Pap smears reduce life-threatening cervical cancer by as much as 90%. Learn more in this video from Marcela del Carmen, MD, Gynecologic Oncologist at the Mass General Cancer Center.
What is Cervical Cancer?
Cancer is caused by malignant (cancerous) cells that grow and multiply without control. When cancer begins in the cells lining the cervix (the lower, narrow part of a woman's uterus), it is called cervical cancer.
It typically takes a long time for cervical cancer to develop. The first warning sign may come in the form of abnormal cells found on the surface of the cervix. These cells are benign (not cancer) and usually cause no symptoms. Over time, however, they may undergo changes and can become cancer. With cervical cancer (also known as invasive cervical cancer), the now cancer cells spread deeper into the cervix, or to other tissues or organs.
The American Cancer Society (ACS) estimated that about 12,900 new cases of cervical cancer would be diagnosed in the United States in 2015, and that the disease would cause about 4,100 deaths. The death rate for cervical cancer has gone down over the past three decades, which the ACS credits largely to "the increased use of the Pap test" for screening purposes.
Cervical Cancer Symptoms
Symptoms of cervical cancer usually do not appear until abnormal cervical cells become cancerous and invade nearby tissue. The most common symptom is abnormal bleeding, which may:
- Start and stop between regular menstrual periods
- Occur after sex, douching or a pelvic exam
Other cervical cancer symptoms include:
- Menstrual bleeding that is heavier and lasts longer than usual
- Increased vaginal discharge
- Pelvic pain, including during sex
- Bleeding after menopause
Cervical cancer symptoms may look like symptoms associated with other medical conditions. Talk to your doctor if you notice any of the above symptoms.
Cervical Cancer Screening and Diagnosis
The first step in diagnosing any disease is to complete a medical history and physical examination. In addition, routine annual (every year) pelvic examinations and Pap tests can help your doctor identify cervical problems early on.
- A pelvic exam involves a complete examination of the uterus, vagina, ovaries, bladder and rectum
- A Pap test (Pap smear), which may be done as part of a pelvic exam, involves the microscopic examination of cells collected from the cervix
If problems or abnormal cells are found during routine exams, further tests and procedures may be performed, such as:
- Colposcopy: A colposcope (an instrument with magnifying lenses) is used to examine the cervix and vagina for abnormalities. If abnormal tissue is found, a colposcopic biopsy (removing tissue samples to examine under a microscope for signs of cervical cancer) is usually performed
- Endocervical curettage: A curette (a narrow, spoon-shaped instrument) is used to scrape the lining of the cervical canal. This type of biopsy is usually done at the same time as a colposcopic biopsy
- Cone biopsy, or conization: A large, cone-shaped piece of tissue is removed from the cervix. This procedure may also be used to treat precancerous lesions or early-stage cervical cancer
- Human papillomavirus (HPV) test: Cells collected from the cervix are checked for certain types of HPV infection that increase your risk of cervical cancer
Treating Cervical Cancer
If you are diagnosed with cervical cancer, your care team will work with you to develop a treatment plan that is right for you. This plan will depend on factors such as type and stage (extent) of cervical cancer, your general health, and your treatment preferences.
Surgical options for removing cervical cancer include:
- Cryosurgery: Use of liquid nitrogen, or a probe that is very cold, to freeze and kill cancer cells
- Laser surgery: Use of a powerful beam of light, which can be directed to specific parts of the body without making a large incision (opening), to destroy abnormal cells
- Hysterectomy: Removal of the uterus, including the cervix. Cutting-edge approaches to this procedure include:
- Robotic-assisted hysterectomy
- Laparoscopic hysterectomy (in which a narrow viewing tube is inserted through a small incision in the belly to remove the uterus)
- Radical hysterectomy: Removal of the uterus, including the cervix, and part of the vagina
Nonsurgical treatment options (treatments other than surgery) for cervical cancer include:
- Radiation therapy uses high-energy radiation beams to kill or shrink tumors while saving healthy tissue. The radiation source can come from outside the body (external radiation therapy) or from implants inside the body (internal radiation therapy). Learn about tandem and ovoid implants.
- Chemotherapy kills cancer cells through the use of intravenous (IV) or oral drugs
- Targeted therapy uses drugs that attack specific parts of cancer cells. These drugs work differently from standard chemotherapy drugs
Some hospitals also offer clinical trials that may provide access to new and promising therapies for cervical cancer.
Cervical Cancer Related Factsheets:
- What You Need to Know About Tandem and Ovoid Implants for Cervical Cancer
- Lo que usted necesita saber sobre los implantes de tándem y ovoides para el cáncer del cuello uterino
- Guide to Radiation Oncology
- Maintain Your Sexual Health During and After Cancer Treatment
- La salud sexual durante y después del tratamiento contra el cáncer
The National Cancer Institute has more information on Cervical Cancer Treatment.