Understanding Cervical Cancer: Symptoms, Diagnosis and Treatment

What is cervical cancer?

The cervix, located at the lower part of the uterus, is a key part of the female reproductive system. Cervical cancer usually develops slowly over several years, starting as precancerous cells in the cervix that eventually become cancerous. According to the World Health Organization, cervical cancer is the fourth most common cancer among women worldwide. However, many cases are preventable, and early detection significantly improves treatment outcomes.

What are the types of cervical cancer?

There are two main types of cervical cancer:

1. Squamous cell carcinoma: This is the most common type of cervical cancer, accounting for about 80% of all cases. This cancer develops in the thin, flat cells lining the cervix.
2. Adenocarcinoma: This is a less common form of cervical cancer that develops in the mucus-producing cells of the cervix.

Another type of cervical cancer is mixed carcinoma. This rare cancer has features of both squamous cell carcinoma and adenocarcinoma.

What are the symptoms to watch for?

Cervical cancer may not be noticeable in its early stages. However, as it progresses it may cause the following symptoms:

• Abnormal vaginal bleeding (e.g. between menstrual periods, after sex or after menopause)
• Unusually heavy or prolonged menstrual periods
• Vaginal discharge that is bloody or foul-smelling
• Pain during sex
• Pain in the pelvic area

These symptoms can also be caused by conditions that are not cancer. If you have any of these symptoms, especially if they don’t go away, talk to your primary care provider.

What causes cervical cancer?

Cervical cancer is mostly caused by ongoing infections from certain types of human papillomavirus (HPV), a common virus spread by sexual contact. Most HPV infections go away on their own, but some types, like HPV-16 and HPV-18, can lead to cervical cancer.

What factors increase the risk of cervical cancer?

Certain lifestyle choices can raise your risk of cervical cancer, along with some types of HPV:

• Smoking: Smoking weakens the immune system, making it harder to fight HPV infections.
  Weak immune system: Having conditions like HIV or taking medications that lower your immunity can increase your risk.
  
• Early sexual activity: This raises the chance of being exposed to HPV.
  
• Multiple sexual partners: This increases exposure to HPV.
  
• Long-term use of birth control pills: Using these pills for many years may slightly increase your risk of cervical cancer.
  
• Not getting screened regularly: Routine exams with an OB/GYN help find precancerous changes early before they turn into cancer. Need an OB/GYN? Find one at bronsonhealth.com/find-a-doctor.

How do we screen for cervical cancer?

Effective screening methods and vaccines prevent most cervical cancers. Screening includes Pap smear and HPV testing.

• Pap smear (Pap test): This test checks for abnormal cells in the cervix that could turn into cancer. A healthcare provider collects a sample of cervical cells to examine in a lab. Women should get a Pap test every three years starting at age 21, or as recommended by their healthcare provider.
• HPV test: This test detects high-risk HPV types in cervical cells. For women over age 30, the HPV test is often combined with a Pap test and can be done every five years.

Remember: Prevention and early detection is key! When caught early, cervical cancer can be treated before it progresses into later stages or moves into other areas of the body.

How is cervical cancer diagnosed?

When abnormalities are detected during a Pap or HPV test, further evaluation is needed. Other tests that help pinpoint cervical cancer include:

• Colposcopy: A colposcope is an instrument that magnifies the cervix and helps identify the abnormal areas.
• Biopsy: If abnormal areas are found, a small sample of cervical tissue is taken for analysis.

Additional imaging tests like CT, MRI or PET scans may be used to determine if the cancer has spread to other areas of the body.

How can cervical cancer be prevented?

Though there is no definite way to prevent cervical cancer, the following actions can significantly reduce your risk.

• HPV vaccination: Vaccines like Gardasil 9 protect against the most common cancer-causing HPV types. It's best to get vaccinated before becoming sexually active, usually around ages 11-12, but it can be given up to age 45.
• Safe sexual practices: Using protection and limiting the number of sexual partners can reduce the risk of HPV transmission.
• Quit Smoking: Smoking increases the risk of cervical cancer, so quitting can help lower that risk.
• Regular screening: Pap smears and HPV tests can detect precancerous changes early, allowing for treatment before they develop into cancer.

How is cervical cancer treated?

Every case is unique, and treatment depends on the type, disease stage and the patient’s overall health and fertility preferences.

If diagnosed with cervical cancer, the care team may include a gynecologist, a gynecologic oncologist, a medical oncologist and/or a radiation oncologist.

Surgery:

• For precancerous conditions: When abnormal cells are detected before developing into cancer, it can be treated using an ablation (destroying tissue) or conization (removing abnormal tissue).
• For invasive cancer: Once cervical cancer develops, a hysterectomy (removal of the uterus) or trachelectomy (removal of the cervix) can be performed. A trachelectomy perseveres the uterus.

Radiation Therapy:

Radiation therapy uses high-energy X-rays to kill cancer cells. It is a common treatment for cervical cancer and may be used on its own or in combination with chemotherapy.

Chemotherapy:

Chemotherapy uses drugs to kill cancer cells. Like radiation therapy, it is a common treatment for cervical cancer and may be used alone or in combination with radiation.

Targeted Therapy:

Targeted therapy uses drugs that target specific proteins within cancerous cells. Some of these drugs cut off the blood supply to cancer cells, while others deliver chemotherapy directly to the cancer cells. Targeted therapy is used to treat advanced or returning cervical cancers and is often used alongside chemotherapy. It’s typically used when the cancer has spread beyond the cervix, returned after initial treatment or isn't responding well to standard treatments like surgery or radiation.

Immunotherapy:

Immunotherapy helps the immune system recognize and kill cancer cells. For cervical cancer, it is used to treat advanced or recurrent cases, typically when the cancer has spread to other areas of the body or returned after initial treatments.

Exceptional Cancer Care

If you’re diagnosed with cancer, trust southwest Michigan’s most preferred healthcare system. With locations in Battle Creek and Kalamazoo, Bronson Cancer Center offers comprehensive care, combining expert medical teams, advanced technology and supportive resources at every stage of your cancer journey. Learn more about Bronson’s regional cancer program.