Cervical cancer: Symptoms, causes, stages, and treatment

Cervical cancer affects the entrance to the womb. The cervix is the narrow part of the lower uterus, often referred to as the neck of the womb.

The American Cancer Society estimates that doctors will make 13,170 new diagnoses of cervical cancer by the end of 2019 in the United States. More than 4,200 women in the U.S. will die from cervical cancer this year.

Human papillomavirus (HPV) causes the majority of cervical cancer cases. The HPV vaccine successfully prevents HPV.

The Centers for Disease Control and Prevention (CDC) initially recommended the vaccine for all people aged 9–26 years. However, the CDC now advise that the vaccine is also available for all women and men aged 26–45 years who did receive the vaccine as a preteen.

Symptoms and early signs

woman with pelvic pain
Pelvic pain is a possible symptom of cervical cancer.

In the early stages of cervical cancer, a person may experience no symptoms at all.

As a result, women should have regular cervical smear tests, or Pap tests.

A Pap test is preventive. It aims not to detect cancer but to reveal any cell changes that indicate the possible development of cancer so that a person can take early action to treat it.

The most common symptoms of cervical cancer are:

bleeding between periods

bleeding after sexual intercourse

bleeding in post-menopausal women

discomfort during sexual intercourse

vaginal discharge with a strong odor

vaginal discharge tinged with blood

pelvic pain

These symptoms can have other causes, including infection. Anyone who experiences any of these symptoms should see a doctor.

Stages

Working out the stage of a cancer is important, as it helps a person decide the most effective type of treatment.

Staging aims to assess how far the cancer has spread and whether it has reached nearby structures or more distant organs.

A 4-stage system is the most common way to stage cervical cancer.

Stage 0: Precancerous cells are present.

Stage 1: Cancer cells have grown from the surface into deeper tissues of the cervix, and possibly into the uterus and to nearby lymph nodes

Stage 2: The cancer has now moved beyond the cervix and uterus, but not as far as the walls of the pelvis or the lower part of the vagina. It may or may not affect nearby lymph nodes.

Stage 3: Cancer cells are present in the lower part of the vagina or the walls of the pelvis, and it may be blocking the ureters, the tubes that carry urine from the bladder. It may or may not affect nearby lymph nodes.

Stage 4: The cancer affects the bladder or rectum and is growing out of the pelvis. It may or may not affect the lymph nodes. Later in stage 4, it will spread to distant organs, including the liver, bones, lungs, and lymph nodes.

Undergoing screening and seeking medical attention if any symptoms occur can help a person access early treatment and increase the chances of survival.

What is human papillomavirus (HPV)?What is human papillomavirus (HPV)?
Find out more about HPV and how to prevent it
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Treatment

Cervical cancer treatment options include surgery, radiotherapy, chemotherapy, or combinations of these.

Deciding on the kind of treatment depends on several factors, such as the stage of the cancer, as well as age and overall state of health.

Treatment for early-stage cervical cancer, when the cancer remains within the cervix, has a good success rate. The further a cancer spreads from its original area, the lower the success rate tends to be.

Early-stage options

Surgery is a common treatment method when the cancer has not spread from the cervix. Radiation therapy may help after surgery if a doctor believes that cancer cells might be present inside the body.

Radiation therapy may also reduce the risk of recurrence (cancer coming back). If the surgeon wants to shrink the tumor to make it easier to operate, the person may receive chemotherapy although this is not a very common approach.

Treatment for advanced cervical cancer

When the cancer has spread beyond the cervix, surgery is not usually an option.

Doctors also refer to advanced cancer as invasive cancer, because it has invaded other areas of the body. This type of cancer requires more extensive treatment, which will typically involve either radiation therapy or a combination of radiation therapy and chemotherapy.

In the later stages of cancer, healthcare professionals provide palliative therapy to relieve symptoms and improve quality of life.

Radiation therapy

Radiotherapy machine.
Doctors commonly use radiation therapy to treat advanced forms of cervical cancer.

Some doctors refer to radiation therapy as radiation oncology or XRT.

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