Cervical cancer can be cured if it is diagnosed and treated early. Different treatment options depend on the stage of the cancer and whether or not you want to have children.
Doctors may use chemotherapy or radiation to kill cancer cells and prevent them from growing. Radiation can be delivered from outside your body (external beam) or inside your body (brachytherapy). Your doctor will talk to you about the benefits and side effects of these treatments.
Surgical removal of the uterus (hysterectomy) is the primary treatment for stage 1 cervical cancer. The doctor may remove only the cervix or the entire uterus and fallopian tubes. A hysterectomy is often performed in conjunction with chemotherapy and radiation to improve the chances for a cure.
A hysterectomy can be performed through an incision in the belly or vagina. Some women with early-stage cervical cancer have a minimally invasive surgery, called a laparoscopic hysterectomy. With this procedure, the doctor inserts a lighted tube (laparoscope) through small cuts in your abdomen or vagina. This allows the doctor to see your organs and remove them with special tools without making a large cut.
For most patients, a hysterectomy causes side effects that improve as the healing process continues. Your doctor will discuss your expected recovery time, including when you can start working and driving again, and what physical activities are safe. The doctor will also talk to you about long-term bladder problems, such as not feeling the need to urinate or having trouble emptying the bladder completely.
Some pre-cancerous changes in the cervix can be treated with hormone therapy and/or a “D & C” (dilation and curettage) to clean out overgrown tissue, but if these do not work or the cancer spreads, a hysterectomy is required. Having a hysterectomy can cause emotional distress because it means the loss of the uterus and the end of childbearing. Some women find comfort in talking with a mental health therapist about these feelings. Other women find that living without a uterus can bring new freedom and peace. Women who want to maintain their sexuality can use alternative methods, such as a penis or a prosthetic ring.
Radiation therapy uses high energy x-rays to kill cancer cells. It can be given alone or alongside chemotherapy. It can be delivered from outside the body (external beam radiation therapy) or from inside the body (brachytherapy). The most common type of radiation treatment for cervical cancer is intensity-modulated radiosurgery or stereotactic body radiation surgery, but other types may be used as well.
Radiation works by causing small breaks in the DNA of cancer cells, which stops them from growing and dividing as they should. It can also cause damage to nearby normal tissue, but it is unlikely that this will lead to any long-term problems. Radiation can be followed up by chemotherapy or targeted therapy to help keep cancer from coming back.
The chemotherapy drugs most often used with radiation to treat recurrent cervical cancer include cisplatin, carboplatin, ifosfamide, irinotecan, gemcitabine, paclitaxel, topotecan, and vinorelbine. These are given by mouth or vein and may be taken alone or with a biologic agent, such as bevacizumab.
For advanced cervical cancer, such as stage IB or IVA, doctors may recommend surgery to remove the cervix along with radiation. They may also recommend a procedure called endocervical curettage or loop electrosurgical excision procedure (LEEP), which involves using a spoon-shaped tool to collect cells or tissues from the area around the tumor.
Other options for advanced cervical cancer include taking part in a clinical trial of new treatments. For example, some patients with adenosquamous cervical cancer or squamous cell adenocarcinoma can benefit from immunotherapy medicines that help the immune system fight cancer. These medications are usually a combination of cisplatin or carboplatin with paclitaxel and bevacizumab or pembrolizumab, if the cancer has the biomarker PD-L1. Learn more in Immunotherapy for Cervical Cancer.
Cervical cancer is a disease in which malignant (cancer) cells form in the cervix, the lower end of the uterus (the hollow, pear-shaped organ where a baby grows). Usually cervical cancer is caused by human papillomavirus (HPV), and most cases of cervical cancer are preventable with routine screening and treatment of precancerous lesions.
There are several treatments for cervical cancer, depending on the type of cervical cancer and how far it has spread (the stage). Chemotherapy is a drug that kills cancer cells or stops them from growing. It may be given alone or in combination with other drugs, radiation therapy, or surgery.
When a person is first diagnosed with cervical cancer, she may have many feelings. She may feel frustrated, helpless, angry, depressed, anxious, or guilty. Sometimes, a woman feels like she should not have had cervical cancer because of lifestyle choices or sexual behavior. She may blame herself for having HPV, even though almost everyone gets HPV at some time in their lives and most of the time, it does not lead to cervical cancer.
If a patient is diagnosed with stage I or II cervical cancer, removing the cervix is not necessary because most of these cancers are treated with chemotherapy and radiation. When a cervical cancer is in later stages, the doctor may decide to remove the cervix.
When a person is being treated with chemotherapy, it is important to ask for help managing side effects, such as fatigue and nausea. It is also a good idea to make arrangements at work. Because chemotherapy can cause you to have a low appetite, eating healthy foods is important. It is also helpful to talk with a counselor or go to a support group.
The cervix is the lower end of the uterus (the pear-shaped organ that holds a fetus during pregnancy). Cancer in the cervix occurs when healthy cells develop changes in their DNA that cause the cells to grow faster than normal. These changes can also prevent the cells from dying as they should. The pre-cancerous or cancerous cells can then grow out of control and form a tumor.
Pap tests detect these abnormal cells before they can become full-blown cervical cancer. Doctors use these results to aEURoestageaEUR the cancer according to how big it is and whether it has spread.
For early stage cervical cancer, doctors may remove the cervix and nearby lymph nodes (lymphadenectomy). This surgery reduces the risk of the cancer coming back. If the cancer is larger or in an advanced stage, doctors might combine surgery with chemoradiation.
If the cervix cancer is in an advanced stage, your doctor might also remove the lymph nodes in the pelvis (lymphadenectomy). This helps to decrease the chance of the cancer returning after surgery.
Other types of surgery might include LEEP conization (a minimally invasive procedure), cold knife conization, cryosurgery, or cauterization (burning, also called diathermy). These surgeries destroy the tissue without damaging any surrounding healthy tissue.
If you have an early cervix cancer and want to be able to have children, your doctor might suggest an operation called a radical trachelectomy. This removes most of the cervix but leaves enough to allow you to have children. It is important to talk with your doctor about your wishes and goals for your treatment.
Most cases of cervical cancer are caused by infection with certain types of the human papillomavirus (HPV). The HPV vaccine can prevent HPV-related diseases.
Symptoms of cervical cancer can include abnormal vaginal discharge, pain and bleeding after sex or during menopause. Your doctor can diagnose cervical cancer with a Pap smear.
The lining of the cervix (the lower part of the uterus or womb that opens into the vagina – also called the birth canal) normally produces a clear mucus. This may change to a yellowish or brownish discharge with a foul-smelling odor, especially if it is persistent. This can be a sign of cervical cancer. It can also be caused by an infection, but a quick diagnosis is important to get the right treatment.
Most women who have cervical cancer do not have any symptoms at all, especially in the early stages. This is why it is so important to get regular screening, called a pap test or smear. It can find changes in the cells of the cervix before they become cancerous and can help to prevent cervical cancer by catching it at an early stage.
In most cases, cervical cancer is caused by a virus called human papillomavirus (HPV) that spreads through sexual activity. Most people have HPV at some time in their lives, but most bodies can fight off the virus and it goes away on its own. But sometimes the HPV becomes persistent and leads to cancer.
If you have abnormal bleeding after sex, between periods or after the menopause, pain with sex and unusual vaginal discharge, make an appointment with your GP to have it checked out. It does not mean you have cervical cancer but it is best to check, just in case.
Occasionally, the tissue surrounding a tumour can develop an infection or inflammation that produces a thick, foul-smelling discharge. This is because cancerous and pre-cancerous cells can not receive enough oxygen and therefore die. In other cases, the cervix can ulcerate and create a painful, inflamed area that oozes pus or blood.
Rarely, cervical cancer can also cause a dull backache or pelvic pain that may be made worse by eating or when you urinate or have sex. This is because the cervical tumor can put pressure on nearby tissues and organs. The cancer can also make it hard to urinate because it may block the kidneys.
There are many causes of painful vaginal bleeding, including some that don’t involve cervical cancer. But it’s important to get any unusual bleeding checked out, especially if you are overdue for your Pap smear test (or have been recalled by your GP after a previous smear).
Almost all cervical cancers are caused by human papillomavirus (HPV), which is spread through skin-to-skin contact and sexual activity. Most HPV infections don’t cause any problems, but some types of HPV can lead to precancer or cervical cancer.
When a tumour grows on the cervix it can interfere with the flow of blood, causing pain and sometimes bleeding. The tumour may also grow into the surrounding tissues or other organs, which can cause a range of symptoms.
Most people who have cervical cancer develop squamous cell carcinoma, which starts in the cells that line the cervix. But a smaller number of people get a less common type of cancer, called glandular cell carcinoma, which starts in the glandular cells on the cervix. Some of these types of cancer can also grow into other parts of the body, for example, the lungs and liver.
Tumours in the early stages of cervical cancer are often small and don’t cause any symptoms. If they do cause any symptoms, they usually include persistent pelvic pain or discomfort during sex (dyspareunia), or vaginal bleeding after sex or between periods (called non-menstrual bleeding).
Other signs of cervical cancer include changes in the colour or smell of your vaginal discharge, which can become watery and red or brown in some cases. The odour may be unpleasant or strong, and some women report a feeling of pressure or heaviness in their abdomen. If the cancer has advanced to later stages, it can cause pain in the low back or pelvis and in the groin area during sexual intercourse.
If a doctor suspects that you have cervical cancer, they’ll carry out a smear test and a colposcopy. During a smear test, doctors collect a sample of cells from the surface of your cervix for laboratory analysis. A GP can do this, but you’ll usually be seen by a specialist gynaecologist or nurse. The doctor will use a speculum to insert into your vagina, and they’ll use a device like binoculars, called a colposcope, to view the cervix more closely. They’ll then take a biopsy of a suspicious looking area to check for cancerous cells.
A Pap test is a way of looking at the cells that line your cervix. It looks for abnormal changes in these cells that may turn into cervical cancer. It can also check for the human papillomavirus (HPV), which is a common virus that’s passed through sexual contact. Long-lasting infections with HPV, especially high-risk types, cause most cases of cervical cancer.
A normal Pap test usually shows that the cells are healthy and there is nothing to worry about. However, sometimes the Pap test will show abnormal results. This doesn’t mean that you have cervical cancer, but it does mean that the Pap test was abnormal and it’s important to have a follow-up appointment with your doctor.
Depending on the outcome of your Pap test, your doctor will let you know if you need to start having regular Pap tests, or if it’s time for you to stop having them. If the Pap test shows that you have precancerous cells, your doctor can take steps to prevent cervical cancer.
When cervical cancer is found and treated early, it’s much more likely to be cured. Regular screening is the best protection against cervical cancer. A Pap test is a simple, painless procedure that can save lives.
If you’re a woman age 25 to 64, you should get a Pap test every 3 years and a HPV test with each visit. If you’re in a high-risk group, your doctor might ask you to have a Pap test more often or to switch to a combined Pap test and hrHPV test.
Most people with cervical cancer don’t have any symptoms in the early stages. And when symptoms do appear, they’re easy to mistake for other conditions, like menstrual periods or a bladder infection. However, as cervical cancer progresses, the symptoms can become more pronounced. For example, advanced cervical cancer that spreads to your pelvic organs can cause pain in the lower back and in your abdomen. And it can make it hard to urinate, because the tumor can block your kidneys. Your symptoms can also include abdominal swelling, which is caused by fluid buildup in the body.
All vaginas have a natural scent that can vary from woman to woman, but if you notice a sharp change in the way your vulva smells, it could be a warning sign. An unpleasant odor can signal an infection, and in some cases, it may be a symptom of cervical cancer.
A Pap smear tests for abnormal cells that might indicate cervical cancer, but other signs and symptoms can include changes in your vulva odor. The scent of your vulva can be affected by your menstrual cycle, pregnancy and even exercise, since the glands that produce it are located near sweat glands. But if you notice an unusual odor, talk to your doctor, especially if it’s accompanied by other symptoms like pain or bleeding between periods.
Cervical cancer typically begins in the squamous cells that line the cervix, the narrow opening of the uterus that connects to the vagina. But it can also begin in the glandular cells, which are found higher up on the cervix. When a cancerous change occurs in these glandular cells, it can be difficult to detect.
In some rare types of cervical cancer, both squamous and glandular cells can become abnormal, which is known as adenosquamous carcinoma or mixed carcinoma. This type of cancer is harder to diagnose than squamous or glandular cancer alone, but it still affects the cervix and can cause the same symptoms.
When the cancer moves into the later stages, it can affect other parts of your body, such as your bladder or rectum. This can cause pain when you pee or it might feel cloudy, and the odor might be stronger. It can also increase your risk of developing blood clots, because the cancer might slow your body’s normal circulation.
You might also notice a stronger odor in your urine if you have a urinary tract infection, or UTI. This is because the fungi that cause a UTI thrive in the moist environment of your vulva. If you notice a strong odor in your urine, along with other symptoms like blood when you pee or burning sensations when you urinate, speak to your doctor.
Cervical cancer treatment depends on the stage of the disease, which is determined by medical imaging and lab tests. It can include surgery, radiation, or chemotherapy.
Surgery for early-stage cervical cancer confined to the cervix can range from simple trachelectomy (removal of a cone-shaped portion of the cervix) to hysterectomy.
The cancer cells that make up a cervical tumor grow very slowly. Pap tests often detect precancerous tissue that can be cured with an office procedure. Most cervical cancer develops over several years and starts at the squamocolumnar junction, where outer squamous cells meet inner glandular cells. This area can have precancerous changes (called dysplasia) or invasive cancer, which are the precursors to adenocarcinoma of the cervix. Dysplastic changes can be removed or destroyed with LEEP (loop electrosurgical excision of the cervix) or laser treatment, before they develop into a more advanced cancer. If the invasive cervical cancer has spread to nearby blood or lymph vessels, your doctor may recommend a surgical removal of the affected areas called a cone biopsy.
Your cancer care team may suggest you receive chemotherapy before surgery or radiation therapy to reduce the risk of the cancer coming back after treatment. Chemotherapy is used in the second or third trimester of pregnancy and is usually not harmful to the fetus, but it can cause early labor and low birth weight. Radiation therapy is not recommended during pregnancy because it can harm the fetus.
If you have stage I cervical cancer and are less than 3 months pregnant, your doctor can give you chemotherapy with cisplatin or carboplatin and paclitaxel. They may also suggest you deliver by cesarean section and have a hysterectomy. If you are diagnosed with slow-growing cervical cancer and are more than 3 months pregnant, your care team can discuss options that are safe for both the fetus and you, such as cold knife conization or radical trachelectomy.
After treatment is completed, follow-up tests or checkups can help find out if the cancer has returned. Tests can include a Pap smear, pelvic exam, chest x-ray, or CT scan.
Some people with cervical cancer take part in a clinical trial to try an experimental treatment. This type of research helps doctors find better ways to treat cancer and improve the quality of life for people with serious illness. Learn more about participating in a clinical trial.
Over time, normal cells in the cervix can change and develop into cancer. These abnormal cells are found by health care providers during regular screenings with a Pap test or HPV test. If these cells are pre-cancerous, they can be removed during an office procedure to prevent cervical cancer from developing.
If the cancer is in a later stage, it may be treated with surgery, radiation, chemotherapy, or a combination of these treatments. Depending on the type of cancer, your doctor will also consider whether you are pregnant or want to become pregnant in the future. The experts at Memorial Sloan Kettering will help you weigh the benefits and risks of your treatment options, including how they might affect pregnancy and future fertility.
Before starting treatment, your health care provider will use a biopsy and other tests to find out the extent of your cervical cancer, which is called the stage. The stage of your cancer determines your treatment options and how you will be monitored after treatment.
Your doctor might recommend a cone biopsy to take deeper layers of tissue for testing. This is done with a special tool in your hospital or doctor’s office. You will be given medicine to put you into a sleep-like state so you won’t feel any discomfort during the procedure. You may have an internal radiation therapy implant (brachytherapy) as well.
Radiation treatment involves using high energy X-rays to kill cancer cells. Your doctor might give you external radiation therapy along with chemotherapy (chemoradiation), or just radiotherapy, or a combination of these treatments.
Another way to treat cervical cancer is with a type of radiation called intensity-modulated radiation therapy (IMRT). This uses a computer to create pictures of your tumor and aims thin beams of radiation of different intensities directly at it from many angles. This helps limit the amount of healthy tissue that is exposed to radiation.
Radiation can also be used to control symptoms, such as bleeding after a miscarriage or pelvic pain. It can also be used to treat metastatic cervical cancer, which has spread to other parts of the body from the cervix.
For cervical cancer that hasn’t spread beyond the cervix (stage 1), surgery is often enough. But it’s important to talk to your doctor about whether you need both surgery and chemotherapy as well.
If you have abnormal cells that are picked up through screening tests, your healthcare provider will perform a colposcopy to examine the lining of your cervix. This looks for abnormal cells that may be cancer. If they are, your doctor will take a sample of those cells to send to a lab for testing. This can be done with a punch biopsy, in which your doctor cuts out a small piece of the cervix lining. Or it can be done with endocervical curettage, in which your provider scrapes the cervix lining with a spoon-shaped tool called a curette.
Your doctor may also recommend a loop electrosurgical excision procedure, in which your provider uses a thin wire loop through which an electrical current passes to remove tissue from the cervix. This is a quick, painless test that’s usually done in the office. It’s sometimes used to remove precancer or early-stage cervical cancers and can be done with local anesthesia. You can also have a cone biopsy, which removes a cone-shaped piece of the cervix with surrounding healthy tissue, to help diagnose and treat cervical cancer.
In some cases, your healthcare provider will suggest surgery to remove the uterus and cervix (hysterectomy). This is often the case for women with stage 4 cervical cancer or those who aren’t planning to have more children.
After surgery, your doctor will use radiation to kill any remaining cancer cells and reduce the chance of the cancer coming back (adjuvant therapy). It can be given externally with a machine that precisely directs a radiation beam at the area. It can also be given internally with a device that contains a radioactive material and is inserted into the vagina for just a few minutes, at several sessions over a few weeks. This is called HDR brachytherapy.
Radiation can cause side effects such as changes to how your bladder and bowel work, and problems with sexual function and fertility. It can also lead to early menopause in some women. Your health care team can give you medicines to prevent or lessen these side effects.
When a test called a Pap smear detects abnormal cells on the surface of the cervix (the entrance to the uterus) that can be precancerous or cancerous, the doctor may need to take a sample of tissue from the cervix for further testing. The procedure is called a cone biopsy, and it is usually done with local anesthesia. During the procedure, a surgeon cuts a larger, cone-shaped piece of tissue from the cervix, then examines it for signs of cervical cancer.
If the results of a cone biopsy are normal, you will likely not need further treatment. However, you will need to continue getting regular screening tests, such as a Pap test and HPV test. These will help make sure that the abnormal cells do not return and grow into cancer.
A gynecologist can use a scalpel or a device called a loop electrosurgical excision procedure to remove a small amount of the cervix. The surgeon also may use a procedure called cold knife conization to remove a bigger, cone-shaped piece of the cervix. During this procedure, the surgeon uses a tool called a speculum to enter your vagina and lubricate the area where she will be working.
Cone biopsies, along with laser and large loop excision of the transformation zone (LLETZ) procedures, have been used in an attempt to preserve fertility for patients with early-stage cervical dysplasia. However, these techniques are not always successful, especially if there is a discordance between cytology and colposcopy findings or if the biopsy does not fully include the cervical transformation zone.
In addition, there is a small chance that the cone biopsy could cause the cervix to narrow. This can interfere with fertility and increase the risk of a miscarriage or a preterm birth. For these reasons, doctors should only recommend this surgery to certain women.
If your doctor does suggest a conization, ask about your options. Your doctor should explain the risks and benefits to you. You may be nervous or worried about the procedure, but you should lean on family, friends and your healthcare team for support. You will likely experience some pain after the cone biopsy, but this should be no more severe than having a period.
