Screening with Pap tests can reduce the risk of this cancer that begins in the cervix. Learn more about symptoms, causes, prevention and treatment.
Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.
Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer.
When exposed to HPV, the body's immune system typically prevents the virus from doing harm. In a small percentage of people, however, the virus survives for years, contributing to the process that causes some cervical cells to become cancer cells.
You can reduce your risk of developing cervical cancer by having screening tests and receiving a vaccine that protects against HPV infection.
Early-stage cervical cancer generally produces no signs or symptoms.
Signs and symptoms of more-advanced cervical cancer include:
Make an appointment with your doctor if you have any signs or symptoms that concern you.
The ovaries, fallopian tubes, uterus, cervix and vagina (vaginal canal) make up the female reproductive system.
Cervical cancer begins when healthy cells in the cervix develop changes (mutations) in their DNA. A cell's DNA contains the instructions that tell a cell what to do.
Healthy cells grow and multiply at a set rate, eventually dying at a set time. The mutations tell the cells to grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can break off from a tumor to spread (metastasize) elsewhere in the body.
It isn't clear what causes cervical cancer, but it's certain that HPV plays a role. HPV is very common, and most people with the virus never develop cancer. This means other factors — such as your environment or your lifestyle choices — also determine whether you'll develop cervical cancer.
The type of cervical cancer that you have helps determine your prognosis and treatment. The main types of cervical cancer are:
Sometimes, both types of cells are involved in cervical cancer. Very rarely, cancer occurs in other cells in the cervix.
Two types of cells line the surface of the cervix, and both can become cancerous. One type (glandular cells) has a column-shaped appearance. The other type (squamous cells) is thin and flat. The boundary between the two types of cells is where cervical cancer most commonly occurs.
Risk factors for cervical cancer include:
To reduce your risk of cervical cancer:
Screening tests can help detect cervical cancer and precancerous cells that may one day develop into cervical cancer. Most guidelines suggest beginning screening for cervical cancer and precancerous changes at age 21.
Screening tests include:
Pap test. During a Pap test, your doctor scrapes and brushes cells from your cervix, which are then examined in a lab for abnormalities.
A Pap test can detect abnormal cells in the cervix, including cancer cells and cells that show changes that increase the risk of cervical cancer.
Discuss your cervical cancer screening options with your doctor.
If cervical cancer is suspected, your doctor is likely to start with a thorough examination of your cervix. A special magnifying instrument (colposcope) is used to check for abnormal cells.
During the colposcopic examination, your doctor is likely to take a sample of cervical cells (biopsy) for laboratory testing. To obtain tissue, your doctor may use:
If the punch biopsy or endocervical curettage is worrisome, your doctor may perform one of the following tests:
If your doctor determines that you have cervical cancer, you'll have further tests to determine the extent (stage) of your cancer. Your cancer's stage is a key factor in deciding on your treatment.
Staging exams include:
In a Pap test, your doctor uses a vaginal speculum to hold your vaginal walls apart and to see the cervix. Next, a sample of cells from your cervix is collected using a small cone-shaped brush and a tiny plastic spatula (1 and 2). Your doctor then rinses the brush and spatula in a liquid-filled vial (3) and sends the vial to a laboratory for testing.
Treatment for cervical cancer depends on several factors, such as the stage of the cancer, other health problems you may have and your preferences. Surgery, radiation, chemotherapy or a combination of the three may be used.
Early-stage cervical cancer is typically treated with surgery. Which operation is best for you will depend on the size of your cancer, its stage and whether you would like to consider becoming pregnant in the future.
Options might include:
Minimally invasive hysterectomy, which involves making several small incisions in the abdomen rather than one large incision, may be an option for early-stage cervical cancer. People who undergo minimally invasive surgery tend to recover more quickly and spend less time in the hospital. But some research has found minimally invasive hysterectomy may be less effective than traditional hysterectomy. If you're considering minimally invasive surgery, discuss the benefits and risks of this approach with your surgeon.
Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer cells. Radiation therapy is often combined with chemotherapy as the primary treatment for locally advanced cervical cancers. It can also be used after surgery if there's an increased risk that the cancer will come back.
Radiation therapy can be given:
If you haven't started menopause yet, radiation therapy might cause menopause. If you might want to consider becoming pregnant after radiation treatment, ask your doctor about ways to preserve your eggs before treatment starts.
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. It can be given through a vein or taken in pill form. Sometimes both methods are used.
For locally advanced cervical cancer, low doses of chemotherapy are often combined with radiation therapy, since chemotherapy may enhance the effects of the radiation. Higher doses of chemotherapy might be recommended to help control symptoms of very advanced cancer.
Targeted drug treatments focus on specific weaknesses present within cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die. Targeted drug therapy is usually combined with chemotherapy. It might be an option for advanced cervical cancer.
Immunotherapy is a drug treatment that helps your immune system to fight cancer. Your body's disease-fighting immune system might not attack cancer because the cancer cells produce proteins that make them undetectable by the immune system cells. Immunotherapy works by interfering with that process. For cervical cancer, immunotherapy might be considered when the cancer is advanced and other treatments aren't working.
Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care.
When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.
Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.
No one can be prepared for a cancer diagnosis. You can, however, try to manage the shock and fear you're feeling by taking steps to control what you can about your situation.
Everyone deals with a cervical cancer diagnosis in his or her own way. With time, you'll discover what helps you cope. Until then, you can start to take control by attempting to:
Make an appointment with your doctor if you have any signs or symptoms that worry you. If you're thought to have cervical cancer, you may be referred to a doctor who specializes in treating cancers that affect the female reproductive system (gynecologic oncologist).
Here's some information to help you get ready for your appointment and what to expect from your doctor.
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions that occur to you.
Your doctor is likely to ask you a number of questions. Being ready to answer them may make time to go over points you want to spend more time on. You may be asked: