What Are the Symptoms of Cervical Cancer?
Some women do not have any symptoms of a precancer. In many women with early-stage cervical cancer, symptoms do typically appear. In women with advanced and metastatic cancers, the symptoms may be more severe depending on the tissues and organs to which the disease has spread. The cause of a symptom may be a different medical condition that is not cancer, which is why women need to seek medical care if they have a new symptom that does not go away.
Cervical cancer is cancer that begins in the uterine cervix,
the lower end of the uterus that contacts the upper vagina. Since 1980, the incidence of cervical cancer has fallen by 45%, and the
mortality (death) rate for cervical cancer has declined by 49%. Survival rates
among African-American women are lower than for any other racial or ethnic
group in the U.S. Cervical cancer remains a common cause of cancer and cancer
death in women in developing countries without access to screening for cervical cancer or vaccines against human papillomaviruses.
How does cervical cancer develop?
Nearly all squamous cervical cancers are caused by a common sexually transmitted infection called human papillomavirus. This is why the UK government is vaccinating children at an early age before they are potentially exposed to the HPV viru.
Around 80% of women will come into contact with HPV at some stage during their life, but this usually clears up on its own without the need for any treatment.
HPV is a group of viruses, of which there are more than 100 different types. It is spread through skin to skin sexual contact (so does not require penetrative sex to be transmitted).
If the body is unable to clear the virus, there is a risk of abnormal cells developing, which could become cancerous over time.
Cervical cancer does not typically cause noticeable symptoms in the early stages of the disease. Routine Pap screening is important to check for abnormal cells in the cervix, so they can be monitored and treated as early as possible. Most women are advised to get a Pap test starting at age 21.
Cervical cancer is different from cancer that begins in
other regions of the uterus (uterine or endometrial cancer). If detected early,
cervical cancer has a very high cure rate. Vaccination against HPVs, which are
known to cause cervical cancer, is an effective preventive measure.
The cervix has 2 different parts and is covered with two
different types of cells. The part of the cervix closest to the body of the
uterus is called the endocervix and is covered with glandular cells. The part
next to the vagina is the exo cervix and is covered in squamous cells. These two
cell types meet at a place called the transformation zone. The exact location
of the transformation zone changes as you get older and if you give birth.
Cervical
cancer does not typically cause noticeable symptoms in the early stages of the
disease. Routine Pap screening is important to check for abnormal cells in the
cervix, so they can be monitored and treated as early as possible. Most women
are advised to get a Pap test starting at age 21. The Pap test is one of the
most reliable and effective cancer screening methods available, and women
should have yearly exams by an OB-GYN. However, the Pap test may not detect
some cases of abnormal cells in the cervix. The HPV test screens women for the
high-risk HPV strains that may lead to cervical tumors. It is approved for
women over age 30.
Although screening methods are not 100% accurate, these
tests are often an effective method for detecting cervical cancer in the early
stages when it is still highly treatable. Talk with your doctor about which
type of cervical cancer screening is right for you.
Causes of cervical
Cancer is the result of the uncontrolled division and growth
of abnormal cells. Most of the cells in our body have a set lifespan, and, when
they die, the body generates new cells to replace them.
Abnormal cells can have two problems:
they do not die
they continue dividing
This results in an excessive buildup of cells, which
eventually forms a lump, or tumor. Scientists are not completely sure why cells
become cancerous.
Some risk factors might increase the risk of
developing cervical cancer. These include:
Smoking: This increases the risk of cervical cancer, as well as other types.
HPV: This is a sexually transmitted virus. More than 100
different types of HPV can occur, at least 13 of which may cause cervical
cancer.
Having many sexual partners or becoming sexually active
early: The transmission of cancer-causing HPV types nearly always occur as a
result of sexual contact with an individual who has HPV. Women who have had
many sexual partners generally have a higher risk of HPV infection. This
increases their risk of developing cervical cancer.
A weakened immune system: The risk of cervical cancer is
higher in those with HIV or AIDS, and people who have undergone a transplant,
leading to the use of immunosuppressive medications.
Other sexually transmitted diseases (STD): Chlamydia,
gonorrhea, and syphilis increase the risk of developing cervical cancer.
Early warning signs of cervical cancer
In the early stages, cervical cancers cause no pain or other symptoms. That's why it's vital for women to get regular pelvic exams and Pap tests to detect cancer in its earliest stage when it's treatable.The first identifiable symptoms of cervical cancer are likely to include:
Abnormal vaginal bleeding, such as after intercourse, between menstrual periods, or after menopause; menstrual periods may be heavier and last longer than normal.
Vaginal discharge and odor.
Pelvic pain.
Pain during intercourse.
If cervical cancer has spread to nearby tissues, symptoms may include:
periods may be heavier and last longer than normal.
Vaginal discharge and odor.
Pain during intercourse.
Pelvic pain.
When present, common symptoms of a tumor that develops in the cervix may include vaginal bleeding, including bleeding between periods, after sexual intercourse or post-menopausal bleeding; unusual vaginal discharge, which may be watery, pink or foul-smelling; and pelvic pain.
All of these cervical cancer symptoms should be discussed with your specialist doctor.
Types of cervical cancer
Cervical cancers and cervical pre-cancers are classified by how it look under a microscope. The main types of cervical cancers are adenocarcinoma and squamous cell carcinoma.
Most cervical cancers are squamous cell carcinomas. These cancers develop from cells in the exocervix and the cancer cells have features of squamous cells under the microscope. Squamous cell carcinomas most often begin in the transformation zone.
Most of the other cervical cancers are adenocarcinomas. Adenocarcinomas are cancers that develop from gland cells. Cervical adenocarcinoma develops from the mucus-producing gland cells of the endocervix. Cervical adenocarcinomas seem to have become more common in the past 20 to 30 years.
Is cervical cancer inherited?
There is no known genetic cause of cervical cancer. However,
it may run in some families. Women with a mother or sister who had the disease
have a higher risk of developing it themselves. It is currently not understood
if this familial tendency is caused by an inherited condition that makes some
women more vulnerable to HPV infection than others. Alternatively, the
increased incidence in some families may be related to the likelihood that
family members may share one or more of the other non-genetic risk factors
described previously.
Less commonly, cervical cancers have features of both squamous cell carcinomas and adenocarcinomas. These are called adenosquamous carcinomas or mixed carcinomas.
Although almost all cervical cancers are either squamous cell carcinomas or adenocarcinomas, other types of cancer also can develop in the cervix. These other types, such as melanoma, sarcoma, and lymphoma, occur more commonly in other parts of the body.
Only the more common cervical cancer types are covered here, and not the rare types.
What are the risk factors for cervical cancer?
As described previously, cervical cancers are caused by infection with one of the high-risk HPV types. However, since not all people who are infected with HPV will develop cancer, it is likely that other factors also play a role in the development of cervical cancer.
When to seek specialist doctor
You should contact your GP if you experience:
bleeding outside of your normal periods
new bleeding after the menopause
bleeding after sex
Vaginal bleeding is very common and can have a wide range of causes, so it does not necessarily mean you have cervical cancer. However, unusual vaginal bleeding needs to be investigated by your GP.
How is cervical cancer diagnosed?
If you have an abnormal Pap test or positive HPV test
result, your doctor may suggest more tests or treatment. This testing
can be another Pap test, an HPV test, or a colposcopy, a procedure that helps
your doctor look more closely at your cervix to see if there are precancerous
cells.
During a colposcopy,
they might also do a biopsy, a procedure to remove a small piece of
tissue from your cervix. The tissue is sent to a lab and examined for signs of
cervical cancer.
Vaccine to prevent cervical cancer?
Cervical cancer often can be prevented with vaccination
and modern screening techniques that detect precancerous changes in the cervix.
The incidence of cervical cancers in the developed world declined significantly
after the introduction of Pap screening to detect precancerous changes, which
can be treated before they progress to become cancer.
Moreover, vaccines are available against the common types of
HPV that cause cervical cancer. Gardasil and Gardasil 9 are HPV vaccines.
Original studies with Gardasil showed it to be very effective in preventing
infection by four common HPV types (6, 11, 16, and 18) in young people who were
not previously infected with HPV. Gardasil 9, a newer version of the vaccine,
was approved in December 2014 and provides immunity to nine HPV types (6, 11,
16, 18, 31, 33, 45, 52, and 58).
Vaccination should occur before sexual activity to offer the
full benefit of the vaccine.
Summary
Cervical cancer is a cancer arising from the cervix. It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body. Early on, typically no symptoms are seen. Later symptoms may include abnormal vaginal bleeding, pelvic pain or pain during sexual intercourse.
