Malignant Neoplasm of Cervix
What is cervical cancer? — Cervical cancer happens when normal cells in the cervix change into abnormal cells and grow out of control. Most women whose cervical cancer is found and treated early do very well. The cervix is the bottom part, or neck, of the uterus (figure 1).
What are the symptoms of cervical cancer? — Cervical cancer might not cause any symptoms at first. When it does cause symptoms, it can cause vaginal bleeding that occurs:
In between menstrual cycles (meaning the bleeding happens when a woman is not having her period)
These symptoms can also be caused by conditions that are not cancer. But if you have vaginal bleeding at these times, tell your doctor or nurse.
Is there a test for cervical cancer? — Yes. A Pap test (also called a "Pap smear") is used to screen women for cervical cancer. Doctors sometimes also do a test for a virus called "human papillomavirus" (HPV). That's because HPV increases a person's risk of cervical cancer.
For these tests, your doctor or nurse looks inside your vagina using a device that looks like a duck beak (called a speculum). He or she will then use a small brush to collect fluid from the cervix. For a Pap test, a doctor will look at the fluid under a microscope to see if the cells are abnormal. For an HPV test, the fluid is tested in a lab to check for the virus. Depending on your age and any test you have had in the past, the doctor might do just a Pap test, just an HPV test, or both.
If the test results are abnormal, the doctor will follow up with a test called a biopsy. During a biopsy, the doctor will remove a tiny piece of abnormal-looking tissue from the cervix. To see the cervix better during a biopsy, the doctor will use a magnifying lens called a "colposcope."
Doctors sometimes find cells in the cervix that are not cancer, but are abnormal and have a high chance of turning into cancer. If you have these "precancer" cells, your doctor can treat them in different ways. He or she might remove them to prevent them from turning into cancer. Or he or she might watch them closely over time.
What is cervical cancer staging? — Cancer staging is a way in which doctors find out how far a cancer has spread.
The right treatment for you will depend a lot on the stage of your cancer, your age, and other health problems. Your treatment will also depend on whether you might want to get pregnant in the future.
How is cervical cancer treated? — Cervical cancer can be treated in different ways. These include:
Surgery – Some cases of cervical cancer are treated with surgery to remove the cancer. Different types of surgery can involve:
•Removing the cervix, uterus, and upper part of the vagina – This is called a "radical hysterectomy" (figure 2).
•Removing all or part of the cervix but leaving the uterus in place – This type of surgery is done only in special situations.
Radiation therapy – Radiation kills cancer cells.
Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing. Women with cervical cancer usually receive chemotherapy at the same time as radiation therapy.
What if I want to get pregnant one day? — If you want to have a baby one day, talk with your doctor before having treatment. Some women can still get pregnant after being treated for cervical cancer. But, a woman cannot get pregnant after some types of treatment, such as a hysterectomy, radiation therapy, or some types of chemotherapy.
Women are often able to get pregnant after other types of treatment. But they usually need to wait 6 to 12 months before they start trying to get pregnant, because their body needs time to heal.
What happens after treatment? — After treatment, you will be checked every so often to see if the cancer comes back. Follow-up tests can include exams, Pap tests, and X-rays.
What happens if the cancer comes back or spreads? — If the cancer comes back or spreads, you might have more surgery, radiation, or chemotherapy.
What else should I do? — It is important to follow all your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.
Getting treated for cervical cancer involves making many choices, such as which type of surgery to have.
Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:
What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
What are the downsides to this treatment?
Are there other options besides this treatment?
What happens if I do not have this treatment?
Can cervical cancer be prevented? — In many cases, yes. Almost all cervical cancer is caused by a virus called HPV (human papillomavirus) that is spread through skin-to-skin contact and sex. Vaccines that prevent people from getting infected with HPV are now available. Ask your doctor if and when you should get an HPV vaccine. This vaccine is available for men and women, and works best if a person receives it before he or she starts having sex. But it can also help if you have already had sex. Also, treating precancer cells can keep them from turning into cervical cancer.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15414 Version 11.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.