CERVICAL CANCER

Those who are at increased risk of developing cancer of the cervix should be especially careful to follow their doctor's advice about checkups. Women should have regular checkups, including a pelvic exam and a Pap test, if they are or have been sexually active or if they are age 18 or older.

What is cevical cancer?

There are two main types of cancer of the cervix. About 80% to 90% are squamous cell carcinomas. The other 10%-20% are adenocarcinomas. If the cancer has features of both types it is called mixed carcinoma. If you have cervical cancer, ask your doctor to explain exactly what type of cancer you have.

Cells on the surface of the cervix sometimes appear abnormal but 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. That is, some abnormal changes are precancerous; they may become cancerous with time.

If abnormal cells spread deeper into the cervix or to other tissues or organs, the disease is then called cervical cancer, or invasive cervical cancer. It occurs most often in women over the age of 40.

If all women had pelvic exams and Pap tests regularly, most precancerous conditions would be detected and treated before cancer develops. That way, most invasive cancers could be prevented. Any invasive cancer that does occur would likely be found at an early, curable stage.

What are the Symptoms of Cervical Cancer?

Precancerous changes of the cervix usually do not cause pain. In fact, they generally do not cause any symptoms and are not detected unless a woman has a pelvic exam and a Pap test.

Symptoms usually do not appear until abnormal cervical cells become cancerous and invade nearby tissue. When this happens, the most common symptom is abnormal bleeding.

How is Cervical Cancer Diagnosed?

The pelvic exam and Pap test allow the doctor to detect abnormal changes in the cervix. If these exams show that an infection is present, the doctor treats the infection and then repeats the Pap test at a later time. If the exam or Pap test suggests something other than an infection, the doctor may repeat the Pap test and do other tests to find out what the problem is.

How are Precancerous Conditions Treated?

Treatment for a precancerous lesion of the cervix depends on a number of factors. These factors include whether the lesion is low or high grade, whether the woman wants to have children in the future, the woman's age and general health, and the preference of the woman and her doctor. A woman with a low-grade lesion may not need further treatment, especially if the abnormal area was completely removed during biopsy, but she should have a Pap test and pelvic exam regularly. When a precancerous lesion requires treatment, the doctor may use cryosurgery (freezing), cauterization (burning, also called diathermy), or laser surgery to destroy the abnormal area without harming nearby healthy tissue. The doctor also can remove the abnormal tissue by LEEP or conization. Treatment for precancerous lesions may cause cramping or other pain, bleeding, or a watery discharge.

How is Cancer of the Cervix Treated?

The choice of treatment for cervical cancer depends on the location and size of the tumor, the stage (extent) of the disease, the woman's age and general health, and other factors.

Most often, treatment for cervical cancer involves surgery and radiation therapy. Sometimes, chemotherapy or biological therapy is used. Patients are often treated by a team of specialists. The team may include gynecologic oncologists and radiation oncologists. The doctors may decide to use one treatment method or a combination of methods. Some patients take part in a clinical trial (research study) using new treatment methods. Such studies are designed to improve cancer treatment.

Some women with cervical cancer are also treated in clinical trials.

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