Cervical Cancer

Symptoms of cervical cancer may include: 

• Vaginal bleeding that isn't normal. This may be bleeding between menstrual periods, after sex, or after menopause. 
• Pain during sex. 
• Vaginal discharge that isn't normal. 
• A significant unexplained change in your menstrual cycle.

The symptoms of advanced cervical cancer may include: 

• Anemia because of abnormal vaginal bleeding. 
• Ongoing pelvic, leg, or back pain. 
• Urinary problems because of a blocked kidney or ureter. 
• Leakage of urine or stool into the vagina. This can happen when an opening (fistula) has developed between the vagina and the bladder or rectum. 
• Weight loss. 

Most cervical cancer is caused by a virus called human papillomavirus, or HPV. You can get HPV by having sexual contact with someone who has it. There are many types of the HPV virus. Not all types of HPV cause cervical cancer. 

Most adults have been infected with HPV at some time. An infection may go away on its own. But sometimes it can cause genital warts or lead to cervical cancer. 

Other things may play a role in causing cervical cancer, such as having more than one sex partner or smoking cigarettes. 

A risk factor for cervical cancer is something that increases your chance of getting this cancer. Having one or more of these risk factors can make it more likely that you will get cervical cancer. But it doesn't mean that you will definitely get it. And many people who get cervical cancer don't have any of these risk factors. 

Things that may increase your risk for cervical cancer include: 

• Having an ongoing infection with a high-risk type of human papillomavirus (HPV). HPV is a sexually transmitted infection (STI). It is the most common cause of cervical cancer. 
• High-risk sexual behaviors. These include having more than one sex partner or having a sex partner who has more than one partner. Safer sex can reduce your risk. 
• Having an impaired immune system. Some conditions such as HIV can make you more likely to get an HPV infection. 
• Smoking cigarettes or breathing in secondhand smoke. 

A screening test can find cervical cell changes that can lead to cervical cancer. Regular screening tests, such as the Pap test, almost always show these cell changes before they turn into cancer. It's important to follow up with your doctor after any abnormal test result so that abnormal cell changes can be managed. This may help prevent cervical cancer. 

If you are age 26 or younger, you can get the HPV vaccine, which protects against types of HPV that cause most cases of cervical cancer. If you are age 27 to 45 and have not been vaccinated for HPV, ask your doctor if getting the vaccine is right for you.

Preventing cervical cancer

You can treat early cervical cell changes (dysplasia), which can reduce your risk for cervical cancer. You can also reduce your risk for abnormal cell changes. 

Have regular cervical cancer screening. Even if you've had the HPV vaccine, you may need regular screening.The recommended screening schedule is based on your age and things that increase your risk. Talk to your doctor about how often to be tested. 

If you smoke, take steps to quit. Cigarette smoking is associated with a higher risk for cervical cancer.

Get the HPV vaccine. If you have not been vaccinated for HPV, ask your doctor if getting the vaccine is right for you. The HPV vaccine protects against the types of human papillomavirus (HPV) that cause cervical cancer. 

Reduce your risk of a sexually transmitted infection (STI). Preventing an STI, including HPV, is easier than treating an infection after it occurs. HPV infection usually doesn't cause symptoms, so you or your partner may not know that you are infected. To reduce your risk: 

• Talk with your partner about STIs before beginning a sexual relationship. Find out if your partner is at risk for an STI. Remember that it's possible to be infected with an STI without knowing it. Some STIs, such as HIV, can take up to 6 months before they are detected in the blood. 
• Be responsible. 
  • Avoid sexual contact if you have symptoms of an STI or are being treated for an STI. 
  • Avoid all intimate sexual contact with anyone who has symptoms of an STI or who may have been exposed to an STI. 
• The fewer sex partners you have in your lifetime, the better it is for your health. Your risk for an STI increases if you have several sex partners or if your sex partner has more than one partner. 
• Use male or female condoms to reduce the risk of getting an STI.

Not having sexual contact is the only certain way to prevent exposure to STIs. Sexually transmitted infections such as human papillomavirus (HPV) can be spread to or from the genitals, anus, mouth, or throat during sexual activities.

If cervical cancer is suspected, your doctor will ask about your medical history and do a physical exam. This may include a pelvic exam and cervical cancer screening. For the screening test, the doctor scrapes a small sample of cells from the surface of the cervix. 

Tests to confirm a diagnosis of cervical cancer include:

Colposcopy and cervical biopsy.
This test can find out whether and where cancer cells are on the surface of the cervix. 

Endocervical biopsy (or curettage).
This test is done to find out whether cancer cells are in the cervical canal. 

Cone biopsy.
This type of biopsy may be done to remove cervical tissue for examination under a microscope. 

Health professionals who can evaluate your symptoms and your risk factors, and who can diagnose cervical cancer include:

• Gynecologists.
• Obstetricians.
• Family medicine physicians.
• Nurse practitioners.
• Physician assistants.
• Internists.

Doctors who can manage your cancer treatment include:

• Gynecologists.
• Gynecologic oncologists.
• Radiation oncologists.
• Medical oncologists.

Treatment for cervical cancer is based on the stage of the cancer and other things, such as whether you might want to become pregnant. The main treatments include:

Surgery.
Most women have surgery. The most common type is hysterectomy. This removes the uterus, the cervix, and part of the vagina. Options to preserve fertility include conization (removing a wedge of tissue that contains cancer) and trachelectomy (removing the cervix and part of the vagina but leaving the uterus).

Radiation therapy.
This therapy uses high-dose X-rays to destroy cancer cells and shrink tumors. Radiation is often used with surgery.

Chemotherapy.
These medicines kill fast-growing cells, including cancer cells and some normal cells. Chemotherapy and radiation may be given together (chemoradiation).

If the cancer is advanced or has come back (recurrent), treatment options may also include targeted therapy and immunotherapy.

Your doctor will talk with you about your options and then make a treatment plan.