Cervical cancer care

Cervical cancer occurs in the cells of the cervix, the lower part of the uterus that connects to the vagina. Often, there are few if any symptoms of early cervical cancer. The American Cancer Society encourages women to begin cervical cancer screening at age 21, which includes Pap and HPV testing.

Cervical cancer is the fourth most common cancer among women, but because it develops slowly, it is one of the easiest gynecologic and reproductive cancers to prevent, detect and treat.

Nearly all cases of cervical cancer are due to the human papillomavirus (HPV).

The most common types of cervical cancer are:

• Squamous cell carcinoma, which develops in the lining of the cervix
• Adenocarcinoma, which develops within gland cells that produce cervical mucus.

Occasionally, people may develop both squamous cell and adenocarcinomas.

HPV spreads through sexual contact and is the cause of almost all cases of cervical cancer, as well as many vaginal and vulvar cancers. It can cause cells in the cervix to change. If abnormal cells are not found and treated, they may become cancer. A Pap smear can find cervical cancer early, when it's most curable. You can help prevent HPV infection by getting an HPV vaccine and practicing safe sex.

You may be at a higher risk of developing cervical cancer if you:

• are age 40 or older
• are overweight or are not eating a balanced diet
• have a weakened immune system
• have had a sexually transmitted disease (STD) including chlamydia
• have had Diethylstilbestrol (DES) exposure before birth, a drug that was used between 1940 and 1971 to help prevent miscarriages
• have HIV infection
• have had human papillomavirus (HPV) or genital warts
• smoke or use tobacco products
• used birth control pills for a long time

Make an appointment with your primary care provider or gynecologist if you experience symptoms of more advanced cervical cancer. These may include:

• abnormal or irregular vaginal bleeding
• heavy or unusual vaginal discharge
• pain during sex or vaginal bleeding after sex
• pain or an increased urge to urinate
• vaginal bleeding after menopause

Screening tests for cervical cancer include:

• Pap test: A swab is used to collect cells from the cervix and vagina.
• Colposcopy: A colposcope is used to examine the cervix.
• Biopsy: A small sample of tissue is removed using local anesthesia.
• Punch biopsy: A sharp tool is used to collect small samples of cervical tissue.
• LEEP: A thin wire loop is used to remove a small piece of cervical tissue.
• Endocervical curettage: A small instrument is used to scrape a tissue sample from the cervix.

Additionally, some imaging tests may be used to detect cervical cancer:

• CT scan
• X-ray
• MRI
• PET scan

Treatment for cervical cancer may include one or more of the following:

• fertility options to help you maintain the ability to get pregnant
• surgical options include:
  • laparoscopic retroperitoneal lymph node dissection
  • robotic and laparoscopic hysterectomy
  • radical hysterectomy
  • specialized advanced radiation techniques
  • trachelectomy
• radiation options include:
  • external radiation therapy
  • internal radiation therapy (brachytherapy)
  • intensity-modulated radiotherapy (IMRT)
• chemotherapy