Cervical cancer starts in the cervix, the narrow opening connecting the uterus and the vagina. This opening has two ends: the exocervix, the part closest to the uterus containing squamous cells and the endocervix, the part closest to the vagina containing glandular cells. The exo and endo portions of the cervix are connected by the transformation zone; most cervical cancers begin in this zone where squamous and glandular cells intermix. Cervical cancers are slow growing; they gradually develop into pre-cancerous cells that eventually may become cancerous. Cervical cancer primarily occurs in women under the age of 501.
Credit: American Cancer Society
What are the different types of cervical cancer?
There are several types of cervical cancer that affect the different cells of the cervix. Read more about the types of cervical cancer at: http://www.cancerresearchuk.org/cancer-help/type/cervical-cancer/about/t...
What are the symptoms of cervical cancer?
Generally, precancerous cervical cell changes and early cancers of the cervix do not have symptoms. Known symptoms of advancing cervical cancer include:
- Bleeding between menstrual periods
- Bleeding after sexual intercourse
- Bleeding after douching
- Bleeding after a pelvic exam
- Bleeding after menopause
- Pelvic pain not related to menstrual cycle
- Heavy or unusual discharge that may be watery, thick and possibly have a foul odor
- Increased urination
- Painful urination
How is cervical cancer diagnosed?
Pre-cancer tests for cervical cancer include the Papanicolaou test (Pap smear/test), a screening test used to indicate the possible presence of precancerous and cancerous cells in the cervix, and an HPV test, which looks for the presence of human papillomavirus, a possible cause cervical cancer.
Physical Exams for cervical cancer will focus on finding swelling or abnormal masses around the pelvic area.
Colposcopy is a magnified examination of the vagina and cervix by a lighted instrument called a colposcope. This exam allows the doctor to clearly inspect the surface of the cervix. During a colposcopy, a doctor will apply a weak acid to the cervix to more clearly show abnormal areas.
Biopsy is the removal of a small amount of cervical tissue for microscopic examination to detect (pre)cancerous cell presence. During a biopsy, the doctor will insert a speculum to hold the vagina open and remove a small sample of tissue from the cervix.
Imaging tests use x-rays, magnetic fields, or sound waves to create pictures of the inside of the body. For cervical cancer these tests may include cystoscopy, computed tomography (CT) scans, magnetic resonance imaging (MRI), positron emission tomography (PET) scans, and chest x-rays.
What are the different stages of cervical cancer?
The 2 systems used for staging most types of cervical cancer are the FIGO (International Federation of Gynecology and Obstetrics) system and the AJCC (American Joint Committee on Cancer) TNM staging system.
What are the treatment options for cervical cancer?
This cervical cancer treatment information does not outline the particular treatment(s) a patient will receive. Rather, it provides general information about the typical treatments used for this type of cancer.
Primary treatment options:
- Surgery is the removal of a cancerous cervical tumor. Types of surgery used to treat cervical cancer include: cryosurgery, conization hysterectomy, radical hysterectomy, trachelectomy, pelvic exenteration, and pelvic lymph node dissection.
- Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or to prevent the tumor from growing. For cervical cancer, external beam and internal radiation therapies may be used.
- Chemotherapy employs drugs to treat cancer. These drugs are injected into the bloodstream and they circulate to destroy cancer cells throughout the body. Chemotherapy for cervical cancer is often used in conjunction with radiation therapies and to treat recurrences of cervical cancer.
Secondary treatment options:
- Hormone therapy is the use of hormones or hormone blocking drugs to fight cancer. For cervical cancer, hormone therapies may include LHRH agonists, Tamoxifen, and aromatase inhibitors.
- Targeted therapies are drugs that prevent the growth of cancer cells and protect healthy cervical cells from damage. Bevacizumab is the most frequently prescribed targeted therapy drug for cervical cancer.
What are the risk factors of cervical cancer?
- Human papilloma virus (HPV): This group of about 100 viruses is a prevalent risk factor for developing cervical cancer.
- Smoking: Women who smoke are twice as likely as non-smokers to get cervical cancer.
- HIV/AIDS: This disease damages the body’s immune system and with a lowered immune system women are at a higher risk for HPV infections.
- Chlamydia infections: Some studies have shown women with a past or current Chlamydia infection have a higher risk of cervical cancer.
- Diet: Eating low amounts of fruits and vegetables may increase your risk of cervical cancer.
- Weight: Overweight women are more likely to develop cervical cancer
How is cervical cancer prevented?
- Finding (via Pap and HPV tests) and treating precancerous cervical conditions
- Avoiding exposure to HPV. HPV infections are more common in younger women and are less common in women older than 30.
- Stopping and/or avoiding tobacco smoking
Mikayla D. Williams, BS, Nursing, University of Arizona
Michael Principe, MA, Information Resources and Library Science, University of Arizona
Expert Review by:
Cheryl Lacasse, MS, RN, OCN Clinical Professor, College of Nursing, The University of Arizona
1American Cancer Society (2014). Cervical Cancer. http://www.cancer.org/cancer/cervicalcancer/detailedguide/index
National Cervical Cancer Coalition. Cervical Cancer Overview. http://www.nccc-online.org/index.php/cervicalcancer
Seattle Cancer Care Alliance (2014). Cervical Cancer Facts. http://www.seattlecca.org/diseases/cervical-cancer-facts.cfm
Cancer Research UK (2014). Cervical cancer. http://www.cancerresearchuk.org/cancer- help/type/cervical-cancer/