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Cervical Cancer

What is it ?

Cervical cancer begins in the lining of the cervix.  This cancer does not form suddenly. First, some cells begin to change from normal to pre-cancer and then to cancer.  This can take a number of years, although sometimes it happens more quickly.  These changes are referred to by several terms, including dysplasia.  For some women, these changes may go away without any treatment.  More often, they need to be treated to keep them from changing into true cancers. 

There are two main types of cancer of the cervix.  About 80% to 90% are squamous cell carcinomas.  The other 10%-20% are adenocarcinomas.  If the cancer has features of both types, it is called mixed carcinoma. If you have cervical cancer, ask your doctor to explain exactly what type of cancer you have.

Symptoms

Early cervical pre-cancers or cancer often have no signs or symptoms.  That's why it's important for women to have regular Pap tests.  Symptoms usually appear when the cancer is further along. 

You should report any of the following to your doctor right away:

  • Any unusual discharge from the vagina (not your normal period)
  • Blood spots or light bleeding other than your normal period
  • Bleeding or pain after sex, douching, or after a pelvic exam 

Of course, these symptoms do not mean that you have cancer.  They can also be caused by something else.  But you must check with your doctor to find out.

Risk Factors Human Papillomavirus (HPV)

For cervical cancer, the most important risk factor is infection with HPV (human papillomavirus).  HPV is passed from one person to another during sex.  Having unprotected sex, especially at a young age, makes HPV infection more likely.  Also, women who have many sexual partners (or who have sex with men who have had many partners) have a greater chance of getting HPV.  The Pap test can find changes in the cells of the cervix caused by HPVs. While there is no cure for HPV, the abnormal cell growth they cause can be treated. 

Even though HPV is an important risk factor for cervical cancer, most women with this infection do not get cervical cancer.  Doctors believe other factors must come into play for this cancer to develop.  Some of these factors are listed below.

  • Smoking
    Women who smoke are about twice as likely as those who don’t to get cervical cancer.  Tobacco smoke can produce chemicals that may damage the DNA in cells of the cervix and make cancer more likely to occur.
  • HIV infection (human immunodeficiency virus)
    HIV is the virus that causes AIDS (it is not the same as HPV).  It can also be a risk factor for cancer of the cervix. Being HIV positive makes a woman's immune system less able to fight both the virus and early cancers.
  • Chlamydia infection
    This is a rather common kind of bacteria that can infect women’s sex organs.  It is spread by having sex.  Many women do not know they have it unless samples taken at the time of their Pap test are looked at for the bacteria.  Some studies suggest that women who have this infection (or have had it in the past) are at greater risk for cancer of the cervix.
  • Birth control pills
    Long-term use of birth control pills increases the risk of this cancer. Some studies show a higher risk after 5 or more years of use.  You should talk to your doctor about the pros and cons of birth control in your own case.
  • Having many pregnancies
    Woman who have had many full-term pregnancies have an increased risk of this cancer.
  • Low income
    Poor women are at greater risk for cancer of the cervix.  This may be because they cannot afford good health care, including Pap tests.
  • Family history 
    Recent studies suggest that women whose mother or sister has had cervical cancer are more likely to get the disease themselves.  This could be because they are less able to fight off HPV than other women.

Treatment

The three main types of treatments for cervical cancer are:  

  • Surgery
  • Radiation
  • Chemotherapy 

Sometimes the best approach is to use two or more of these methods.  If a cure isn’t likely, the goal may be to remove or destroy as much of the cancer as possible to keep it from growing for as long as possible.

Robotic-Assisted Surgery

Fletcher Allen offers a robotic-assisted surgical option for a range of gynecologic conditions, including cervical cancer. Because these procedures are minimally invasive, they usually result in reduced risk of infection and a faster return to normal activities. More>>