Cervical Cancer: Causes, Symptoms and Treatment

One of the primary goals of physicians in the OB/GYN field is preventing disease in the reproductive organs, and one of the most common types of disease is cervical cancer. Cervical cancer describes cancer in the cervix, which is the lower section of the uterus connected to the vagina.

Like many other forms of cancer, the success of treatment for cervical cancer depends in large part on how early it was detected. This makes regular screenings as part of preventive care vital – detecting the early signs of cervical or other cancers allows you to treat them early, and can limit invasive procedures and expenses later in life while improving life expectancy and quality.

Types of Cervical Cancer

There are two primary types of cervical cancer:

Squamous cell carcinoma: The more common form. Begins in cells on the outside of the cervix
Adenocarcinoma: Begins in glandular cells in the cervical canal

Symptoms

Most cases of cervical cancer have no visible symptoms in their earliest stages, which is part of what makes it tough to detect early. In the later stages, symptoms may still not be present, but they can include:

Vaginal bleeding at abnormal times – after sex, between periods, after menopause
Pain during intercourse
Watery or bloody discharge, often with a bad smell

Causes and Risk Factors

While doctors still aren’t 100 percent sure how it develops, they’re certain that a condition called human papillomavirus (HPV) is directly related to most cases of cervical cancer. HPV is a sexually transmitted infection which is usually stopped by the immune system naturally, but in some cases it can survive for years and lead to the formation of cancer cells in the cervix. There are vaccines available to help prevent HPV, and these are recommended for both women and men.

Healthy cells can mutate and become cancerous, and there are several factors that can increase the risk of mutations:

Early sexual activity
Sexually transmitted infections (STIs)
Several sexual partners (increases risk of getting HPV)
Smoking
Limited immune system
Outside environment – factors that can weaken immune system

Prevention is the most effective treatment against conditions like cervical cancer. Paying attention to these risk factors and getting the proper vaccines can help lower your risk.

Diagnosis

From the age of 21, or even earlier in some cases, all women should be screened for signs of cervical cancer. The two most common screening tests are:

Pap test: Also called a Pap smear, this is when a doctor takes a sample of cells from your cervix and tests them in a lab
HPV DNA test: Also tests cells, but specifically for presence of HPV

If your doctor thinks there’s a chance you have cervical cancer, you’ll be given a further examination. These tests can include:

Punch biopsy: Removal of a tissue sample
Endocervical curettage: Sample taken with a thin brush or a spoon-like tool
Electrical wire loop: Uses low-voltage wire to pull a tissue sample
Cone biopsy: A deeper tissue sample, sometimes under anesthesia

Treatment

The first step of treatment is figuring out which stage your cancer is in. This will be done using imaging tests like MRIs or CT scans, or sometimes a visual exam. There are four stages of cervical cancer:

Stage I: Cancer is only in the cervix itself and has not spread
Stage II: Cancer is in the cervix and the upper part of the vagina
Stage III: Cancer has moved to the vagina or the pelvic side wall
Stage IV: Cancer has spread to other organs or other areas of the body – lungs, liver, bladder, rectum, etc.

There are three major forms of treatment for cervical cancer, depending on its stage.

Surgery: A hysterectomy, or surgery to remove the uterus, is performed. In simple hysterectomy, only the uterus and cervix are removed along with the cancer (this can only be done for early stages). In radical hysterectomy for all later-stage cervical cancers, parts of the vagina and lymph nodes are also removed
Radiation therapy
Chemotherapy

All treatment options will be discussed with your doctor. For any questions about prevention or treatment of cervical cancer, contact your healthcare provider.