Symptoms and early signs

HPV can lead to cervical cancer.

In the early stages of cervical cancer, a person may experience no symptoms at all. As a result,
women should have regular cervical smear, or Pap, tests.

A Pap test is preventive. It aims not to detect cancer but to reveal any cell changes that indicate
that cancer could develop, so that early action can be taken.

The most common symptoms of cervical cancer are:

 bleeding between periods

 bleeding after sexual intercourse
 bleeding in post-menopausal women
 discomfort during sexual intercourse
 smelly vaginal discharge
 vaginal discharge tinged with blood
 pelvic pain

These symptoms can have other causes, including infection. Anyone who experiences any of
these symptoms should see a doctor.

Stages
Working out the stage of a cancer is important as it helps decide what kind of treatment can be
effective.

Staging aims to assess how far the cancer has developed and whether it has reached nearby
structures or more distant organs.

There are different ways of describing the stages, but a 4-stage system is commonly used.

Stage 0: Precancerous cells are present.

Stage 1: Cancer cells have grown from the surface into deeper tissues of the cervix, and possibly
into the uterus and to nearby lymph nodes

Stage 2: The cancer has is now beyond the cervix and uterus, but not as far as the walls of the
pelvis or the lower part of the vagina. It may or may not affect nearby lymph nodes.

Stage 3: Cancer cells are present in the lower part of the vagina or the walls of the pelvis, and it
may be blocking the ureters, the tubes that carry urine from the bladder. It may or may not affect
nearby lymph nodes.
Stage 4: The cancer affects the bladder or rectum and is growing out of the pelvis. It may or may
not affect the lymph nodes. Later in stage 4, it will spread to distant organs, including the liver,
bones, lungs, and lymph nodes.

It is important to undergo screening and to see a doctor if any symptoms occur, as early
treatment increases the chance of survival.

Causes
Cancer is the result of the uncontrolled division and growth of abnormal cells. Most of the cells
in our body have a set lifespan and when they die, new cells are produced to replace them.

Abnormal cells can have two problems:

 they do not die

 they continue dividing

This results in an excessive accumulation of cells, which eventually forms a lump, otherwise
known as a tumor. Scientists are not completely sure why cells become cancerous.

However, there are some risk factors that are known to increase the risk of developing cervical
cancer. These risk factors include:

Treatment
Cervical cancer treatment options include surgery, radiotherapy, chemotherapy, or combinations
of these.

Deciding on the kind of treatment depends on several factors, such as the stage of the cancer, as
well as the patient's age and state of health.

Treatment for early-stage cervical cancer, when it is confined to the cervix, has a good success
rate. The further the cancer has spread out of the area it originated from, the lower the success
rate tends to be.

Early stage cervical cancer treatment options

Surgery is commonly used when the cancer is confined to the cervix. Radiotherapy may be used
after surgery if a doctor believes there may still be cancer cells inside the body.

Radiotherapy may also be used to reduce the risk of recurrence (cancer coming back). If the
surgeon wants to shrink the tumor to make it easier to operate, the person may receive
chemotherapy although this is not a very common approach.

Treatment for advanced cervical cancer

When the cancer has spread beyond the cervix, surgery is not usually an option.

Advanced cancer is also referred to as invasive cancer because it has invaded other areas of the
body. This type of cancer requires more extensive treatment, which will typically involve either
radiotherapy or a combination of radiotherapy and chemotherapy.

In the later stages of cancer, palliative therapy is administered to relieve symptoms and improve
quality of life.

Radiotherapy
Radiotherapy is commonly used to treat advanced forms of cervical cancer. Around 40% of all
cancer patients undergo some form of radiotherapy.

Radiotherapy is also known as radiation therapy, radiation oncology, and XRT. It involves the
use of beams of high-energy X-rays or particles (radiation) to destroy cancer cells. Radiation that
is aimed at the pelvic area may cause the following side effects, some of which may not emerge
until after the treatment is over:

 diarrhea
 nausea
 upset stomach
 bladder irritation
 narrowing of the vagina
 interrupted menstrual cycle
 early menopause

Chemotherapy

Chemotherapy is the use of chemicals (medication) to treat any disease. In this context, it refers
to the destruction of cancer cells.

Chemotherapy for cervical cancer, as with most other cancers, is used to target cancer cells that
surgery cannot or did not remove, or to help the symptoms of people with advanced cancer.

Side effects of chemotherapy can vary, and they depend on the specific drug being used. Below
is a list of the more common side effects:

 diarrhea
 nausea
 hair loss
 fatigue
 infertility
 early menopause

Cervical cancer clinical trials

Participating in a clinical trial may be the best treatment option for some people. Many of the
current treatments that are available are the results of clinical trials.

Clinical trials are an integral part of the cancer research process. They are done to determine how
safe and effective new treatments are, and whether they are better than existing ones. People who
participate in clinical trials are contributing to cancer research and innovation.

Outlook
The stage at which cervical cancer is diagnosed can help indicate the chances that a person will
survive for at least 5 years more years.

 Stage 1: In early stage 1, the chance of surviving at least 5 years is 93 percent, and in late
stage 1, it is 80 percent.
 Stage 2: In early stage 2, the rate is 63 percent, falling to 58 percent by the end of stage 2.
 Stage 3: During this stage, the chances fall from 35 percent to 32 percent.
 Stage 4: There is a 15 to 16 percent chance of surviving another 5 years.

These are average survival rates and do not apply to everyone. In some cases, treatment is
successful up to stage 4.

Prevention
There are a number of measures that can be taken to reduce the chances of developing cervical
cancer.

Human papillomavirus (HPV) vaccine

The link between the development of cervical cancer and some types of HPV is clear. If every
female adheres to current HPV vaccination programs, cervical cancer could potentially be
reduced.

Safe sex and cervical cancer

The HPV vaccine only protects against two HPV strains. There are other strains which can cause
cervical cancer. Using a condom during sex helps protect from HPV infection.

Cervical screening

Regular cervical screening will make it much more likely that signs of cancer are picked up early
and dealt with before the condition can develop, or spread too far. Screening does not detect
cancer but detects changes to the cells of the cervix.

Having fewer sexual partners

The more sexual partners a woman has, the higher the risk of transmitting the HPV virus, which
can lead to a higher likelihood of developing cervical cancer.

Delaying first sexual intercourse

The younger a female is when she has her first sexual intercourse, the higher the risk of HPV
infection. The longer she delays it, the lower her risk.

Stopping smoking

Women who smoke and are infected with HPV have a higher risk of developing cervical cancer
than people who do not.

Diagnosis
The earlier cervical cancer is diagnosed, the more successful treatment for it can be.

Women aged 30 years and over are advised to undergo a regular Pap, or cervical smear, test, to
detect early signs of cancer of the uterus and cervix. HPV testing can be done at the same time.

Cervical smear test

In the U.S. over 11,000 women receive a diagnosis of invasive cervical cancer each year, and
around 4,000 die as a result of this disease.

Most of these deaths could be prevented through regular cervical screening.

Screening does not detect cancer, but it looks for abnormal changes in the cells of the cervix. If
left untreated, some abnormal cells can eventually develop into cancer.

HPV DNA testing

This test determines whether the patient is infected with any of the HPV types that are the most
likely to cause cervical cancer. It involves collecting cells from the cervix for lab testing.

The test can detect high-risk HPV strains in cell DNA before any cervix cell abnormalities
appear.

If there are signs and symptoms of cervical cancer, or if the Pap test reveals abnormal cells,
additional tests may be recommended.

These include:

 Colposcopy: A visual examination of the vagina using a speculum and a coloscope, a

lighted magnifying instrument.
 Examination under anesthesia (EUA): The doctor can examine the vagina and cervix
more thoroughly.
 Biopsy: A small section of tissue is taken under general anesthesia.
 Cone biopsy: Small, cone-shaped section of abnormal tissue is taken from the cervix for
examination.
 LLETZ: Diathermy, using a wire loop with an electric current, is used to remove
abnormal tissue. The tissue is sent to the lab to be checked.
 Blood tests: A blood cell count can help identify liver or kidney problems.
 CT scan: A barium liquid may be used to show up any abnormalities.
 MRI: Special types of MRI may be able to identify cervical cancer in its early stages.
 Pelvic ultrasound: High-frequency sound waves create an image of the target area on a
monitor.