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What is cervical cancer?
Cervical cancer is abnormal growth of cells in a woman’s cervix. The cervix is the lowest part of the uterus (womb). It connects the uterus and the vagina. Cervical cancer is almost always caused by the human papillomavirus (HPV).
Symptoms of cervical cancer
In its early stages, cervical cancer may not have any symptoms. This is the case with many cancers. In later stages, symptoms could include:
- Unusual vaginal bleeding (not during your menstrual cycle)
- Abnormal vaginal discharge
- Pelvic pain
- Pain during sex
These could also be signs of a condition other than cervical cancer. If you experience any of these symptoms, see your family doctor.
What causes cervical cancer?
Almost all cervical cancers are caused by HPV. This is a common sexually transmitted virus that can cause infections. There are more than 100 types of HPV. Some types cause no symptoms. Others cause body warts or genital warts. More aggressive kinds can cause cancer in both women and men. Cervical cancer is the most common kind of cancer caused by HPV.
How is cervical cancer diagnosed?
Abnormal results from a routine Pap test (or smear) could lead to a cervical cancer diagnosis. During a Pap test, your doctor takes a sample of cells from your cervix. The sample is sent to a lab and checked under a microscope.
Abnormal Pap test results could mean there are changes in the cells on your cervix, including:
- Inflammation (irritation). This can be caused by an infection of the cervix. These include yeast infections, HPV, the herpes virus, or many other infections.
- Abnormal cells. These changes are called cervical dysplasia. The cells are not cancerous but may be precancerous. This means they could eventually turn into cancer.
- More serious signs of cancer. These changes affect the top layers of the cervix, but don’t go beyond the cervix.
- More advanced cancer. These cell changes extend into tissues beyond the cervix.
If the results of your Pap test are abnormal, your doctor may repeat the test. He or she may also do a cervical HPV test. This test can show if you have one of the types of HPV that can cause cancer. Your doctor may want you to have a colposcopy. During this procedure, he or she will use a magnifying lens to look more closely at your cervix. They can also take a sample of tissue (biopsy) to test for cancer.
Cells of the cervix go through many changes before they turn into cancer. A Pap test can show if your cells are going through these changes. If caught and treated early, cervical cancer is not life threatening. This is why it is so important that you get regular Pap tests.
Can cervical cancer be prevented or avoided?
In many cases, cervical cancer can be prevented. The best ways to do this are to avoid getting HPV and to get regular Pap tests.
Avoiding HPV
An HPV vaccine can protect young people against the virus. The vaccine is FDA-approved for all boys and girls between 9 years and 26 years of age. It is most effective when you get it before you have been exposed to HPV. The Centers for Disease Control and Prevention (CDC) recommends that girls and boys who are 11 or 12 get the vaccine. But anyone age 26 or younger should get the vaccine, even if you’ve already had HPV.
Other ways to lower your risk of getting HPV include:
- Limit your number of sex partners.
- Don’t have sex with someone who has had a lot of partners.
- Use condoms anytime you have sex. (Remember, condoms aren’t 100% effective. HPV is spread by skin-to-skin contact. This makes condoms less reliable for prevention.)
Get regular Pap tests
All women should get regular Pap tests. These can detect abnormal cells before they turn into cancer.
Certain things put you at higher or lower risk for cervical cancer. Your doctor will consider these when recommending how often you should have a Pap test. Most women can follow these guidelines:
- Every 3 years beginning at 21 years of age and continuing until 65 years of age.
- If you are between 30 and 65 years of age, you might be able to combine a Pap test with HPV testing every 5 years.
- If you are older than 65, ask your doctor if you still need regular Pap tests.
Cervical cancer treatment
In many cases, precancerous cells are found before cancer develops. Treatment for these is different than for invasive cancer cells.
Precancerous lesions
Treatment will depend on several factors. These include severity, age, general health, desire to get pregnant in the future, and preference. Options include cryosurgery (freezing), cauterization (burning), or laser surgery. These procedures destroy the abnormal cells without causing much damage to nearby healthy tissue.
Invasive cervical cancer
This means that the cancer has spread from the surface of the cervix. It may spread to tissue deeper within the cervix or to other parts of the body. Treatment options depend on the size of the tumor and how far the cancer has spread. They also may depend on your plans for having children in the future. The most common treatments include:
- Surgery — The cancerous tissue is removed in an operation.
- Radiation —High-energy rays like X-rays shrink or kill the cancerous cells.
- Chemotherapy — Powerful medicines, in pill form or injected into the veins, shrink or kill the cancer.
Treatment of invasive cancer often involves a team of specialists. This could include your family doctor, a gynecologist, and an oncologist (cancer specialist). You will all work together to develop the best treatment plan for you.
Living with cervical cancer
Cervical cancer is treatable, especially when detected early. Precancerous cells can be removed before they develop into cancer. Early treatment often does not affect your ability to have children. Treatment of more advanced cancers could require removal of the uterus or other reproductive organs. Some women have their eggs frozen for future use before undergoing this kind of surgery.
Cancer treatments can be stressful. Treatments can have different side effects on your body. Take good care of yourself. Eat a healthy diet, get plenty of sleep, and try to keep your energy up by staying mildly active.
Even after your cancer goes into remission, you are at higher risk of cancer returning to your body. You will need to get regular follow-up care and check-ups for years after your treatment.
Questions to ask your doctor
If you are sexually active:
- How often do I need a Pap test?
- Should I be tested for any sexually transmitted infections? How often?
If the results of your last Pap test were normal:
- When do I need another Pap test?
If the results of your last Pap test were abnormal:
- What do the results mean?
- Do I need a follow-up Pap test or an HPV test?
- Will I need a colonoscopy or a biopsy?
- Do I need any treatment?
- Am I at risk for cervical cancer?
- Is it safe for me to have sex?
If you are diagnosed with cervical cancer:
- What is the stage of my cancer?
- What treatments are available to me?
- What are the risks and possible side effects of each treatment?
- Will treatment affect my daily activities, including sex?
- Will I be able to get pregnant and have children after the treatment?
- What is my outlook for recovery?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
