Cervical cancer
Cervical cancer develops in the cervix, the entrance to the womb.
What is cervical cancer?
Cervical cancer develops in the cervix, the entrance to the womb and it often has no symptoms in its early stages. This is one of the reasons why awareness and cervical screening is so important.
Cervical cancer occurs when the genetic material of cells in the cervix, which is the entrance to the womb from the vagina, become damaged or changed, producing mutations that affect normal cell growth and division. The abnormal cells then replicate, causing cancer. If undetected, the cancer can spread beyond the cervix and move to other parts of the body.
Almost all cases of cervical cancer are caused by the human papillomavirus (HPV), a common virus that can be spread through sexual intercourse. HPV comes in over 100 different types, but only a few can disrupt the normal functioning of the cells and potentially trigger the onset of cancer. 70% of all cases of cervical cancers are known to be caused by HPV 16 or HPV 18*. Neither of these viruses cause noticeable symptoms, meaning it can be hard to spot the infection without tests. That said, HPV is relatively common and easily treatable and most women who have it do not develop cervical cancer.
What are the symptoms of cervical cancer?
Cervical cancer often has no symptoms in its early stages, but when symptoms do occur the most common is unusual vaginal bleeding. Unusual bleeding occurs at any of the following times:
- After sexual intercourse
- At any time other than your expected monthly period
- After the menopause
Vaginal bleeding is very common and can have a range of causes, so it doesn’t necessarily mean that you have cervical cancer. However, unusual vaginal bleeding is a symptom that needs to be investigated by your doctor.
Other symptoms of early-stage cervical cancer include:
- Vaginal discharge that smells unpleasant
- Pain or discomfort during intercourse
If you develop any of these symptoms it is important to seek medical advice as soon as possible.
How is cerival cancer diagnosed?
Your consultant or oncologist will advise you on which tests are relevant to your individual symptoms. Following an abnormal smear test, a number of diagnostic procedures will be run to ensure a diagnosis of cervical cancer. These include:
- A Colposcopy, which is when a colposcope (a small microscope with a light on the end) is used to examine your cervix
- A Cone biopsy, which involves the removal of a small, cone-shaped section of your cervix for examination
If the results of the biopsy suggest you have cervical cancer and there’s a risk that the cancer may have spread, you’ll probably need to have some further tests to assess how widespread the cancer is.
Stages of cervical cancer
After all of the tests have been completed and your test results are known, it should be possible to tell you what stage cancer you have. Staging is a measurement of how far the cancer has spread. The higher the stage, the further the cancer has spread. The staging for cervical cancer is as follows:
- Stage 0 (pre-cancer) – there are no cancerous cells in the cervix, but there are biological changes that could trigger the onset of cancer in the future
- Stage 1 – the cancer is still contained inside the cervix
- Stage 2 – the cancer has spread outside the cervix into the surrounding tissue, but has not reached the pelvic wall or the lower part of the vagina
- Stage 3 – the cancer has spread into the lower section of the vagina and/or into the pelvic wall
- Stage 4 – the cancer has spread into the bowel, bladder or other organs, such as the lungs
Treatment for cervical cancer
If cervical cancer is diagnosed in its early stages, it is usually possible to treat it using surgery. In some cases, a hysterectomy may need to be undertaken in order to try to remove all of the cancer cells. Radiotherapy uses high-energy radiation, and can also be used to treat early-stage cervical cancer too – it is used alongside or instead of surgery.
Locally advanced cervical cancer is usually treated using a combination of chemotherapy and radiotherapy, known as Chemoradiation. Advanced-stage cervical cancer is treated using chemotherapy which treats cancer that has spread around the body. Chemotherapy is a treatment using cell-killing (cytotoxic) drugs which can shrink and control the cancer and relieve symptoms.
Prevention of cervical cancer
In the UK it is recommended that all women between the ages of 25 and 64 are regularly screened for cervical cancer. The screening, known commonly as a smear test, involves a small sample of cells being taken from the cervix. The cells are then checked for abnormalities. Most abnormal smear test results are caused by an infection or the presence of easily treatable precancerous cells.
Using protection during sexual intercourse will reduce the risk of you developing HPV which can lead to cervical cancer. The HPV vaccination will protect against the two strains of this virus responsible for cervical cancer. Although these methods can reduce the risk of HPV it does not guarantee that it will not develop at some point.