An estimated half million women globally were diagnosed with cervical cancer in 2018 and 311,000 died from it. Despite that, the World Health Organization (WHO) believes that unlike most cancers, cervical cancer can be completely eliminated. Learn more about this unique cancer, its symptoms, causes, and how to reduce your risk, detect it early, and get treatment if necessary.

What is Cervical Cancer?

The cervix is the entrance to the uterus (womb), found at the back of the vagina (birth canal). When cancerous cells develop on the cervix it is called cervical cancer.

Who Gets Cervical Cancer?

Because cervical cancer affects the cervix, only patients born as women, with a cervix, get cervical cancer. In women, it is the fourth most common cancer, behind breast cancer, colorectal cancer, and lung cancer.

What Are the Causes of Cervical Cancer?

99% of all cases of cervical cancer are a result of infection from high-risk types of human papillomaviruses (HPV). HPV is a sexually transmitted virus that is so common that most people will likely get it at some point in their life. Most people don’t have symptoms of HPV and the body’s natural immune system usually controls it. Women with persistent HPV infections have the highest risk for cervical cancer.

What are the Risk Factors for Cervical Cancer?

You are more likely to be diagnosed with cervical cancer if you…

• Became sexually active before the age of 18
• Have multiple sex partners
• Smoke
• Have a condition that compromises your immune system (such as HIV)
• Have been prescribed medications or treatments that suppress your immune system (such as chemotherapy, immunotherapy, radiation therapy, or drugs meant to prevent organ rejection)
• Use oral contraceptives (birth control pills)
• Have given birth to many children
• Suffer with obesity
• Have not had an HPV vaccination

You can reduce your likelihood of being diagnosed by avoiding these risk factors and reducing your exposure to HPV by practicing safe sex.

What are the Types of Cervical Cancer?

There are two primary types of cervical cancer.

• Squamous cell carcinoma comprises about 90% of cervical cancer cases. It develops in the ectocervix (also called exocervix), the outer part of the cervix.
• Adenocarcinoma makes up the majority of the remaining types of cervical cancer. It develops in the endocervix, the inner part of the cervix. A rare sub-type of adenocarcinoma is clear cell adenocarcinoma, also called mesonephroma or clear cell carcinoma.

Cervical cancer can also have aspects of both types and, in that case, it’s called mixed carcinoma or adenosquamous carcinoma. Sometimes cancer can develop in other cells of the cervix but that is extremely rare.

What are the Symptoms of Cervical Cancer?

Symptoms of early-stage cervical cancer include:

• Pelvic pain
• Pain during sex
• Vaginal bleeding after menopause
• Vaginal bleeding after sex
• Vaginal bleeding between periods
• Periods that are heavier or longer than normal
• Abnormal vaginal discharge (watery, bloody, strong-smelling)

Symptoms of late-stage cervical cancer (after it has metastasized, or spread to other areas of the body) include:

• Backache
• Abdominal pain
• Leg swelling
• Painful bowel movements or urination
• Bloody stools or urine
• Fatigue

Most people don’t have symptoms of cervical cancer until these later stages, when it is less treatable. That’s why it’s so important to get preventative care and screenings during your regular gynecological exam or physical.

Can you Screen for Cervical Cancer?

Cells of the cervix can become abnormal, a process called dysplasia. These pre-cancerous cells in the cervix can eventually become cancer cells if not removed or treated. A test called a pap smear can detect these abnormal cells. These tests, also called a pap for short, or cervical cancer screening, are routinely done in a regular gynecological exam. Need a reminder to set your appointments? Try our free cancer screening reminder tool!

How is Cervical Cancer Diagnosed?

If you have an abnormal pap smear, your doctor might do a colposcopy. This procedure involves applying a vinegar-based liquid to the cervix and then examining it more closely with a light and magnifying glass. A biopsy, taking a sample of tissue, is usually done during this procedure. The tissue is then examined in a lab to see if it’s cancerous.

What is the Staging for Cervical Cancer?

If cancerous cells are confirmed in the lab sample, additional tests will help determine the cervical cancer staging and whether it has spread (metastasized). They can include imaging tests like PET-CT scans, magnetic resonance imaging (MRI) scans, ultrasounds, or chest x-rays; lab tests like complete blood counts (CBC) and blood chemistry studies; and visual exams like cystoscopies and sigmoidoscopies.

• Stage 1 cervical cancer is when the cancer is confined to the cervix only. This stage is further divided into IA1, IA2, IB1, IB2, and IB3, based on the size of the cervical tumor.
• Stage 2 cervical cancer is when the cancer has spread to the tissue around the uterus or to the upper 2/3 of the vagina. This stage is subdivided into IIA1, IIA2, or IIB based on where it has spread and how large the tumor is.
• Stage 3 cervical cancer is when the cancer has spread to the pelvic wall or lower third of the vagina, or involves the lymph nodes or is causing kidney problems. This stage is subdivided into IIIA, IIIB, IIIC based on its location.
• Stage 4 cervical cancer (also called metastatic cervical cancer)is when the cancer has spread to the rectum, bladder, or beyond the pelvis to other parts of the body like the lungs. This stage is further divided into IVA and IVB based on where it’s spread.

How is Cervical Cancer Treated?

Cervical cancer can be treated through surgeries, radiation therapy, chemotherapy, targeted therapy, immunotherapy, or a combination of these. Surgeries are the most common treatment prescribed and can include:

• Cold knife conization scrapes the cancerous cells from the cervix with a scalpel.
• Sentinel node biopsy removes the sentinel lymph node.
• Hysterectomy removes the uterus and sometimes the cervix, parts of the vagina, and surrounding tissue.
• Radical trachelectomy (also called radical cervicectomy) removes the cervix, upper part of the vagina, tissue nearby and sometimes the lymph nodes.
• Bilateral salpingo-oophorectomy removes both fallopian tubes and ovaries.
• Total pelvic exenteration removes the cervix, ovaries, vagina, nearby lymph nodes, lower colon, bladder and rectum.

What are the Survival Rates & Prognosis for Cervical Cancer?

The 5-year survival rate for cervical cancer is…

• 67% for all stages
• 91% for early-stage
• 60% when it has spread to nearby lymph nodes, organs or tissue
• 19% when it has metastasized to distant parts of the body

Cervical cancer has a very good rate of recovery at early stages. Early detection is key! Remember your regular gynecological checkups and always check with your doctor when you have any changes in your body. If you’ve been diagnosed with cancer or need help understanding your test results or treatment plan, give us a call. SHAREing & CAREing’s free patient navigation services, individual counseling, and support groups can help you in your cancer journey. Remember, you are not alone!

SOURCES

• Cervical Cancer, World Health Organization (WHO)
• Worldwide Cancer Data, World Cancer Research Fund International
• Cervical Cancer Symptoms, National Cancer Institute
• What is Cervical Cancer?, National Cancer Institute
• Cervical Cancer Diagnosis, National Cancer Institute
• Cervical Cancer Prognosis and Survival Rates, National Cancer Institute

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