What Is Cervical Cancer?

The cervix is the lower part of the uterus (womb). The upper part, or body, of the uterus, is where a fetus grows. The cervix connects the body of the uterus to the vagina (birth canal). The part of the cervix closest to the body of the uterus is called the endocervix. The part next to the vagina is the ectocervix. Most cervical cancers start where these 2 parts meet.

Cancer of the cervix (also known as cervical cancer) begins in the lining of the cervix. Cervical cancers do not form suddenly. Normal cervical cells gradually develop pre-cancerous changes that turn into cancer. Doctors use several terms to describe these pre-cancerous changes, including cervical intraepithelial neoplasia (CIN), squamous intraepithelial lesion (SIL), and dysplasia.

There are 2 main types of cervical cancers: squamous cell carcinoma and adenocarcinoma. Cervical cancers and cervical precancers are classified by how they look under a microscope. About 80% to 90% of cervical cancers are squamous cell carcinomas, which are composed of cells that resemble the flat, thin cells called squamous cells that cover the surface of the endocervix. Squamous cell carcinomas most often begin where the ectocervix joins the endocervix.

The remaining 10% to 20% of cervical cancers are adenocarcinomas. Adenocarcinomas are becoming more common in women born in the last 20 to 30 years. Cervical adenocarcinoma develops from the mucus-producing gland cells of the endocervix. Less commonly, cervical cancers have features of both squamous cell carcinomas and adenocarcinomas. These are called adenosquamous carcinomas or mixed carcinomas.

Only some women with pre-cancerous changes of the cervix will develop cancer. This process usually takes several years but sometimes can happen in less than a year. For most women, pre-cancerous cells will remain unchanged and go away without any treatment. But if these precancers are treated, almost all true cancers can be prevented. Pre-cancerous changes and specific types of treatment for precancers are discussed in the section, "Can Cervical Cancer Be Prevented?"

Precancerous changes can be separated into different categories based on how the cells of the cervix look under a microscope. These categories are discussed in the section, "Can Cervical Cancer Be Prevented?"

Cervical Cancer Treatment

Treatment of cervical cancer is directed at preventing precancerous cells from becoming cancerous cells.

• This is usually a step-by-step process, involving the removal of cells or tissue to diagnose cancer and to find out how far it has invaded.
  
  
• If the deepest cells removed by biopsy were normal, no further treatment may be needed.
  
  
• If the deepest cells removed by biopsy were cancerous or precancerous, this means the cancer has invaded farther than the biopsy. In these cases, treatment generally starts with removal of additional tissues. As these tissues are removed, they are checked for dysplastic change to be sure all the precancerous or cancerous cells have been removed from the body or are otherwise destroyed.

What happens after treatment for cancer of the cervix?

Regular follow-up exams; including a pelvic exam, a Pap test, and other laboratory tests, are very important for any woman who has been treated for precancerous changes or for cancer of the cervix. The woman should have frequent tests and exams for several years so that the doctor can check for any signs that the condition has returned.

Cancer treatment can cause side effects many years later. For this reason, patients should continue to have regular checkups and should report any health problems that appear.

Living with a serious disease is not easy. Cancer patients and those who care about them face many problems and challenges. Coping with these problems is often easier when people have helpful information and support services. Several useful booklets, including the National Cancer Institute booklet, Taking Time, are available from the Cancer Information Service.

Cancer patients may worry about holding their job, caring for their family, or keeping up with daily activities. Worries about tests, treatments, hospital stays, and medical bills are common. Doctors, nurses, and other members of the health care team can answer questions about treatment, working, or other activities. Also, meeting with a social worker, counselor, or a member of the clergy can be helpful to patients who want to talk about their feelings or discuss their concerns.

Friends and relatives can be very supportive. Also, it helps many patients to discuss their concerns with others who have cancer. Cancer patients often get together in support groups, where they can share what they have learned about coping with cancer and the effects of treatment. It is important to keep in mind, however, that each patient is different. Treatments and ways of dealing with cancer that work for one person may not be right for another, even if they both have the same kind of cancer. It is a good idea to discuss the advice of friends and family members with the doctor.

Often, a social worker at the hospital or clinic can suggest groups that can help with rehabilitation, emotional support, financial aid, transportation, or home care. For example, the American Cancer Society has many services for patients and their families. They also offer many free booklets, including one on sexuality and cancer. Local offices of the American Cancer Society are listed in the white pages of the telephone directory.

Cervical Cancer Symptoms

• Abnormal bleeding.Women with cervical cancer may experience abnormal vaginal bleeding. This can be heavy or light bleeding during the month.
  
  
• Unusual heavy discharge. An increased vaginal discharge is also a symptom of cervical cancer. It may be foul smelling, watery, thick, or contain mucus. It varies from woman to woman. It is important to report any unusual vaginal discharge to your doctor.
  
  
• Pelvic pain. Pelvic pain that is not related to the normal menstrual cycle can be a cervical cancer symptom. Many women describe them ranging from a dull ache to sharp pains that can last hours. It can be mild or severe.
  
  
• Pain during urination. Bladder pain or pain during urination can be a symptom of advanced cervical cancer. This cervical cancer symptom usually occurs when cancer has spread to the bladder.
  
  
• Bleeding between regular menstrual periods, after sexual intercourse, douching, or pelvic exam. Bleeding after sexual intercourse, douching, or pelvic exam can be cervical cancer symptoms. This is due to the irritation of the cervix during these activities. While a healthy cervix may have a very small amount of bleeding, many conditions may cause bleeding after activities like sex.

Please keep in mind that these cervical cancer symptoms are also symptoms of many other illnesses. If you are experiencing these cervical cancer symptoms, please see a doctor. He or she will most likely do a pelvic exam and may order further tests.