human papillomavirus – or HPV – cause most cases of cervical cancer. Most women who contract HPV will not develop cervical cancer. However, in a small percentage of women, HPV causes normal cervical cells to become cancerous.

Cervical cancer risk factors

Factors that increase your risk for developing cervical cancer include:

• Being a smoker
• Being exposed to the miscarriage prevention drug diethylstilbestrol (DES) while in utero (common during the 1950s)
• Having a weakened immune system
• Having many sexual partners
• Having other sexually transmitted infections (STIs), such as chlamydia, gonorrhea, syphilis and HIV/AIDS
• Having sexual intercourse at an earlier age

Cervical cancer symptoms

In its early stages, cervical cancer doesn’t cause any signs or symptoms. For this reason, it’s critical that all women undergo regular screening exams (pap test). Getting the HPV vaccine can also reduce your risk of developing cervical cancer.

In its advanced stages, cervical cancer can cause:

• Pain during intercourse
• Pain in the pelvis
• Vaginal bleeding after intercourse, between periods or after undergoing menopause
• Water, bloody vaginal discharge that can be heavy or have a foul odor

Cervical cancer diagnosis

Your specialist may recommend one or more of the following tests to diagnose cervical cancer:

• Punch biopsy - your specialist uses a sharp tool to pinch off small samples of cervical tissue for closer examination in the lab.
• Endocervical curettage - your specialist uses a small, spoon-shaped instrument – called a curet – to scrape a tissue sample from your cervix. This sample is sent for closer analysis in the lab.
• Electrical wire loop - you will be under local anesthesia for this procedure, meaning that your specialist will numb the affected area. Your specialist will use a thin, low-voltage electrified wire to remove a small tissue sample from your cervix. This sample is sent for closer analysis in the lab.
• Cone biopsy (conization) - you will be under general anesthesia (fully asleep) for this procedure, and it is typically performed in an outpatient hospital setting. Your specialist uses specialized tools to obtain deeper layers of cervical cells. This sample is sent for closer analysis in the lab.
• Imaging tests - if your specialist has determined that you have cervical cancer, they may order imaging tests – such as X-ray, computerized tomography (CT) scan, magnetic resonance imaging (MRI) or positron emission tomography (PET) – to stage your cancer and determine your course of treatment.

Cervical cancer treatment

Depending on your unique situation, your specialist may recommend one or more of the following treatment options for cervical cancer

• Surgery to remove only the cancer - if your area of cancerous cells is small, your specialist may be able to remove the entire area with a cone biopsy. With a cone biopsy, the cervix remains intact and pregnancy may be possible in the future.
• Trachelectomy - in this procedure, your specialist removes the cervix and some surrounding tissue. Because the uterus remains, pregnancy may be possible in the future.
• Hysterectomy - in this procedure, your specialist removes the cervix, uterus, part of the vagina and nearby lymph nodes. While this procedure prevents recurrence of cervical cancer, future pregnancies are impossible.
• Radiation therapy - this treatment uses high-energy beams – such as X-ray or protons – to destroy cancerous cells. People typically have to undergo several rounds of radiation therapy treatment for results.
• Immunotherapy - this treatment is a medication therapy that helps your immune system fight the cancer. Immunotherapy is typically used in advanced stages of cervical cancer.
• Chemotherapy - this treatment involves using medications – either oral (by mouth) or intravenous (by vein) – to destroy cancer cells.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.