Facts and Information About Cervical Cancer Diagnosis, Symptoms and Treatment
What is cervical (cervix) cancer?
Cervical cancer (or cervix cancer) is cancer of the cervix. The cervix is the lower part of the uterus (womb), which opens into the vagina.
How common is cervical (cervix) cancer?
Worldwide, cervical cancer is the second-most-common type of cancer that strikes women – behind only breast cancer. In the United States, cervical cancer is the 14th most common cause of new cancers diagnosed among women every year. The American Cancer Society estimates that in 2007, about 11,150 women in the United States developed cervical cancer and about 3,700 died from it. That lower occurrence of cervical cancer in the United States is largely thanks to the Pap test, which has helped decrease the number of American women with cervical cancer by about 75 percent in the past 50 years.
The bad news is that too many women are still getting cervical cancer and are still dying. It's estimated that globally, one in every 123 women will develop cervical cancer, if screened only with the Pap test. This, however, can change for the better. In addition to regular Pap testing of all eligible women, cervical cancer prevention can be improved with the use of the HPV test
(if age 30 or older) and the new HPV vaccine
What causes cervical cancer?
"High-risk" types of the human papillomavirus (HPV) have been shown to be the cause of cervical cancer.
Most women will get one or more types of "high-risk" (potentially cancer-causing) HPV at least once in their lives. The body's immune system usually fights off the infection, and most women with HPV never suffer from any problems as a result.
In some women, however, the infection does not go away. When the virus stays active in the body for a long period of time, cervical cells may begin to change and the risk of cervical cancer increases.
Are there other causes of cervical cancer?
High-risk types of the HPV virus are the cause of cervical cancer.
However, other factors can increase the likelihood that an HPV infection develops into cervical cancer:
- Exposure while in the womb to a medication called diethylstilbestrol (DES), which was prescribed to many women to prevent miscarriage between 1938 and 1971.
- Infection with chlamydia or herpes simplex virus type 2 (both different types of sexually transmitted diseases).
- A first-degree relative (mother or sister) with a history of cervical cancer, which the International Journal of Cancer reports increases personal risk three-fold.
- Conditions that weaken the body's immune system, such as HIV/AIDS.
- Smoking, which interferes with the body's ability to fight off infection. [In fact, one study showed that smokers are 60 percent more likely to develop cervical cancer, and former smokers are 12 percent more likely.]
- Low levels of folic acid (a type of Vitamin B).
There also are some data that suggest that long-term use of oral contraceptives (10 or more years) may increase the risk of some types of cervical cancer.
What can you do to prevent cervical cancer?
The best way to protect yourself is to get regular cervical cancer screenings with the Pap and – if you're older than 30 – the HPV test. Together, these tests determine if you are likely to have or to develop abnormal cells that could become cancerous if not removed. If your Pap looks abnormal and HPV testing shows you have an infection with a high-risk type of the virus, your doctor, nurse or other healthcare professional can perform an additional exam called a colposcopy to determine if any abnormal cells need to be removed.
How long does it take for cervical cancer to develop?
Once cervical cells begin to change, it typically takes 10-15 years before invasive cervical cancer develops. As the cells change, they first become "pre-cancerous" – a condition also known as "dysplasia" or CIN – the abbreviation for cervical intraepithelial neoplasia.
If detected early, dysplasia can be treated before the cells become cancerous. See the discussion of dysplasia on the Web site.
What are the symptoms of cervical cancer?
Symptoms do not always occur when cervical cancer develops.
However, when they do, they may include:
- unusual vaginal discharge or bleeding (especially after sexual intercourse).
- lower back pain.
- painful urination (particularly when there is also pain in the lower abdomen).
- pain during sex.
Remember: These symptoms can have a number of causes. They do not necessarily mean you have cervical cancer. Talk to your doctor or nurse if you have any of these symptoms.
How is cervical cancer diagnosed?
Cervical cancer is diagnosed through a series of exams, typically beginning with a Pap and – if you’re older than 30 – the HPV test, followed by a colposcopy (in which a lighted, magnifying instrument is used to examine your cervix) and biopsy (in which a sample of tissue is removed for analysis in a laboratory).
How is cervical cancer treated?
If you are diagnosed with cervical cancer, your physician(s) will discuss the best treatments with you.
Treatment options depend on the following:
- The stage of the cancer.
- The size of the tumor.
- Your age.
- Your desire to have children.
Treatment typically involves one or more of the following:
- Surgery to remove the uterus (hysterectomy). However, for young women with small tumors, minimally invasive surgery that preserves the ability to have children may be an option. This procedure is called "radical vaginal trachelectomy with laparoscopic pelvic lymphadenectomy."
- Radiation therapy, in which high-energy x-rays or other types of radiation are used to kill the cancer cells. Radiation therapy can be delivered using a machine positioned outside the body to bombard the cancer, or through a radioactive substance sealed in a wire, catheter or other device and then placed in the body in or near the cancerous area.
- Chemotherapy, which uses drugs to stop the growth of cancer cells. Chemotherapy can be taken by mouth, or injected into a vein, muscle, spinal column, organ or body cavity.
Note that if a woman is pregnant when diagnosed with cervical cancer, the treatment will depend on the stage of the cancer and of the pregnancy. For cervical cancer found in its early stages, or for cancer diagnosed during the last trimester of pregnancy, treatment may be delayed until after the baby is born.
What is the chance of recovery from cervical cancer?
The prognosis (chance of recovery) depends on factors such as:
- The stage of the cancer (whether it affects part of the cervix, involves the whole cervix or has spread to the lymph nodes or other places in the body).
- The size of the tumor.