Your Guide to Cervical Cancer
This article will explain more about what cervical cancer is, what can cause it, the symptoms of cervical cancer, and treatment and prevention.
Cervical cancer is a type of cancer that is found anywhere in the cervix.
Cervical cancer was once the leading cause of cancer death in females in the United States. However, due to routine Pap smear screening, cervical cancer rates and deaths are now far less common in the U.S.
Sex and gender terms
Sex and gender exist on spectrums. This article will use the terms “female” and “women” when discussing people assigned female at birth to reflect language that appears in source materials.
According to the American Cancer Society, just over 14,000 people in the U.S. receive a cervical cancer diagnosis yearly. Additionally, 4,280 people in the U.S. die of cervical cancer per year.
Cervical cancer starts in the cervix, which is the structure that provides an opening between the vagina and the uterus. Typically, cervical cells that are old or damaged will stop dividing and die. Healthy new cells replace these cells.
Cervical cancer can happen when the old or damaged cells continue to grow in the superficial layer of the cervix. This is a precancerous stage of cervical cancer called cervical dysplasia. Without treatment, cervical dysplasia can progress and spread into the deeper tissues of the cervix, developing into cervical cancer.
Pap smears catch precancerous cells before they develop into cervical cancer. The earlier you catch cervical cancer, the better the chance of successful treatment.
The most common types of cervical cancers are squamous cell carcinomas and adenocarcinomas. However, there are 4 different types of cervical cancer:
- Squamous cell carcinoma: This cancer begins in the cervical cells closest to the vagina. It is the most common type of cervical cancer, accounting for up to 90% of cases.
- Adenocarcinoma: This cancer develops in the cervical gland cells closest to the uterus. It is the second most common form of cervical cancer.
- Mixed carcinoma: This cancer shares features with adenocarcinoma and squamous cell carcinoma.
- Adenosquamous carcinoma: This cancer also shares features with both squamous cell carcinoma and adenocarcinoma. It is much less common than other types of cervical cancer.
Cervical cancer may have no symptoms in its earliest stages. The HPV infection typically does not have symptoms either. This infection causes most cases of cervical dysplasia and cervical cancer.
Cervical cancer symptoms may indicate that the cancer has progressed to more advanced stages. Potential cervical cancer warning signs include:
- unusual vaginal bleeding that occurs after sex, after menopause, or between menstrual periods
- foul-smelling, bloody, or unusual vaginal discharge
- lower back pain
- pain during sexual intercourse
- pelvic pain
- periods that are longer or heavier than usual
If you experience any of the above symptoms or notice a change in your reproductive health, seek medical advice to rule out the possibility of cancer. Signs to look out for include pelvic pain or unusual vaginal bleeding.
Staging tells doctors how widespread a cancer is at diagnosis, which helps them plan treatment. The stage of cervical cancer will depend on:
- the size of the tumor
- if it affects nearby tissues
- if there is cancer in the lymph nodes
- whether or not cancer has spread, or metastasized, to other organs
There are 5 cervical cancer stages, with higher numbers indicating more advanced disease. The precancer stage comes before any of the following:
- Stage 0: Also called carcinoma in situ, this type of cancer only exists on the surface of the cervix. The main treatment for Stage 0 cancer is surgical removal.
- Stage I: Cancer in this stage has grown deeper than the surface but remains in the cervix. Surgery is still the main treatment. However, it may involve removing the entire uterus with the cervix.
- Stage II: Cancer in this stage has become invasive but has not spread to the lymph nodes. Early cancers in this stage have spread to the vagina. Later cancers have grown into the tissues surrounding the uterus. Standard treatment is a combination of surgery, chemotherapy, and radiation therapy.
- Stage III: Cancer in this stage has spread to nearby lymph nodes, organs, or tissues. It may spread to the pelvic wall or kidney ureters. Standard treatment is a combination of chemotherapy and radiation therapy.
- Stage IV: Cancer in this stage has spread outside the pelvic area to distant lymph nodes or body sites. It is not curable. Treatment usually involves radiation therapy with or without chemotherapy and targeted therapy.
In general, early stage cancers tend to have a better outlook because they often respond better to treatment.
HPV makes two proteins that turn off tumor suppressor genes. These genes are one way the body controls cell growth and death. HPV infection of the cervix can result in cervical cells growing too much. In some cases, this turns into cancer.
However, not everyone with an HPV infection will develop cervical cancer. Other risk factors can contribute to cancer. In addition, there are many types of HPV, and some strains are more likely to cause cervical cancer than others.
Several factors may increase your chances of developing cervical cancer.
Not all people with risk factors will develop cervical cancer. Additionally, some people who do not have risk factors will develop cervical cancer.
Risk factors include:
- having a family history of cervical cancer, which may indicate a genetic link
- using birth control pills for 5 or more years
- having an HPV infection
- having several sexual partners
- giving birth to three or more children
There are three main ways to reduce your risk of cervical cancer:
- receiving the HPV vaccine
- getting regular Pap smears
- getting an HPV test
According to the American College of Obstetricians and Gynecologists (ACOG), the guidelines for Pap smears and HPV testing for people with female reproductive vary based on age.
- If you are between the ages of 21–29: You should get a Pap smear every 3 years.
- If you are between the ages of 30–35: You should get a Pap smear and an HPV test every 5 years. Alternatively, you can get a Pap smear alone every 3 years or an HPV test every 5 years.
- If you are over the age of 65: You can stop cervical cancer screenings if you have never had irregular cells or have had 2–3 negative tests in a row.
People ages 9–26 can protect themselves from an HPV infection by getting the HPV vaccine. Males can also benefit from the vaccine, as HPV is also responsible for anal, head, and neck cancers. Additionally, protecting males from infection can help prevent infections in females.
You can also lower your risk of cervical cancer by:
- practicing safe sex
- limiting the number of sexual partners you have
- limiting your sexual activity to monogamous relationships
- not smoking, or quitting smoking
Regular Pap smears are the most effective way of finding cervical cancer early. In fact, Pap smears can find abnormal cells before they become cervical cancer. Doctors find these precancerous changes far more often than actual cervical cancer.
If the results of a Pap smear are abnormal, additional testing is necessary to diagnose or rule out cervical cancer.
Diagnosing cervical cancer may involve a colposcopy. This procedure uses a lighted instrument, or colposcope, to examine the cervical cells. Your doctor may also suggest a biopsy, which takes a tissue sample from the cervix to examine it for cancer.
Questions your doctor may ask include:
- Are you experiencing any symptoms?
- Are you sexually active?
- When was your last Pap smear or HPV test?
- Have you ever had an abnormal Pap smear?
- Have you ever had a sexually transmitted infection?
- Do you smoke?
- Have you ever been pregnant?
- Do you want to have children in the future?
Cervical cancer treatment depends on the stage. Therefore, doctors often use imaging exams to determine the stage of cancer after diagnosing it. Surgery is usually an option for early cervical cancers.
Sometimes, doctors can remove all of the very early cancers during a biopsy. In other cases, more radical surgery may be necessary to remove the uterus and nearby pelvic structures.
Cervical cancer treatment aims to permanently cure the cancer or bring about a complete remission. Remission means that there is no longer any sign of cancer in the body. However, it may relapse later.
Cervical cancer treatment plans depend on the type of cancer and stage of advancement. Your doctor will consider your age, medical history, and other factors.
Doctors base cervical cancer treatment options on the stage of cancer.
Therapy treatments for cervical cancer
The most common treatments for cervical cancer involve various therapies, such as:
- immunotherapy, which boosts the immune system to fight cancer
- clinical trials to test novel therapies and treatments for cervical cancer
- radiation therapy
- targeted therapy, which targets proteins that cervical cancer cells need to live, grow, and spread
Surgical treatments for cervical cancer
Sometimes doctors opt for different surgeries to remove the cervix or parts of it, such as:
- Cone biopsy: This procedure surgically removes a cone-shaped section of the cervix where abnormal cells grow. It also removes a margin of healthy tissue. This is the preferred treatment for early stage cancers in people who want to preserve fertility.
- Hysterectomy: This procedure removes the uterus and cervix.
- Radical trachelectomy: This procedure removes the cervix and nearby lymph nodes. This is another option for early stage cancers in people who want to preserve fertility.
Other cervical cancer treatments
Doctors may add other therapies to manage side effects of treatment, including:
- antinausea medications
- dietary counseling to help people with cancer maintain their strength and nutritional status
- pain medications
- palliative care to improve the overall quality of life for families and patients with late-stage cervical cancer
- physical therapy to help strengthen the body, increase alertness, reduce fatigue, and improve functional ability during and after cancer treatment
Some complementary treatments may help people better deal with cervical cancer. These treatments, sometimes called alternative therapies, augment medical treatments.
Complementary treatments can include nutritional supplements and homeopathic remedies. They are not a substitute for traditional medical care. Be sure to tell your doctor if you are using alternative therapies, as they may interact with the prescribed medical therapy.
Complementary treatments may include:
- massage therapy
- dietary supplements, herbal remedies, tea beverages, and similar products
Complications of cervical cancer can be life threatening. Over time, cancer can spread and interfere with vital body processes, such as organ function.
Serious complications of cervical cancer include:
- reoccurring cervical cancer after treatment
- infertility due to cervical cancer treatment
You can best treat cervical cancer and lower your risk of complications by catching it early and following a treatment plan developed with your doctor. If complications do occur, following your treatment plan may help delay them.
Cervical cancer is highly preventable with regular screening and an HPV vaccination. It is also treatable in the early stages before it spreads beyond the cervix and uterus.
Doctors describe cervical cancer in terms of a 5-year relative survival rate. This rate looks at people with the same type and stage of cancer 5 years after diagnosis. It compares them with people of the same age and sex in the general population. The comparison shows how much cervical cancer can shorten life.
When cervical cancer is only in the cervix and uterus, the 5-year relative survival rate is 92%. With regional spread to nearby structures, the rate is 58%. The rate drops to 18% when it has spread to distant sites, such as the bones, liver, or lungs.
Keep in mind that these numbers are only statistics. They cannot tell you your outlook or how long you will live. There are many factors specific to you that affect your prognosis. Your doctor is the best source of information about your future.
Here are some frequently asked questions about cervical cancer.
What does cervical cancer look like?
Cervical cancer usually does not have any symptoms at early stages. That is why regular screenings are important to help identify early signs.
What are the early warning signs of cervical cancer?
Certain risk factors, such as HPV infection and smoking, can increase your risk of cervical cancer. However, there are usually no early warning signs of cervical cancer.
How do you feel when you have cervical cancer?
Cervical cancer that has reached a more advanced stage can cause vaginal bleeding and pain.
What is the first stage of cervical cancer?
The first stage of cervical cancer is cervical dysplasia, a precancerous stage.
Does cervical cancer spread fast?
According to the World Health Organization (WHO), cervical cancer can spread in females with healthy immune systems in about 15–20 years. It can spread faster in females with compromised immune systems.
How long can you live with untreated cervical cancer?
A person’s prognosis depends on the stage of cancer, along with other risk factors that could increase the spread of cancer.
Cervical cancer is a common type of cancer in those with female reproductive organs. However, the incidence and death rates of cervical cancer have decreased over the years.
Regular Pap smears can help detect abnormal cells and cervical dysplasia long before it develops into cervical cancer. Early treatment for abnormal cells is generally very effective.
Cervical cancer can cause life threatening complications. It can also be fatal, especially without detection or treatment.
Seeking regular medical care, including Pap smears, offers the best chance of discovering cervical cancer in its earliest, most curable stage. The Centers for Disease Control and Prevention (CDC) strongly recommends an HPV vaccine to prevent cervical cancer and other HPV-related cancers.
If you have cervical cancer, following your treatment plan may help reduce your risk of serious complications. If you receive an early diagnosis and treatment, cervical cancer is curable in many cases.
Cervical cancer is one of the most preventable cancers. Doctors can screen for precancerous changes before cancer develops using a Pap smear. They can also test cervical cells for the presence of HPV. You can have these tests as part of a regular gynecologic exam.
The frequency of screening will depend on your age, previous screening results, and your medical history.