Cervical cancer is a common cancer that can at first affect the cervix, the area attached to and lying just below the uterus, and then can spread to the uterus, the vaginal wall, and metastasize to other parts of the body. In recent years, the medical community has made huge leaps forward in being able to recognize the predominant risk factor for cervical cancer, which is contraction of several forms of human papillomavirus (HPV). In most cases of this condition, women also test positive for an earlier infection of HPV, which is often without symptoms. Not all cases of cervical cancer are caused by HPV and there are people who get HPV and don’t get this cancer. However, the risk factor increases significantly for those who have had HPV, and there is now a vaccination for these forms of HPV that may greatly decrease risk.
In the US alone, about 11,000 women yearly receive a diagnosis of cancer of the cervix, and of these cases, as many as 4,000 of these women may die. With yearly visits to gynecologists and yearly pap smears, it can be very easy to diagnose early stage cancer when it is most treatable. Since scientists have discovered the HPV connection, women at risk may also be asked to take an HPV blood test at a lab to rule out this risk factor for the condition. It’s important to note that even if you don’t test positive for HPV, you can still develop cervical cancer. Other risk factors like becoming sexually active at a young age, having multiple partners, having unsafe sex, and smoking can increase risk for the condition.
Early stage cancer of the cervix, where a few abnormal cells are present, often has few symptoms. As the cancer progresses and these few cells turn into squamous cell lesions, then tumors, and begin affecting the uterus, pelvis, and metastasizing, other symptoms begin to emerge. Vaginal bleeding in between periods, or after you’ve gone through menopause may occur. It may be painful to have intercourse, and the intercourse may cause yet more bleeding. Women may also note slightly watery discharge tinged with blood that may smell bad. Noting any of these symptoms means you should see a gynecologist right away, even if your pap smears have been normal in the past.
Once this cancer has been detected, additional tests help to confirm diagnosis and determine the stage of the cancer. These tests include a physical exam, biopsies of any areas that appear cancerous, and a procedure called conization or cone biopsy, which removes a conical piece of tissue from the cervix. You may also expect to undergo more blood tests, x-rays, and various body scans to look for areas of cancer outside the cervix.
Treatment of the condition depends much on the stage of the cancer. When the cancer is in early stages, conization, laser surgery or cryosurgery (freezing the cells) can remove abnormal cells from the outside of the cervix. Once the cancer has moved more deeply into the cervix or is affecting the uterus, a hysterectomy is almost always called for, and if the cancer has metastasized, women may also need to undergo radiation and/or chemotherapy to kill cancerous cells. The best treatment options are available for those who have this condition diagnosed early, which is why it cannot be emphasized enough that regular gynecological exams and pap smears are important.
For many women who have cervical cancer, having a child in the future may be difficult or impossible. When the condition is caught in early stages, removal of abnormal cells or conization, and even removal of most of the cervix doesn’t mean you can’t get pregnant. Yet since the cervix is essentially the holding point for a growing fetus, pregnancies are much more likely to miscarry. Obviously more significant treatment, like hysterectomy, means pregnancy is not possible.
The HPV vaccination may be the best chance of preventing cervical cancer, although it is certainly not a license to have unprotected sex, and it is not a 100% guarantee that cancer won’t occur. Some parents believe the vaccination will give kids license to engage in sex early or send a mixed message to their children, and are wary of having their daughters vaccinated. It should be noted that HPV may be contracted by skin-to-skin contact and does not necessarily have to be contracted through standard sexual intercourse. Girls and boys should be counseled to abstain from sex and wait, since multiple sex partners and early sexual intercourse increases risk of HPV infection for both. Those who are sexually active should always use condoms, which may decrease HPV infection risk, in addition to protecting both men and women from other sexually transmitted diseases.