What is cervical cancer?

Cervical cancer is a disease in which abnormal cells in the cervix grow into tumors. Cervical cancer is serious and can be life-threatening if it is not treated.

Cervical cancer usually begins as a small area of abnormal cells on the surface of the cervix (the lower part of the uterus). If these cells are not found and removed, they can grow into a tumor and spread deeper into surrounding tissues. Cervical cancer often has no symptoms until it has reached an advanced stage, when it may cause bleeding between menstrual periods or after intercourse, pelvic pain, and changes to vaginal discharge such as increased bleeding or watery vaginal discharge with an odor.

In most cases, cervical cancer occurs in women who are not sexually active or who have had only one partner who also was not sexually active. However, sexual activity does increase your risk for cervical cancer if you do not always use condoms during intercourse or if your partner does not always use condoms during intercourse.

Symptoms of cervical cancer

The early stages of cervical cancer may not cause any symptoms. If symptoms do occur, they may include:

• A vaginal discharge that doesn’t clear up after a few days or weeks
• Bleeding between periods or after sexual intercourse (this could be with or without pain)
• Pain during sex or discomfort during bowel movements
• Tenderness or pain in the pelvis
• Back pain

Sometimes it’s hard to know whether your symptoms are caused by something serious, like cervical cancer, or by another less serious condition. If you have any of these symptoms and they don’t go away, talk with your doctor.

Symptoms include:

• Vaginal bleeding that is not during your period or after sex
• Unusual vaginal discharge (for example, other than clear and watery)
• Pain during intercourse
• Lower back pain

Cervical cancer causes

Cervical cancer is caused by a virus called human papillomavirus (HPV). There are more than 100 types of HPV, and some types can cause cancer. Other types cause genital warts or nothing at all. The most common type of HPV is called HPV 16, which causes about 50% of cervical cancers.

HPV 16 is spread during sexual contact with someone who has HPV 16 or another high-risk type of HPV. Most cases occur in people who have had multiple sex partners or an existing sexually transmitted infection (STI).

Infection with HPV usually doesn’t cause symptoms, so most people don’t know they’re infected until they develop a visible sign of cancer, such as abnormal cells on the cervix.

Cervical cancer treatment

Cervical cancer treatment depends on the stage of the disease and other factors.

Treatment for cervical cancer may include surgery, radiation therapy, or chemotherapy. The choice of treatment depends on the size of the tumor, its location, how far it has grown into surrounding structures, and whether it’s invaded lymph nodes.

Surgery

Surgery is usually the first line of treatment for cervical cancer. It can be used to remove a precancerous lesion or treat stage 0 or I cervical cancer.

During surgery, your surgeon removes any visible cervical cancer cells. If you have stage II or III cervical cancer, your doctor may remove your uterus and/or ovaries at the same time as your cervix is removed. This procedure is called radical hysterectomy with bilateral salpingo-oophorectomy (RHBSO).

Radiation therapy

Radiation therapy uses high-energy rays to kill cancer cells in place of surgery. It’s usually used after surgery to treat certain stages of cervical cancer that haven’t responded well to chemotherapy or when chemotherapy isn’t an option because of other medical conditions. Radiation therapy may be given alone or combined with chemotherapy.

Cervical cancer stages

The stage of a cancer describes its size and whether it has spread. Doctors also use the stage to predict how a person’s cancer might respond to treatment. The TNM staging system is used for cervical cancer.

Cervical cancer has four stages:

• Stage 1: The cancer is small. It may have spread to the lymph nodes. It hasn’t spread to other parts of your body.
• Stage 2: The cancer is larger. It may have spread outside of the uterus and cervix or to the lymph nodes. It still hasn’t reached other parts of your body.
• Stage 3: The cancer has spread to the lower part of the vagina or to the pelvis. It may be blocking the ureters, the tubes that carry urine from the kidneys to the bladder. It hasn’t spread to other parts of your body.
• Stage 4: The cancer may have spread outside of the pelvis to organs like your lungs, bones, or liver.

Cervical cancer test

A Pap test is a simple and painless procedure that can help detect cervical cancer early, when it’s more treatable. During the Pap test, your doctor collects a sample of cells from your cervix and sends them to a lab for analysis. If the results are abnormal, your doctor may recommend additional testing or treatment.

Pap tests are usually done at a women’s health clinic or medical office. You’ll be asked to lie on an exam table with your knees bent and feet in stirrups. The doctor will use an instrument called a speculum to spread the walls of your vagina apart so he or she can see the cervix. Then the doctor will take samples of your cervical cells by gently scraping them with a tiny brush or spatula that’s dipped in vinegar solution. Your doctor may also use a device called a colposcope (or sometimes an acetic acid spray) to get a closer look at the cervix during this procedure.

Cervical cancer risk factors

Risk factors for cervical cancer include:

Age: The average age of diagnosis is 49 years old, according to the Centers for Disease Control and Prevention (CDC). But it’s important to remember that anyone can develop cervical cancer, regardless of their age. The CDC reports that nearly 90 percent of cases are diagnosed in women over 30.

HIV infection: People with HIV infection have higher levels of certain viruses that can cause cervical cancer. HPV infection is more common in people living with HIV compared with those who don’t have HIV. Having an active STD can also increase your risk for HPV infection. This includes chlamydia, gonorrhea and syphilis infections. A history of genital warts or other STD symptoms may also put you at higher risk for developing cervical cancer later on in life. It’s best to get screened regularly if you’re sexually active or if you’ve had an STD in the past year — or ever — so any existing infections can be detected early on before they become serious problems.