Cancer of the cervix is named for the part of the body in which it begins. Cancer of the cervix may also be called cervical cancer.
Cancers of the cervix are also named for the type of cell in which they begin. Most cervical cancers are squamous cell carcinomas. Squamous cells are thin, flat cells that form the surface of the cervix.
Cells on the surface of the cervix sometimes appear abnormal but are not cancerous. Scientists believe that some abnormal changes in cells on the cervix are the first step in a series of slow changes that can lead to cancer years later. Some abnormal changes are precancerous and may become cancerous with time.
Squamous intraepithelial lesion (SIL) refers to abnormal changes in the cells on the surface of the cervix. These cell changes are divided into two categories:
- Low-grade SIL: Low-grade SIL refers to early changes in the size, shape and number of cells that form the surface of the cervix. Some low-grade lesions may go away on their own; however, some may grow larger or become more abnormal and form a high-grade lesion. Precancerous low-grade lesions may also be called mild dysplasia or cervical intraepithelial neoplasia. Such early changes in the cervix most often occur in women between the ages of 25 and 35 but may appear in other ages as well.
- High-grade SIL: High-grade SIL means that there are a large number of precancerous cell changes on the surface of the cervix. The cells may not become cancerous and invade deeper layers of the cervix for many months, perhaps years. High-grade lesions may be called moderate or severe dysplasia, or carcinoma in situ. Such changes in the cervix most often develop in women between the ages of 30 and 40 but may occur in other ages as well.
If abnormal cells spread deeper in the cervix or to other tissues or organs, the disease is then called cervical cancer or invasive cervical cancer. The disease most often occurs in women over the age of 40 but may occur in other ages as well.
Risk Factors
Any of the following may affect the development of cervical cancer:
- Smoking
- Previous abnormal pap smears
- Multiple sexual partners
- Male partners who have had multiple sexual partners
- History of human papilloma virus
- History of genital sores
- HIV positive status
Diagnosis
Cervical cancer is detected by a pelvic exam and Pap test. If all women had pelvic exams and Pap tests regularly, most precancerous conditions would be detected and treated before cancer develops.
- Pelvic Exam: A clinician checks the uterus, vagina, ovaries, fallopian tubes, bladder and rectum during a pelvic examination. The clinician feels these organs for any abnormality in shape or size. A speculum is used to widen the vagina for a view of the upper part of the vagina and cervix.
- Pap Test: Also known as a Pap smear, a Pap test is a simple, painless test to detect abnormal cells in and around the cervix. Fluid is taken from the cervix with a small brush. It is then sent to a lab where a doctor looks for tiny cells that may be abnormal. Not all abnormal Pap smears mean that a woman has cancer. A woman should have this test when she is not menstruating. The best time for a Pap smear is between 10 and 20 days after the first day of the last menstrual period. If the Pap test suggests something is abnormal, the clinician may repeat the Pap test and/or perform other tests to determine the problem.
Follow this link for screening guidelines recommended by the American Cancer Society.
Every woman who is or has been sexually active should get an annual Pap smear. Women who are 18 years of age or older should get a Pap test and pelvic examination. If any of the following changes occur between Pap smears, see your health-care provider: bleeding, pain or any other changes that are not normal for you or have occurred since the time of your last Pap smear.
Symptoms
Precancerous changes of the cervix usually do not cause pain. There may be no symptoms and the changes may not be detected unless a woman has a pelvic exam and Pap test.
Symptoms may not appear until abnormal cervical cells become cancerous and invade nearby tissue. When this happens, the most common symptom that may occur is abnormal bleeding. Bleeding may occur between regular menstrual periods, after sexual intercourse, douching or pelvic exam. Menstrual bleeding may last longer and be heavier than usual. Bleeding after menopause may also be a symptom of cervical cancer. Increased vaginal discharge may also be apparent.
Treatment
The following options are available for treatment of cervical cancer:
- Surgery: A local therapy to remove abnormal tissue in or near the cervix. In some cases, a woman may choose to have a hysterectomy.
- Radiation Therapy: High-energy rays are used to damage cancer cells and stop them from growing.
- Chemotherapy: Chemotherapy involves the use of drugs to kill cancer cells.
- Biological Therapy: A treatment that uses substances to improve the ability of the body's immune to fight disease.
- Clinical Trials: Some women may choose to take part in clinical trials as part of their treatment.
For a physician referral, call 1-877-THR-WELL (1-877-847-9355).
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