What is cervical cancer?
Cancer of the cervix is a common cancer in women. The disease occurs when cancer (malignant) cells are found in the tissues of the cervix - the opening of the uterus (womb). The cervix connects the uterus to the vagina (birth canal). Cancer of the cervix usually grows slowly over a period of time. Before cancer develops, cervical tissues change and cells that are not normal begin to appear (called dysplasia).

What are the symptoms of cervical cancer?

Since there are usually no symptoms associated with precancerous changes of the cervix, you must be sure your doctor does an important test, called a Pap smear, to look for it. The Pap smear is done by using a piece of cotton, a brush, or a small wooden spatula to gently scrape the outside of the cervix to pick up cells that can be examined under a microscope. Symptoms usually don’t appear until abnormal cervical cells become cancerous and invade nearby tissue. When this happens the most common symptom is abnormal bleeding. Bleeding may start and stop between periods or occur after intercourse, douching or a pelvic exam. Menstrual bleeding may last longer and be heavier than usual.

When should I start getting a Pap smear?

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

What are the risk factors for developing cervical cancer?

According to the National Cancer Institute, strong risk factors include:

• early age of first intercourse
• a history of multiple sex partners
• genital human papillomavirus (HPV) or other sexually transmitted disease (STD)
• smoking — the risk appears to increase with the number of cigarettes and number of years the woman has smoked
• women whose mothers were given the drug Diethylstilbestrol (DES) during pregnancy to prevent miscarriage

How is cervical cancer diagnosed?

A Pap smear is the first step in diagnosing cervical cancer. If the Pap smear is abnormal, procedures may need to be done for further diagnosis:

• Colposcopy — the doctor applies a vinegar-like solution to the cervix and using a colposcope looks closely at the cervix.
• Schiller test — the cervix is coated with an iodine solution, the healthy cells turn brown and the abnormal cells turn white or yellow.
• Biopsy — the doctor may remove a small amount of cervical tissue for examination.
• Loop electrosurgical excision procedure (LEEP) — the doctor uses an electric wire loop to slice off a thin, round piece of tissue.
• Endocervical curettage (ECC) — the doctor uses a curette (a small, spoon-shaped instrument to scrape tissue from inside the cervical opening.
• Conization (cone biopsy) — the doctor removes a larger, cone-shaped sample of tissue.

How are precancerous conditions treated?

Treatment depends on several factors, such as 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. A low-grade lesion may not need further treatment especially if the abnormal area was completely removed during the biopsy and can be watched with regular Pap tests. Cryosurgery (freezing), cauterization (burning) or laser surgery can be used to destroy the abnormal area without harming healthy tissue. The doctor also can remove abnormal tissue by LEEP or conization.

How is cervical cancer treated?

The choice of treatment depends on the location and size of the tumor, the stage (extent) of the disease, the woman's age, general health and other factors. Most often, the treatment involves surgery and radiation therapy. Sometimes, chemotherapy or biological therapy is used. The doctor may decide to use one treatment or a combination of treatments. Surgery may involve removing the tissue in or near the cervix, the cervix or the entire uterus (hysterectomy). Radiation therapy uses high-energy rays to damage cancer cells and stops them from growing. Chemotherapy is the use of drugs to kill cancer cells. It is most often used when cervical cancer has spread to other parts of the body. The doctor may use one drug or a combination of drugs. Biological therapy is treatment using substances to improve the way the body's immune system fights disease, and it may be used to treat cancer that has spread from the cervix to other parts of the body.

More information about cervical cancer can be obtained by contacting:

National Cancer Institute’s Cancer Information Service
800-422-6237
http://cis.nci.nih.gov