Reviewed by Dr. Clement J. Cheng
Cervical cancer is the third most common type of cancer among women in the United States. The average age of cancer diagnosis is 45; however, cervical cancer can afflict women in their 20s and 30s. Untreated, cervical cancer can spread to other pelvic organs, such as the uterus, rectum, and bladder. When cervical cancer is diagnosed in its early stages, the survival rate is very good.
Cervical cancer develops gradually over a period of several years. It can begin as cervical dysplasia, a condition that occurs when subtle changes take place in the superficial cells lining the cervix. Dysplasia is a pre-malignant condition. The next stage, noninvasive cancer, occurs when dysplasia progresses to the outer layer of the cervix. If the cancer is untreated in the noninvasive phase, it eventually spreads to deeper layers of tissue and then onto other organs, such as the uterus, rectum, and bladder.
Often, the early stages of cervical cancer are asymptomatic. When symptoms occur, they usually present as abnormal bleeding, or persistent vaginal discharge. Advanced symptoms include weight loss, appetite loss, back pain, fatigue, leg pain, and loss of urine or rectal contents through the vagina because of an abnormal tube-like passage between the rectum and vagina called the fistula.
The cause of cervical cancer is unknown, however, researchers have identified a number of risk factors. Multiple sexual partners, early onset of sexual activity, early childbearing, and exposure to sexually transmitted diseases all increase a woman’s chances of developing cervical cancer.
The most important preventative step women can take against cervical cancer is having an annual gynecological exam with a pap smear. Pap smears detect abnormal cells in the cervix and alert a doctor to the need for more testing. Because cervical cancer is easily overlooked in its early stages, it is crucial that women receive routine pap smears. With early detection of abnormal cells, doctors can begin treating cervical cancer before it develops.
If the pap smear detects abnormalities, the doctor may perform a Human Papillomavirus (HPV) test. HPV is the
sexually transmitted virus that causes 99.7 percent of all cases of cervical cancer. HPV testing used alone, without a pap smear, detects 98 percent of cerivical cancers; used together, the tests detect virtually 100 percent of all cases. The presence of HPV does not necessarily indicate cancer.
In addition to these tests, your doctor can perform a colposcopy to pinpoint areas of concern in the cervix. A cervical biopsy, also called a cone biopsy, confirms cervical cancer by removing a cone-sized sample of suspicious tissue from the wall of the cervix and analyzing it for cancerous cells.
Treatment of cervical cancer depends on a number of factors, including the age of the woman, the type and progression of the disease, and the woman’s desire to retain her childbearing ability. Surgical options exist and range from localized surgery for surface lesions to a radical hysterectomy for cancer that has spread beyond the cervix. Cryosurgery, or the destruction of tissue by freezing, is an option for women who desire children in the future. Finally, a combination of radiation therapy and chemotherapy are used to treat invasive cervical cancer.
