Patient education: Cervical cancer (The Basics)

What is cervical cancer? — 

Cancer of the cervix (cervical cancer) happens when normal cells in the cervix change into abnormal cells and grow out of control. The cervix is the bottom part of the uterus, where it meets the vagina (figure 1).

Almost all cervical cancer is caused by the human papillomavirus virus, or "HPV." This virus can spread through skin-to-skin contact and sex. There are vaccines that prevent people from getting HPV. The vaccine works best if you get it before you start having sex, but it can also help if you have already had sex.

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 happens:

●Between menstrual cycles (meaning when you are not having your period)

●After sex

●After menopause

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.

What is cervical cancer screening? — 

"Screening" is a way to check for cancer before it causes any symptoms. Screening tests can find cervical cancer and precancer in the early stages, when it can be treated or even cured.

The tests include:

●Pap test (also called a "Pap smear")

●HPV test

For both, the doctor or nurse looks inside your vagina using a device called a "speculum." Then, they use a small brush to collect fluid from your cervix:

●For a Pap test, a doctor looks 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 tests you had in the past, the doctor might do just a Pap test, just an HPV test, or both.

Is there a test for cervical cancer? — 

Yes. If the results of a screening test are abnormal, the doctor might follow up with a "colposcopy." For this test, the doctor uses a magnifying lens called a "colposcope" to look at your cervix. They will also probably do a biopsy. This involves taking a tiny sample of abnormal-looking tissue from the cervix to check for cancer.

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 might remove them to prevent them from turning into cancer. Or they might watch these cells closely over time to see if they change.

What is cervical cancer staging? — 

Cancer staging is a way to find out how far a cancer has spread.

Your doctor or nurse will do an exam, including a pelvic exam. They might also do imaging tests (such as MRI or CT) to help with staging. Imaging tests create pictures of the inside of the body.

How is cervical cancer treated? — 

Cervical cancer can be treated in different ways. The right treatment for you depends a lot on the stage of your cancer, your age, and other health problems. It also depends on whether you might want to get pregnant in the future.

●Surgery – Some cervical cancers 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 – This is done only in special situations.

•Checking the lymph nodes for cancer cells

●Radiation therapy – This kills cancer cells.

●Chemotherapy – These are medicines that kill cancer cells or stop them from growing. People with cervical cancer usually get chemotherapy and radiation therapy at the same time.

What if I want to get pregnant in the future? — 

Talk with your doctor before starting treatment. You might be able to get pregnant after being treated for cervical cancer, depending on the treatment. If you want to get pregnant, your doctor will usually ask you to wait 6 to 12 months after finishing treatment before you start trying. This is because your body needs time to heal.

If you have a hysterectomy, or certain types of radiation or chemotherapy, it will not be possible to get pregnant afterward. If you need one of these treatments, your doctor or nurse can talk to you about other options for growing your family in the future.

What happens after treatment? — 

You will be checked regularly to see if the cancer comes back. Follow-up tests can include exams and Pap tests, and sometimes imaging tests.

What happens if the cancer comes back or spreads? — 

You might have more surgery, radiation, or chemotherapy.

What else should I do? — 

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 tell your doctors and nurses 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 of this treatment?

●Are there other options besides this treatment?

●What happens if I do not have this treatment?

More on this topic

Patient education: Cervical cancer screening tests (The Basics)
Patient education: Cervical dysplasia (The Basics)
Patient education: Human papillomavirus (HPV) (The Basics)
Patient education: Human papillomavirus (HPV) vaccine (The Basics)
Patient education: Colposcopy (Beyond the Basics)
Patient education: Hysterectomy (The Basics)
Patient education: Chemotherapy (The Basics)
Patient education: Preserving fertility after cancer treatment in women (The Basics)

Patient education: Cervical cancer screening (Beyond the Basics)
Patient education: Cervical cancer treatment; early-stage cancer (Beyond the Basics)
Patient education: Management of a cervical biopsy with precancerous cells (Beyond the Basics)
Patient education: Follow-up of high-grade or glandular cell abnormal Pap tests (Beyond the Basics)
Patient education: Human papillomavirus (HPV) vaccine (Beyond the Basics)
Patient education: Colposcopy (Beyond the Basics)
Patient education: Fertility preservation in early-stage cervical cancer (Beyond the Basics)