Cervical Cancer: Overview

What is cervical cancer?

Cancer starts when cells change and grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby tissues. And they can spread to other parts of the body. This is called metastasis.

Cervical cancer is cancer that starts in the cervix. The cervix is the narrow, lower end of the uterus. It connects the uterus to the vagina. Most cervical cancers start with changes in the squamous cells on the surface of the cervix. Squamous cells are the cells that make up most of the skin and other surfaces of the body. These cancers are called squamous cell carcinomas.

Who is at risk for cervical cancer?

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone's cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change.

The risk factors for cervical cancer include:

• High-risk types of HPV (human papillomavirus) infection (related to most cervical cancers)

• Sex at a young age

• Multiple sexual partners

• Smoking

• A weak immune system caused by infection with HIV, or a disease or medicine that weakens the immune system

• Long-term use of birth control pills

• Three or more full-term pregnancies

• First full-term pregnancy before age 20

• No regular cervical cancer screening tests with Pap & HPV tests

• Personal or family history of cervical cancer

• History of sexually transmitted infections, such as past chlamydia infection

• Your mother took the medicine DES (diethylstilbestrol) while pregnant with you

Talk with your healthcare provider about your risk factors for cervical cancer and what you can do about them.

Can cervical cancer be prevented?

Cervical cancer most often starts with precancer cell changes. You can take steps to help prevent these changes that lead to cervical cancer. To help lower your risk:

• Don't get infected with HPV.

• Get the HPV vaccine.

• Don't smoke.

• Use condoms every time you have sex, from start to finish, to provide some protection.

• Limit your number of sexual partners.

• Don't have sex with someone who has had many sexual partners.

• Don't have sex with people who you know have HPV infection or have genital warts or other symptoms.

Regular cervical cancer screening is a proven way to prevent this cancer.

What are the symptoms of cervical cancer?

Women with precancer cells and early cancers on their cervix rarely have symptoms. Symptoms tend to start when the cancer cells grow and invade the deeper parts of the cervix or other pelvic organs. 

Symptoms of cervical cancer can include:

• Abnormal vaginal bleeding, such as between your periods, after sex, or after menopause

• Abnormal vaginal discharge that's watery or bloody

• Periods with heavier bleeding or that last longer than normal

• Pain during vaginal sex

• Pain in the pelvis or low back

Many of these are more often caused by other health problems. But it's important to see your healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

How is cervical cancer diagnosed?

Cervical cancer is often found when doing a routine Pap test. You'll be asked about your health history, symptoms, risk factors, and family history of disease. A physical exam and a pelvic exam will be done.

You may also have one or more of these tests:

• Pap and HPV tests

• Colposcopy (a lighted tool is used to look closely at the surface of your cervix)

• Biopsy

A biopsy is the only way to know if cell changes are cancer. During a biopsy, small pieces of tissue are taken from the cervix and then tested for precancer and cancer cells. Your healthcare provider will tell you what to expect during and after the biopsy.

After a diagnosis of cervical cancer, you'll likely need more tests. These help your healthcare providers learn more about the cancer. They can help find the stage of the cancer. The stage is how much cancer there is and how far it has spread (metastasized) in your body. It's one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.

How is cervical cancer treated?

Your treatment choices depend on the type of cervical cancer you have, test results, and the stage of the cancer. You also may need to think about if you want to be able to have children in the future. The goal of treatment may be to cure you, control the cancer, or help ease problems caused by cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy and targeted therapy are systemic treatments. You may have just one treatment or a combination of treatments.

Cervical cancer may be treated with:

• Surgery

• Radiation therapy

• Chemotherapy (chemo)

• Targeted therapy

• Immunotherapy

Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Some treatments may make you unable to have children in the future. Talk about your concerns with your healthcare provider before making a decision.

What are treatment side effects?

Cancer treatment such as chemo and radiation can damage normal cells. This can cause side effects like hair loss, mouth sores, and vomiting.

Talk with your healthcare provider about side effects linked to your treatment and ways to manage them. There may be things you can do and medicines you can take to help prevent or control side effects.

Coping with cervical cancer

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be tough on your mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effect of cancer and its symptoms on your daily life.

Here are tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group in person or online.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with a focus on high-protein foods.

• Drink plenty of water, fruit juices, and other liquids.

• Be physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

When should I call my healthcare provider?

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse

• Signs of an infection, such as a fever or chills

• Side effects of treatment that affect your daily activity or don't get better with treatment

Ask your healthcare provider what signs to watch for and when to call. Know how to get help after office hours and on weekends and holidays.

Key points about cervical cancer

• Cervical cancer is cancer that starts in the cervix. The cervix is the lower end of the uterus. It connects the uterus to the vagina.

• Symptoms include abnormal vaginal bleeding and discharge, pain during sex, and pain in the pelvis or low back.

• Regular cervical cancer screening is a proven way to prevent this cancer.

• You can also help prevent cervical cancer by not getting infected with HPV (human papillomavirus), getting the HPV vaccine, not smoking, using condoms each time you have sex, and limiting your number of sex partners.

• Treatments include surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your healthcare provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.