Cervical cancer begins in cells on the surface of the cervix. Over time, the cervical cancer can invade more deeply into the cervix and nearby tissues. The cancer cells can spread by breaking away from the original (primary) tumor. They enter blood vessels or lymph vessels, which branch into all the tissues of the body. The cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues. The spread of cancer is called metastasis. See the Staging section for information about cervical cancer that has spread.
Growths on the cervix can be benign or malignant. Benign growths are not cancer. They are not as harmful as malignant growths (cancer).
Benign growths (polyps, cysts, or genital warts):
- are rarely a threat to life
- don’t invade the tissues around them
Malignant growths (cervical cancer):
- may sometimes be a threat to life
- can invade nearby tissues and organs
- can spread to other parts of the body
Every cancer diagnosis is different, just as every person who is diagnosed with cancer is different. Cancer knows no barriers to race, age, or social group. However there is one thing that each and every person who is diagnosed with cancer will have in common: help with fighting and beating the disease.
Life after being diagnosed with cancer will be different for everyone. Some people will have minimal disease and it will be a short chapter of their lives, while others will have a diagnosis that will change the course of the rest of their lives. Cancer diagnoses can change relationships, your routines, your work and home life. One thing is certain, no one person’s experience will be exactly the same. There are however, plenty of resources to learn about what life was like for other people, and what they did to achieve balance, maintain their health and personal life, keep peace of mind, and enjoy their lives with or after cancer.
Clinical Trials
The search for a cure for cancer is an ongoing, constant battle. Clinical trials are the basis upon which new treatments and medications are proven to help the fight against cancer, or if researchers should pursue another tactic. The advancement of medicine depends on willing and able cancer patients to volunteer for experimental treatments so that future generations will have proven and effective cures. Not every patient with cancer will be eligible for a clinical trial, as the scientific method needs specific patients with specific types of cancers. However, patients who are selected for trials may benefit from being at the cutting edge of new research, and gain time they otherwise might not have had.
The National Cancer Institute at the National Institutes of Health has a comprehensive database of over 10,000 ongoing clinical trials that both help advance medicine and help patients.
Financial Help
Unfortunately, cancer treatment can be costly, even if a patient has very comprehensive health insurance. For patients who do not have health insurance, the cost of treatment may seem insurmountable. Fortunately many pharmaceutical companies offer cost assistance to help make treatment more affordable. The National Comprehensive Cancer Network has compiled a Virtual Reimbursement Room where patients can find information for accessing financial help with their treatment costs.
When you get a diagnosis of cancer, it’s natural to wonder what may have caused the disease. Doctors cannot always explain why one woman develops cervical cancer and another does not. However, we do know that a woman with certain risk factors may be more likely than others to develop cervical cancer. A risk factor is something that may increase the chance of developing a disease.
Studies have found a number of factors that may increase the risk of cervical cancer. For example, infection with HPV (human papillomavirus) is the main cause of cervical cancer. HPV infection and other risk factors may act together to increase the risk even more:
- HPV infection: HPV is a group of viruses that can infect the cervix. An HPV infection that doesn’t go away can cause cervical cancer in some women. HPV is the cause of nearly all cervical cancers.
- HPV infections are very common. These viruses are passed from person to person through sexual contact. Most adults have been infected with HPV at some time in their lives, but most infections clear up on their own.
- Some types of HPV can cause changes to cells in the cervix. If these changes are found early, cervical cancer can be prevented by removing or killing the changed cells before they can become cancer cells. The NCI fact sheet “Human Papillomaviruses and Cancer” has more information.
- A vaccine for females ages 9 to 26 protects against two types of HPV infection that cause cervical cancer.
- Lack of regular Pap tests: Cervical cancer is more common among women who don’t have regular Pap tests. The Pap test helps doctors find abnormal cells. Removing or killing the abnormal cells usually prevents cervical cancer.
- Smoking: Among women who are infected with HPV, smoking cigarettes slightly increases the risk of cervical cancer.
- Weakened immune system (the body’s natural defense system): Infection with HIV (the virus that causes AIDS) or taking drugs that suppress the immune system increases the risk of cervical cancer.
- Sexual history: Women who have had many sexual partners have a higher risk of developing cervical cancer. Also, a woman who has had sex with a man who has had many sexual partners may be at higher risk of developing cervical cancer. In both cases, the risk of developing cervical cancer is higher because these women have a higher risk of HPV infection.
- Using birth control pills for a long time: Using birth control pills for a long time (5 or more years) may slightly increase the risk of cervical cancer among women with HPV infection. However, the risk decreases quickly when women stop using birth control pills.
- Having many children: Studies suggest that giving birth to many children (5 or more) may slightly increase the risk of cervical cancer among women with HPV infection.
- DES (diethylstilbestrol): DES may increase the risk of a rare form of cervical cancer in daughters exposed to this drug before birth. DES was given to some pregnant women in the United States between about 1940 and 1971. (It is no longer given to pregnant women.)
Having an HPV infection or other risk factors does not mean that a woman will develop cervical cancer. Most women who have risk factors for cervical cancer never develop it.
Life after being diagnosed with cancer will be different for everyone. Some people will have minimal disease and it will be a short chapter of their lives, while others will have a diagnosis that will change the course of the rest of their lives. Cancer diagnoses can change relationships, your routines, your work and home life. One thing is certain, no one person’s experience will be exactly the same. There are however, plenty of resources to learn about what life was like for other people, and what they did to achieve balance, maintain their health and personal life, keep peace of mind, and enjoy their lives with or after cancer.
Your experience with cancer will depend on the type of cancer you have, your choices of treatment and the lifestyle you lead. Be sure to speak with your Doctor about the side effects of your disease and the treatments you choose. Your Doctor will be able to consult with you on realistic lifestyle expectations.
Early cervical cancers usually don’t cause symptoms. When the cancer grows larger, women may notice one or more of these symptoms:
- Abnormal vaginal bleeding
- Bleeding that occurs between regular menstrual periods
- Bleeding after sexual intercourse, douching, or a pelvic exam
- Menstrual periods that last longer and are heavier than before
- Bleeding after going through menopause
- Increased vaginal discharge
- Pelvic pain
- Pain during sex
Infections or other health problems may also cause these symptoms. Only a doctor can tell for sure. A woman with any of these symptoms should tell her doctor so that problems can be diagnosed and treated as early as possible.
Doctors all over the country are conducting many types of clinical trials (research studies in which people volunteer to take part). They are studying new ways to treat cervical cancer. Some are also studying therapies that may improve the quality of life for women during or after cancer treatment.
Clinical trials are designed to answer important questions and to find out whether new approaches are safe and effective. Research already has led to advances in the prevention, diagnosis, and treatment of cervical cancer. Doctors continue to search for new and better ways to treat cervical cancer. They are testing new treatments, including new drugs, combinations, and schedules. Some trials are combining chemotherapy, surgery, and radiation therapy.
Doctors also are studying surgery to remove sentinel lymph nodes. A sentinel lymph node is the first lymph node to which the cancer is likely to spread. Today, surgeons often have to remove many lymph nodes and check each of them for cancer. But if the research shows that it’s possible to identify the sentinel lymph node (the lymph node most likely to have cancer), doctors may be able to avoid more surgery to remove other lymph nodes.
Even if the people in a trial don’t benefit directly, they may still make an important contribution by helping doctors learn more about cervical cancer and how to control it. Although clinical trials may pose some risks, researchers do all they can to protect their patients.
Women with cervical cancer have many treatment options. The options are surgery, radiation therapy, chemotherapy, or a combination of methods.
The choice of treatment depends mainly on the size of the tumor and whether the cancer has spread. The treatment choice may also depend on whether you would like to become pregnant someday.
Surgery
Surgery is an option for women with Stage I or II cervical cancer. The surgeon removes tissue that may contain cancer cells:
- Radical trachelectomy: The surgeon removes the cervix, part of the vagina, and the lymph nodes in the pelvis. This option is for a small number of women with small tumors who want to try to get pregnant later on.
- Total hysterectomy: The surgeon removes the cervix and uterus.
- Radical hysterectomy: The surgeon removes the cervix, some tissue around the cervix, the uterus, and part of the vagina.
Radiation Therapy
Radiation therapy (also called radiotherapy) is an option for women with any stage of cervical cancer. Women with early stage cervical cancer may choose radiation therapy instead of surgery. It also may be used after surgery to destroy any cancer cells that remain in the area. Women with cancer that extends beyond the cervix may have radiation therapy and chemotherapy
Radiation therapy uses high-energy rays to kill cancer cells. It affects cells only in the treated area.
Doctors use two types of radiation therapy to treat cervical cancer. Some women receive both types:
- External radiation therapy: A large machine directs radiation at your pelvis or other tissues where the cancer has spread. The treatment usually is given in a hospital or clinic. You may receive external radiation 5 days a week for several weeks. Each treatment takes only a few minutes.
- Internal radiation therapy: A thin tube is placed inside the vagina. A radioactive substance is loaded into the tube. You may need to stay in the hospital while the radioactive source is in place (up to 3 days). Or the treatment session may last a few minutes, and you can go home afterward. Once the radioactive substance is removed, no radioactivity is left in your body. Internal radiation may be repeated two or more times over several weeks.
Chemotherapy
- For the treatment of cervical cancer, chemotherapy is usually combined with radiation therapy. For cancer that has spread to distant organs, chemotherapy alone may be used.
- Chemotherapy uses drugs to kill cancer cells. The drugs for cervical cancer are usually given through a vein (intravenous). You may receive chemotherapy in a clinic, at the doctor’s office, or at home. Some women need to stay in the hospital during treatment.
Doctors recommend that women help reduce their risk of cervical cancer by having regular Pap tests. A Pap test (sometimes called Pap smear or cervical smear) is a simple test used to look at cervical cells. Pap tests can find cervical cancer or abnormal cells that can lead to cervical cancer.
If you have abnormal Pap or HPV test results, your doctor will suggest other tests to make a diagnosis:
- Colposcopy: The doctor uses a colposcope to look at the cervix. The colposcope combines a bright light with a magnifying lens to make tissue easier to see. It is not inserted into the vagina. A colposcopy is usually done in the doctor’s office or clinic.
- Biopsy: Most women have tissue removed in the doctor’s office with local anesthesia. A pathologist checks the tissue under a microscope for abnormal cells.
- Punch biopsy: The doctor uses a sharp tool to pinch off small samples of cervical tissue.
- LEEP: The doctor uses an electric wire loop to slice off a thin, round piece of cervical tissue.
- Endocervical curettage: The doctor uses a curette (a small, spoon-shaped instrument) to scrape a small sample of tissue from the cervix. Some doctors may use a thin, soft brush instead of a curette.
- Conization: The doctor removes a cone-shaped sample of tissue. A conization, or cone biopsy, lets the pathologist see if abnormal cells are in the tissue beneath the surface of the cervix. The doctor may do this test in the hospital under general anesthesia.
Removing tissue from the cervix may cause some bleeding or other discharge. The area usually heals quickly. Some women also feel some pain similar to menstrual cramps. Your doctor can suggest medicine that will help relieve your pain.