Cervical Cancer

CancerGuru Types of Cancer Cervical

Overview

Cervical cancer starts in the cells of the cervix. Most cases are caused by HPV (human papillomavirus) infections. Regular Pap tests and safe sex can help lower your risk. Treatment usually includes surgery, radiation, and chemotherapy.

What is Cervical Cancer?

Cervical cancer is a type of cancer that starts on the surface of the cervix, which is the lower part of the uterus. It begins when normal cells in the cervix change into precancerous ones. Nearly all cases of cervical cancer are linked to HPV, a common virus spread through sexual contact. Getting regular screenings like Pap smears and receiving the HPV vaccine can greatly lower the risk of developing cervical cancer.

This cancer often doesn’t show symptoms right away, which is why early screening is so important. When found early, cervical cancer is highly treatable with options like surgery, radiation, chemotherapy, or other medications. Each year, around 14,000 people in the U.S. are diagnosed with cervical cancer, with women aged 35 to 44 being the most affected.

Types of Cervical Cancer

Cervical cancer can start in different types of cells in the cervix, and the type of cancer is named based on where it begins. Knowing the type helps doctors decide on the best treatment plan. The two main types of cervical cancer are squamous cell carcinoma and adenocarcinoma.

Squamous cell carcinoma:
Squamous cell carcinoma is the most common type, making up about 90% of all cervical cancer cases. It starts in the thin, flat cells that cover the outer part of the cervix, known as the ectocervix.
Adenocarcinoma:
Adenocarcinoma begins in the glandular cells that line the inside of the cervix, called the endocervix. A rare form of this type is known as clear-cell adenocarcinoma, also called clear-cell carcinoma or mesonephroma.

Risk Factors

Cervical cancer is mainly caused by HPV, but several other factors can increase your risk of developing the disease. These factors can affect how your body responds to an HPV infection and whether it clears or develops into cancer.

Smoking Tobacco:
Smoking weakens the immune system, making it harder to fight off HPV. In people who smoke, HPV infections are more likely to last longer and less likely to clear, which raises the risk of cervical cancer.
Multiple Sexual Partners:
The risk of getting HPV increases with the number of sexual partners you have. If your partner has had many sexual partners, that also raises your chances of being exposed to HPV.
Early Sexual Activity:
Having sex at a young age increases the chance of HPV infection. The cervix is more vulnerable during the teenage years, making early sexual activity a risk factor for cervical cancer.
Other Sexually Transmitted Infections (STIs):
Having STIs like herpes, chlamydia, gonorrhea, syphilis, or HIV/AIDS raises the risk of cervical cancer. These infections can make it easier for HPV to cause lasting damage.
A Weakened Immune System:
If your immune system is weakened by a health condition or medical treatment, your body may not be able to clear HPV. This increases the chances that an HPV infection will lead to cervical cancer.
Exposure to DES (Diethylstilbestrol):
If your mother took DES during pregnancy in the 1950s to prevent miscarriage, your risk of cervical cancer may be higher. This drug is linked to a rare form of the disease called clear-cell adenocarcinoma.

Symptoms

In its early stages, cervical cancer usually doesn’t cause any noticeable symptoms, which makes it hard to detect without regular screening. It can take time for signs to appear, and they often don’t show up until the cancer starts to grow or spread.

Early Signs of Stage I Cervical Cancer

Watery or bloody vaginal discharge, which may be heavy and have a strong odor
Vaginal bleeding after sex, between periods, or after menopause
Pain during sex (dyspareunia)

Symptoms as Cancer Spreads

If the cancer moves into nearby tissues or organs, other symptoms may appear, such as:

Pain or difficulty while urinating, sometimes with blood in the urine
Diarrhea or bleeding from the rectum during bowel movements
Fatigue, weight loss, or loss of appetite

Ongoing backache or swelling in the legs
Pain in the pelvic area or lower abdomen
A general feeling of being unwell

Causes

Most cases of cervical cancer are caused by HPV, a common virus spread through sexual contact, including vaginal, oral, or anal sex. HPV often goes unnoticed because most people don’t have symptoms and their immune systems clear the virus on their own. But when the body can't get rid of the infection, HPV can cause changes in the cells of the cervix. Over time, these changes can turn into cancer.

Diagnosis

If a Pap test or symptoms raise concern for cervical cancer, doctors will take further steps to understand what’s happening. They’ll ask about your medical history, lifestyle, and family health. Then, they may order a few tests to check for abnormal cells, confirm a diagnosis, or see if the cancer has spread. These tests can also help track how well treatment is working.

Colposcopy

A colposcopy is a test that lets the doctor take a closer look at the cervix, vagina, or vulva using a special magnifying device called a colposcope. It looks like a pair of binoculars mounted on a stand and helps identify abnormal areas that may need further testing. The procedure is done in a clinic, and while it may cause slight discomfort, it’s usually not painful.

Punch Biopsy

A punch biopsy involves using a small tool called biopsy forceps to pinch off a tiny sample of tissue from the surface of the cervix. This sample is sent to a lab and checked for abnormal or cancerous cells. The procedure is quick and may cause mild cramping or spotting afterward.

Endocervical Curettage (ECC)

In this test, a doctor scrapes cells from the canal of the cervix using a curette or soft brush. These cells come from just beyond the visible part of the cervix. ECC helps detect abnormal changes deeper inside the cervix that might not be seen during a regular Pap test or colposcopy.

LEEP (Loop Electrosurgical Excision Procedure)

LEEP uses a thin wire loop heated with electrical current to remove abnormal tissue from the cervix. This procedure can diagnose and treat abnormal cells at the same time. It’s usually done in a doctor’s office under local anesthesia and may cause mild cramping or discharge for a few days.

Cone Biopsy

A cone biopsy removes a cone-shaped piece of tissue from the cervix that includes abnormal cells and tissue underneath the surface. This procedure is usually done in a hospital under local or general anesthesia. It provides a larger tissue sample than other biopsies and helps determine how far abnormal cells have spread.

Cystoscopy

Cystoscopy is a procedure used to look inside the bladder using a thin, lighted tube called a cystoscope. It helps doctors check if cervical cancer has spread to the bladder. This test is typically done under local anesthesia and might cause mild discomfort when urinating afterward.

Proctoscopy

Proctoscopy is a test where a doctor uses a lighted scope to examine the anus, rectum, and lower colon. It helps detect if cervical cancer has reached these areas. The procedure is usually done in a clinic and may cause slight pressure or discomfort during the exam.

CT Scan

A CT (computed tomography) scan uses X-rays to create detailed images of the inside of the body. It helps doctors find tumors, see if cancer has spread, and plan treatment. The scan is painless, though you might need to drink a special contrast liquid or receive it through an IV.

MRI Scan

An MRI (magnetic resonance imaging) scan uses strong magnets and radio waves to make detailed images of soft tissues in the body. It helps doctors check the size of the tumor and see if the cancer has spread beyond the cervix. The test is painless but may take longer than other scans and involves lying still in a tunnel-like machine.

PET Scan

A PET (positron emission tomography) scan shows how active cancer cells are by using a small amount of radioactive sugar injected into the body. Cancer cells absorb the sugar quickly, helping doctors see where the cancer is and how it’s behaving. This test helps spot cancer that has spread to other parts of the body.

Chest X-ray

A chest X-ray takes pictures of the lungs to check if cervical cancer has spread there. It’s a quick and painless test that uses a small dose of radiation. While it doesn’t give as much detail as a CT scan, it’s often one of the first tests done to look for signs of cancer in the chest.

Ultrasound

An ultrasound uses sound waves to create images of the organs inside your body. It’s often used to check the uterus, ovaries, and nearby tissues when evaluating cervical cancer. The test is painless, doesn’t use radiation, and is commonly done with a probe placed on your abdomen or inside your vagina for better images.

Treatments

When it comes to treating cervical cancer, there are various options depending on the stage and location of the cancer. These treatments can include radiation, chemotherapy, surgery, targeted therapy, and immunotherapy. Each approach has its specific method for fighting cancer and may be used alone or in combination to increase effectiveness. Here is an overview of each treatment option

Radiation Therapy

Radiation therapy uses energy beams to target and kill cancer cells in the cervix. There are two main types of radiation therapy: external beam radiation therapy (EBRT) and brachytherapy. EBRT involves a machine that directs high-powered radiation from outside the body onto the cancer. Brachytherapy, on the other hand, places radiation directly inside or very close to the tumor, allowing for a more focused treatment.

Chemotherapy

Chemotherapy uses powerful drugs to kill cancer cells throughout the body. These drugs are either injected into the veins or taken orally, and they circulate through the bloodstream to attack cancer cells in different areas. Chemotherapy is typically administered in cycles, with each cycle followed by a rest period to allow the body to recover. The specific drugs and schedule will vary depending on the cancer's characteristics and location.

Surgery

Surgery is a common treatment for cervical cancer, especially in its early stages. Different types of surgery can be performed, such as laser surgery, which uses a laser to burn off cancer cells, or cryosurgery, which freezes and destroys cancer cells. In more advanced cases, a hysterectomy (removal of the uterus and cervix) or trachelectomy (removal of the cervix and part of the vagina) may be necessary. For cancers that have spread, a pelvic exenteration, which removes the bladder, rectum, and part of the colon, might be required.

Targeted Therapy

Targeted therapy is a treatment that specifically targets cancer cells without harming healthy cells. It works by focusing on proteins that control how cancer cells grow and spread. By blocking or altering these proteins, targeted therapy can stop cancer cells from continuing to divide or metastasize. This type of treatment is often used in combination with other therapies to maximize its effectiveness.

Immunotherapy

Immunotherapy helps your immune system recognize and attack cancer cells. Normally, cancer cells can disguise themselves as healthy cells to evade detection by the immune system. Immunotherapy drugs help to remove this disguise, enabling the immune system to destroy the cancer cells. This type of therapy can be particularly effective in treating cancers that have become resistant to other forms of treatment.

Side Effects of Treatment

Treatments for cervical cancer can be effective, but they may also cause side effects. These can affect how your body feels and works, both during and after treatment. Here are some common side effects to be aware of.

Fatigue:
Fatigue is a deep tiredness that doesn’t go away with rest. It’s common during treatment and can make daily activities feel harder. Rest, light exercise, and healthy meals may help you manage it better.
Nausea and Vomiting:
Chemotherapy often causes nausea or vomiting. These symptoms may come right after treatment or last longer. Doctors usually prescribe anti-nausea medications to help you feel better and maintain your appetite.
Bowel Changes:
Radiation to the pelvic area can cause diarrhea or constipation. These bowel changes may bring discomfort and affect daily life. Eating fiber-rich foods and staying hydrated can help reduce symptoms over time.
Bladder Problems:
Radiation may irritate your bladder, causing burning, urgency, or discomfort when peeing. Some people also have trouble holding urine. Most symptoms improve after treatment, but your doctor can help if they continue.
Vaginal Dryness or Narrowing:
Radiation or surgery can make the vaginal area dry or narrow, causing discomfort during sex or exams. Moisturizers, lubricants, or vaginal dilators can ease these symptoms and improve comfort and flexibility.
Early Menopause:
Some treatments affect hormone levels, causing menopause earlier than usual. Symptoms may include hot flashes, mood changes, and missed periods. Your doctor might recommend hormone therapy or other ways to manage these effects.
Lymphedema:
When lymph nodes are removed or damaged, fluid can build up in the legs, causing swelling. This condition is called lymphedema. Special massages, compression garments, and exercise may help reduce swelling and discomfort.

Support

Going through cervical cancer can be physically and emotionally challenging. Support comes in many forms, from medical care to emotional and practical help. Knowing where and how to get support can make the journey feel less overwhelming.

Emotional Support

It’s common to feel anxious, sad, or scared during and after treatment. Talking to a counselor, joining a support group, or connecting with loved ones can help you cope and feel more emotionally balanced.

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Family and Friends

Your close ones can be a strong source of comfort. They can help with daily tasks, come to appointments, or simply listen. Letting others in can reduce stress and make you feel less alone.

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Medical Team

Doctors, nurses, and support staff aren’t just there to treat cancer, they’re also there to support you. Don’t hesitate to ask questions, express concerns, or talk about side effects or emotional stress.

Support Groups

Joining a cervical cancer support group—online or in person, can give you a safe space to share experiences. Talking to others who understand what you’re going through can bring relief and encouragement.

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Financial Assistance

Cancer treatment can be expensive. Hospitals often have social workers who can guide you toward financial aid, insurance help, or nonprofit organizations that assist with costs like travel, lodging, or medication.

Workplace Support

Balancing work and treatment can be tough. Talk to your employer about flexible hours or medical leave options. Many workplaces offer employee assistance programs that include counseling or mental health support.

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Spiritual or Faith-Based Support

Some people find comfort in their faith or spiritual beliefs. Speaking with a religious leader, joining a spiritual group, or practicing meditation or prayer can bring peace during difficult times.

Research

Ongoing research is helping improve how we prevent, detect, and treat cervical cancer. Scientists are working to find better ways to stop disease, make treatments more effective, and improve the quality of life for patients.

HPV and Vaccine Studies

Researchers continue to study how different strains of HPV affect the cervix. They’re also testing new vaccines and improving existing ones to better protect people from developing cervical cancer in the first place.

New Screening Methods

Studies are being done to develop more accurate and easier screening tools. These tests could help catch cervical cancer or pre-cancer earlier, even in people who don’t show symptoms.

Improved Treatments

Scientists are testing new drugs and combinations for chemotherapy and targeted therapies. The goal is to make treatment more effective while causing fewer side effects for people going through cervical cancer.

Immunotherapy Trials

Immunotherapy is a major area of focus. Clinical trials are exploring how to better activate the immune system so it can recognize and destroy cervical cancer cells more efficiently.

Genetic and Molecular Research

Researchers are studying genetic changes in cervical cancer cells. Understanding how these genes behave could lead to more personalized treatment plans tailored to the patient’s unique cancer type.

Quality of Life Studies

Beyond survival, scientists are researching ways to help patients live better during and after treatment. This includes managing side effects, improving fertility options, and addressing emotional health.

Global Health Initiatives

International research focuses on making prevention and care more accessible in low-resource areas. This includes testing low-cost vaccines and simpler screening methods for countries with limited medical access.

Prevention

You can take steps to help prevent cervical cancer. The most important ones are having regular checkups with your gynecologist and getting Pap tests. Here are a few other things that can help:

Get the HPV vaccine if you qualify.
Use condoms or other barrier protection during sex.
Try to limit how many sexual partners you have.
Quit smoking and avoid tobacco products.

Questions to Ask your Healthcare Provider about Cervical Cancer

If you’ve been diagnosed with cervical cancer, you might have some important questions. Here are a few things to consider:

Q1. What type of cervical cancer do I have?
Q2. Has my cancer spread outside the cervix?
Q3. Can the stage of my cancer be determined, and what does that mean?
Q4. Will I need other tests before we can decide on treatment?
Q5. Do I need to see any other doctors or health professionals?
Q6. If I’m concerned about the costs and insurance coverage for my diagnosis and treatment, who can help me?