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Cervical Cancer

Cervical cancer is the second most common gynecologic cancer and is the fifth most common cancer in women, behind breast, lung, colon and endometrial cancer in the United States. The development of the Pap smear test, in the early 1900's, serves as a shining example of the ability of a screening test to decrease the overall cases of cancer (see Pap smear). As a result, during the 20th century, cases of cervical cancer were greatly reduced in the United States; unfortunately, this is not the case worldwide. Access to screening and health care, in general, are factors which greatly affect the development of this, largely preventable, disease. Lifestyle choices also play and important part in a woman's risk for cervical cancer. The more sexual partners a woman has (and the number of partners they have), sexual intercourse at any early age (<18 years old), smoking, and past history of a sexually transmitted disease all increase a woman's risk for developing cervical cancer. This is thought to be related to exposure to the sexually transmitted virus, HPV, or human papilloma virus. There are many HPV viruses, some just cause venereal warts (condyloma), others are thought to be potentially cancer causing. On a woman's Pap smear, it is possible to pick up changes in the cells caused by HPV, but it is impossible to tell which of they many types of HPV it is. Once HPV is in the cervical cells, it cannot be removed. Therefore, prevention and early detection become critical in controlling the development of cervical cancer.

Diagnosis

Many women do not have symptoms in the early stages of cervical cancer. One of the first symptoms may be abnormal vaginal bleeding or bleeding after intercourse. As the cancer grows, it can produce more symptoms ranging from leg swelling, pelvic pain, difficulty with bowel movements and urination, and a foul smelling vaginal discharge. The Pap smear or Pap test is designed to find abnormal cells in the cervix before the woman has any symptoms. Cervical cancer cannot be diagnosed by Pap smear and if the Pap test comes back abnormal, a biopsy, or removal of a small piece of tissue from the cervix, is necessary to figure out why the Pap test was abnormal. Most women with abnormal pap smears do not have cervical cancer, but they may have a precancerous condition, which if left untreated, could turn in to cervical cancer.

Once the diagnosis of cervical cancer has been made, it is important to figure out how large the cancer is and whether it has spread to other organs. This process is called staging and usually involves a pelvic exam, x-ray tests (chest x-ray, CT scan/IVP test), and in some cases, an exam under anesthesia is necessary to evaluate the size of the tumor and look in the bowel or bladder for spread of disease. Results of these tests help the physician recommend the right treatment.

Treatment

Cervical Cancer Follow-up Care & Concerns