UofL Health – Brown Cancer Center is dedicated to providing the best care for cervical cancer. From diagnosis through treatment and follow-up, your care is designed to meet your individual needs.
Our Multidisciplinary Gynecologic Oncology Team has a combination of gynecologic oncologists, radiation oncologists, reconstructive surgeons, colorectal surgeons, pathologists and radiologists who collaborate to provide the best treatment for you.
Facts
The cervix is the lower part of the uterus (womb) that opens to the top of the vagina. Cervical cancer is cancer that starts in the cervix. Almost all cervical cancers are caused by the virus, HPV (human papilloma virus). HPV is a common virus spread through sex. There are many kinds of HPV. Some cause genital warts. Some cause cancer or precancer.
Cervical cancer is the third most common cause of cancer in women in the world. It is less common in the United States due to the use of Pap smears to screen for cervical cancer.
Cervical cancer is usually slow-growing. It starts as a precancerous condition called dysplasia. This can be detected by a Pap smear and is treatable.
Risk factors
There are several risk factors for cervical cancer. They include:
- Having sex at an early age
- Having multiple sexual partners
- Having a partner or many partners who take part in high-risk sexual activities
- Not getting the HPV vaccine
- Having a weakened immune system
- Having other sexually transmitted diseases
- Having cervical dysplasia
- Not having regular Pap smears
- Smoking
Having risk factors for cervical cancer does not mean that you will have cervical cancer. However, if you have these risk factors, talk to your doctor about them.
Prevention
Cervical cancer can be prevented. Ways to prevent cervical cancer include:
- Get the HPV vaccine. The vaccine protects you against HPV that causes cervical cancer. Ask your doctor if the vaccine is right for you.
- Get regular Pap smears and pelvic exams. Pap smears can detect precancerous conditions before they turn into cancer.
- Practice safe sex. Use condoms with new partners to prevent HPV.
- Quit smoking. Smoking increases your risk of cervical cancer.
Symptoms
Cervical cancer may not have symptoms if it is caught early. Symptoms that may happen include:
- Abnormal bleeding between periods or after sex
- Abnormal bleeding after menopause
- Vaginal discharge that does not stop
- Vaginal discharge that is abnormal smelling or watery
- Periods that are heavier than usual
- Pelvic pain
- Leg pain or swelling
- Back pain
- Unexplained weight loss
Having these symptoms does not mean that you have cervical cancer. However, if you have these symptoms, talk to your doctor.
Diagnosis
Cervical cancer is diagnosed by exam, biopsy, blood tests and imaging. On exam, some cervical cancers can be seen with the naked eye. Small cervical cancers or precancerous lesions cannot be seen with the naked eye.
If you have symptoms of cervical cancer, your doctor will do an exam and discuss your medical history.
Tests may need to be done to determine if you have cervical cancer. Special tests to diagnose cervical cancer include:
- Pap smears
- HPV test
- Colposcopy: Looking at the cervix with a special microscope.
- Biopsies
- A cone biopsy or a LEEP procedure. These may be done in the office or in the operating room.
Imaging studies may be done to evaluate if cancer has spread. These include:
- Chest X-ray
- CT or CAT (computed axial tomography) scan
- MRI (magnetic resonance imaging)
- Cystoscopy: Using a small camera to look inside the bladder
- Proctoscopy: Using a small camera to look inside the rectum
- PET (positron emission tomography)
Treatment
Treatment of cervical cancer depends on:
- The stage of the cancer
- The size and shape of the tumor
- The woman’s age and general health
- Her desire to have children in the future
Precancerous lesions can be treated with surgery. Early cervical cancer can be treated with surgery or radiation therapy.
Precancerous lesions can be treated with surgery to remove a portion of the cervix. These surgeries include:
- LEEP (loop electrosurgical excisions procedure): Uses electricity to remove the abnormal tissue
- Cold knife cone: The cervix is removed
- Cryoablation: Freezes the abnormal cells on the cervix
- Laser therapy: Uses a laser to burn the abnormal cells
Early cancer can be treated with surgery. These surgeries include:
- Cold knife cone: The cervix is removed. This is done if cancer is small.
- Hysterectomy: The uterus and cervix are removed. This is done if cancer is small.
- Radical hysterectomy: The uterus, cervix, and tissue around the cervix are removed. The upper part of the vagina is removed. Lymph nodes in the pelvis are removed.
- Radical trachelectomy: The cervix and tissue around the cervix are removed. This is done for early cervical cancer and if you want to have children.
- Pelvic exenteration: A complex surgery where all of the organs in the pelvis, including the bowel and bladder, are removed.
Radiation therapy may be used to treat early cervical cancer if surgery cannot be done. Radiation therapy is also the main treatment for cervical cancer that has spread outside the cervix.
Chemotherapy may be added to radiation therapy to kill more cancer cells. Chemotherapy may be used if cancer has spread.
