Cervical Cancer

Cervical cancer is a disease in which cancer cells form in the tissues of the cervix—the organ that connects the lower end of the uterus and the vagina. Over time, cervical cancer can invade more deeply into the cervix and other nearby tissues, or can spread through lymph vessels or blood vessels to other parts of the body. This cancer is usually fairly slow growing, and it is almost always caused by an infection caused by the human papillomavirus (HPV). An estimated 12,340 cases of cervical cancer are expected to be diagnosed in the U.S. this year, and there are an estimated 4,030 deaths expected from the disease.

5 steps to protect your cervix

  1. Keep up with Pap smears. Regular Pap tests (a procedure in which cells are scraped from the cervix and examined under a microscope) can help determine abnormalities before they have a chance to spread and grow. New guidelines from the U.S. Preventive Services Task Force suggest that women over the age of 21 undergo a Pap test screening along with HPV testing every three years instead of annually. Since HPV can take more than a decade to progress, this can help cut down on the rates of false positives or unnecessary treatments.All women should start getting Pap tests at age 21. Screening is not recommended for women age 65 or older who have had three or more normal Pap tests in a row and no abnormal Pap tests results in the past 10 years. Talk to your doctor about the recommendations and what works for you. If your Pap result is normal but you receive a positive HPV test, both tests should be repeated, or you may get a genetic test that can help determine which type of HPV you have. HPV 16 and 18 are known to cause about 70% of cervical cancers. If you receive a mildly abnormal Pap test paired with a negative HPV test, follow up with either another HPV test at intervals and/or another Pap test at intervals of three years or longer.
  2. Get vaccinated early in life. The HPV virus causes almost all cervical cancers. Most adults have been infected with HPV at some point in their lives, but often these infections clear up on their own over time. An HPV vaccine (usually three shots given over a six-month period) can help protect against HPV infection and potential cervical cancer. The vaccine works best in children and young adults (beginning at age 11 or 12) so they can develop an immune response before becoming sexually active. The vaccine is recommended for preteens, teens and young women through age 26 and teens and young men through age 21. Even if you’ve received an HPV vaccine, however, you should still begin cervical cancer screenings at age 21.
  3. Don’t smoke. Smoking obviously increases the risk of things like throat and lung cancer, but it can also boost your risk of cervical cancer. Women who smoke are about twice as likely as nonsmokers to develop cervical cancer. Chemicals from the smoke may damage DNA in cells of the cervix, leading to the development of cancer. Smoking also makes it harder for your immune system to fight off HPV infections.
  4. Practice safe sex. HPV infections are often sexually transmitted, meaning it can be spread through vaginal and anal intercourse, and even oral sex. Use a condom during sex and limit your number of sexual partners to cut down on your odds of getting the disease. In addition, the sexually transmitted disease Chlamydia may also increase the risk of cervical cancer, but using a condom can also help prevent the spread of this disease.
  5. Weigh the pros and cons of certain forms of birth control. Some methods of birth control appear to increase the risk of cervical cancer while others may reduce it. Oral contraceptives (birth control pills) seem to increase the risk. In one study, the risk of cervical cancer doubled in women who took birth control pills for more than 5 years—however the risk returned to normal 10 years after they stopped taking the medication. On the other hand, a recent study found women who used an intrauterine device (IUD) had a lower risk of cervical cancer, even if they only used the device for less than a year. The protective effect continued after the IUDs were removed. IUDs do carry their own risks so talk to your doctor about the best birth-control methods for you.

Ask Your Doctor

Cervical cancer is known to progress very slowly, with almost no symptoms at its earliest stages. However, as the disease becomes more advanced, you may see such warning signs as bleeding between regular menstrual periods, after sexual intercourse or a pelvic exam, heavy or longer menstrual periods, and vaginal bleeding after menopause. There may also be increased vaginal discharge, pelvic pain and/or pain during sex.

If you have some or all of these symptoms, additional testing will help determine a more specific diagnosis. In a lab test, cells are scraped from the cervix to look for cancer cells or signs of HPV infection. With a cervical exam, a doctor will look at the cervix itself. He or she may do a biopsy, removing small amounts of tissue to be examined by a pathologist. There are a number of different biopsy methods, including LEEP (an electric wire loop slices off a thin, round piece of cervical tissue), punch biopsy (using a sharp tool to take a small sample of cervical tissue), endocervical curettage (using a small, spoon-shaped instrument or brush to scrape tissue from the cervical canal) and a cone biopsy (removing a cone-shaped sample of tissue, which includes cells beneath the cervix). Cervical cancer diagnoses range from stage 0 (carcinoma in Situ) to Stage IVB.

Treatment Options

Once a diagnosis is made, treatment may include surgery to remove the cancerous cells. Options may include a conization or cone biopsy (removing a cone-shaped piece of tissue from the cervix and cervical canal) and a partial or total hysterectomy (removing the uterus and cervix). Additional surgery options may include cryosurgery (freezing and destroying abnormal tissue), laser surgery (using a laser beam to remove tissue) and LEEP (loop electrosurgical excision procedure), where an electrical current passes through a thin wire to remove abnormal tissue. In later stages, radiation therapy and chemotherapy may also be used to kill cancer cells or keep them from growing.

At North Shore-LIJ Cancer Institute, we treat the entire person, not just the cancer. And because each diagnosis is unique, we customize a treatment plan to fit your specific needs. We’ll have questions. You’ll have questions. Together, we’ll have a dialogue that continues throughout your care so you have an active role in deciding next steps, making choices and selecting the best treatment options available

Find a cancer specialist at the North Shore-LIJ Cancer Institute.