Cervical Cancer

Cervical cancer is a common type of slow-growing cancer in women that affects the mouth of the womb (uterus). The cervix connects the uterus to the vagina. Each year in the United States, about 16,000 new cases of cervical cancer are diagnosed. The condition may start with changes in the shape, size or formation of cervical cells called dysplasia.

Prevention

Gardasil® is the first vaccine developed to prevent some cervical cancers, precancerous genital lesions and genital warts caused by the human papillomavirus (HPV). The Centers for Disease Control recommend that the vaccine be given to girls between the ages of nine and 26. The vaccine is given in a series of three injections over a six-month period.

Symptoms

Pre-cancerous cervical conditions are generally painless. They are not easily detected unless the patient has a pelvic exam and a Pap smear. Symptoms include:

  • Abnormal bleeding. This happens only after the cervical cells become cancerous and invade neighboring tissues
  • Unusual vaginal discharge
  • Increased bleeding during menstruation. Increased bleeding during menstruation
  • Bleeding between regular menstrual periods or after sexual intercourse, douching or a pelvic exam
  • Difficulty or pain in urination
  • Pain during intercourse
  • Pain in the pelvic area
  • Pre- or post-menopausal bleeding

These symptoms may also be caused by other less serious health problems. Patients are encouraged to visit their doctors when experiencing similar symptoms.

Causes and Risk Factors

A virus called human papillomavirus (HPV) is believed to cause cells and tissues in the cervix to grow abnormally to develop into cervical cancer. About 6 million women in the U.S. are infected with HPV. While researchers work to learn more about this form of cancer, certain risk factors are known:

  • Having many sexual partners
  • First intercourse at a young age
  • History of smoking

Diagnosis

Pelvic exams, Pap smears and biopsies are methods used to detect cervical cancer and abnormal, pre-cancerous cervical lesions.

A pelvic exam involves the doctor probing for lumps or abnormalities in shape or size of the uterus, vagina, ovaries, fallopian tubes, bladder and rectum using a speculum. This instrument enlarges the vagina and allows the doctor to see the upper portion of the vagina and the cervix.

A pap smear is a simple and painless test often done during a pelvic exam. A small wooden scraper (spatula) and/or a small brush is used to collect cell samples from the upper portion of the vagina and the cervix. Samples are looked at under a microscope to check for abnormal cells. Pap smears examine only cervical cells and are not indicators of uterine cancer.

Biopsy requires a doctor scraping or removing a small amount of tissue from the cervix while the patient is under anesthesia. The sample is sent to the laboratory to see if cancer cells are present.

Treatment

After test and examination results are in, the doctor will discuss with the patient what treatments will likely work best for her condition. Treatment plans depend on:

  • Patient's age
  • Patient's general health
  • Tumor size
  • Stage of the disease
  • Speed of cell growth and degree of spreading (tumor grade)
  • Effect of female hormones on tumor size
  • Patient's desire to have children in the future

Treatments for cervical cancer include:

Resources at Cedars-Sinai

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