Elsevier – Patient Education │ Cervical Cancer

Cervical cancer is abnormal growth of cells in the cervix. The cervix is the opening and bottom part of the uterus. It is between the vagina and the uterus.

There are three main types of cervical cancer:

Squamous cell carcinoma. This cancer starts in the cells that line the surface of the cervix.
Adenocarcinoma. This cancer starts in the gland cells that line the cervix.
Cervical sarcoma. This is a rare cervical tumor that grows and spreads very fast.

What are the causes?

Most cervical cancers are caused by a virus called human papillomavirus (HPV).

What increases the risk?

This condition is more likely to develop in women who have a certain sexual history, family or genetic factors, or other medical conditions.

Sexual history

You have a sexually transmitted infection (STI). These include:
- Chlamydia.
- Herpes.
- HPV.
You have more than one sexual partner, or you are having sex with someone who has more than one sexual partner.
You do not use condoms correctly every time you have sex.
You were sexually active before the age of 18.

Family or genetic factors

Your mother took diethylstilbestrol (DES) during pregnancy.
Your mother or sister has had cervical cancer.

Other medical conditions

You are between the ages of 40–50.
You have had cancer of the vagina or vulva.
You use birth control pills.
You smoke or regularly breathe in second hand smoke.
You have a weakened immune system.
You have a history of dysplasia of the cervix.

What are the signs or symptoms?

There are no symptoms during the early stages of cervical cancer. Once the cancer is in the cervix and spreads to nearby tissues, symptoms may include:

Abnormal vaginal discharge, bleeding or a period that is longer or heavier than usual.
Vaginal bleeding after sex, douching, or a Pap test.
Vaginal bleeding after menopause.
Pelvic discomfort or pain during sex.
An abnormal Pap test.
Being very tired.

How is this diagnosed?

This condition is diagnosed based on your medical history and a physical exam, which includes a pelvic exam and Pap test. Your health care provider may also do:

A colposcopy. A microscope is used to closely check the cells of the cervix, vagina, and vulva.
A cervical biopsy. Small samples of tissue from the cervix are removed and checked under a microscope.
A cone biopsy. Tissue with cancer cells is removed and tested.
Imaging tests, including ultrasound, CT scan, MRI, or PET scan.

If cervical cancer is found, it will be staged. Staging assesses tumor size and if and where the cancer has spread.

How is this treated?

Treatment for this condition depends on the cancer stage and may include:

Cone biopsy to remove the cancerous tissue.
Removing the entire uterus and cervix.
Removing the uterus, cervix, upper vagina, lymph nodes, and nearby tissue. The ovaries may be left or removed.
Medicines to treat cancer. These include chemotherapy or targeted therapy.
A combination of surgery, radiation, and chemotherapy.
Biological therapy. These are substances that strengthen your immune system's fight against cancer or infection. They may be used with chemotherapy.

Follow these instructions at home:

Medicines

Take over-the-counter and prescription medicines only as told by your health care provider.

General instructions

Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.
Do not have sex until your health care provider says it is safe.
Use a condom correctly every time you have sex.
Consider joining a support group with others who have a diagnosis of cervical cancer.
Keep all follow-up visits as told by your health care provider. This is important.

Where to find more information

National Cancer Institute: www.cancer.gov
American Cancer Society: www.cancer.org
American College of Obstetricians and Gynecologists: www.acog.org

Contact a health care provider if:

You have pelvic pain or pressure.
You have leg or back pain.
You have a fever.
You have abnormal vaginal bleeding or discharge.
You lose weight.
You develop a cough.

Get help right away if:

You cannot urinate.
You have blood in your urine.
You have blood in your stool.
You develop severe back, stomach, or pelvic pain.

Summary

Cervical cancer is abnormal growth of cells in the cervix.
Most cervical cancers are caused by a virus called human papillomavirus (HPV).
Treatment for this condition depends on the stage of the cancer. Treatment may include a combination of surgery, radiation, and chemotherapy.
Getting vaccinated with the HPV vaccine can prevent most cervical cancers.