What is cervical cancer?

Cancer is a disease in which certain body cells do not function correctly, divide very fast, and produce too much tissue that forms a tumor. Cervical cancer is cancer of the cervix, the lower narrow part of the uterus (womb). The uterus is the hollow, pear-shaped organ where a baby grows during a woman’s pregnancy. The cervix forms a canal that opens into the vagina (birth canal), which leads to the outside of the body. Cervical cancer is a disease that can be very serious; however, it is one that you can help prevent. Usually it takes several years for normal cells in the cervix to change into cancer cells, but sometimes it can happen in a very short period of time.

What are the symptoms of cervical cancer?

Cervical pre-cancers and early cancers usually show no symptoms or signs. A woman usually develops symptoms when the cancer has become invasive and attacks nearby tissue. When this happens, the most common symptom is abnormal vaginal bleeding. Abnormal bleeding may include bleeding after menopause, bleeding that starts and stops between periods, bleeding that occurs after intercourse or a pelvic exam, or menstrual bleeding that lasts longer and heavier than usual. Another symptom may be vaginal discharge because of a large tumor that has become infected causing a malodorous discharge (bad smelling) which may occur before bleeding.

What are the risk factors for developing cervical cancer?

According to the National Cancer Institute, strong risk factors include:
infection with the human papillomavirus (HPV). Doctors believe that women must have been infected by this virus before they will develop cervical cancer. HPVs are a group of more than 100 types of viruses that can cause warts, or papillomas, which are non-cancerous (benign) tumors. Certain types, however, cause cancer of the cervix. These are called “high-risk” types of HPV and include HPV 16, HPV 18, HPV 31 HPV 33 and HPV 45, as well as some others.

sexual behaviors - early age of first intercourse and a history of multiple sex partners

tobacco use – women who smoke are about twice as likely as non-smokers to get cervical cancer.

women whose mothers were given the drug Diethylstilbestrol (DES) during pregnancy to prevent miscarriage.

Can cervical cancer be prevented?

Recently, the U.S. Food and Drug Administration (FDA) approved a vaccine that is highly effective in preventing HPV infection with types 16 and 18, two “high-risk” types that cause 70 percent of cervical cancers, and types 6 and 11, which cause 90 percent of genital warts. The HPV vaccine is recommended for 11- to 12-year-old girls, and if the doctor decides, the vaccine can be given to girls as young as 9. The vaccine also is recommended for 13- to 26-year-old girls/women who have not yet received or completed the vaccine series. The vaccine is given through a series of three shots over a six-month period. The vaccine should be given before sexual activity begins (before contact with the HPV virus). Those who have not been infected with any type of HPV will benefit the most from the vaccine. Girls/women who are sexually active should still be vaccinated because they can get protection from the HPV types that they haven’t been infected with. For further information go to www.cdc.gov/std/hpv/STDFact-HPV-vaccine.htm.

The vaccine may not fully protect everyone and does not prevent all types of cervical cancer, so it is important to continue regular cervical cancer screenings.

The only way you can totally protect yourself against HPV is to avoid any sexual activity that includes genital contact.

How can cervical cancer be found early?

Cervical cancer can usually be found early by having regular Pap tests. Women should have regular checkups, including a pelvic exam and a Pap test. Pap tests should begin within three years after becoming sexually active or at 21 years of age, whichever happens first. If a woman has had three consecutive, negative pap tests within a five-year period, she may get screened every three years. Those who are at increased risk of developing cancer of the cervix should follow their doctor’s advice about checkups.

How is cervical cancer diagnosed?

A Pap test is the first step in diagnosing cervical cancer. If the Pap test is abnormal, procedures may need to be done for further diagnosis:

Colposcopy: the doctor applies a vinegar-like solution to the cervix and using a colposcope looks closely at the cervix.

Biopsy: the doctor removes tissue to look for precancerous cells or cancer cells.

Loop electrosurgical excision procedure (LEEP): the doctor uses an electric wire loop to shave off a thin, round piece of tissue.

Endocervical curettage (ECC): the doctor uses a curette (a small, spoon-shaped instrument) to get tissue from inside the cervical opening.

Conization (cone biopsy): the doctor removes a larger, cone-shaped sample of tissue.

How are precancerous conditions treated?

Treatment depends on several factors, such as whether the lesion is low or high grade, whether the woman wants to have children in the future, the woman’s age and general health. A low-grade lesion may not need further treatment especially if the abnormal area was completely removed during the biopsy and can be watched with regular Pap tests. Cryosurgery (freezing), cauterization (burning) or laser surgery can be used to destroy the abnormal area without harming healthy tissue. The doctor also can remove abnormal tissue by LEEP or conization.

How is cervical cancer treated?

The choice of treatment depends on the location and size of the tumor, the stage (extent) of the disease, the woman's age, general health and other factors. Most often, the treatment involves surgery and radiation therapy. Sometimes, chemotherapy or biological therapy is used. The doctor may decide to use one treatment or a combination of treatments. Surgery may involve removing the tissue in or near the cervix, the cervix or the entire uterus (hysterectomy). Radiation therapy uses high-energy rays to damage cancer cells and stop them from growing. Chemotherapy is the use of drugs to kill cancer cells. It is most often used when cervical cancer has spread to other parts of the body. The doctor may use one drug or a combination of drugs. Biological therapy is treatment using substances to improve the way the body's immune system fights disease, and it may be used to treat cancer that has spread from the cervix to other parts of the body.