Cervical cancer

Cervical cancer is cancer that forms in the cells of the cervix.

The cervix

The cervix is a strong muscle that connects the womb and vagina. Normally it is closed tight, but it opens up during labour to let the baby out.

Types of cervical cancer
Causes, screening and vaccination
Who does it affect?
What are the symptoms?
How is it diagnosed?
How is it treated?
What are the treatment side-effects?
After treatment

Types of cervical cancer

There are two different types of cervical cancer:

  • Squamous cell cervical cancer, which forms on the skin-like cells on the outer surface of the cervix
  • Adenocarcinoma of the cervix, which forms on the glandular cells lining the inside surface of the cervix.

Causes, screening and vaccination

The most common cause of cervical cancer is the human papilloma virus (HPV), which is passed on through sexual contact. Some types of HPV cause changes in the cells of the cervix that make them more likely to become cancerous over a period of time. However, it is important to remember that most people who have HPV do not develop cervical cancer.
 
Cervical screening (also known as a smear test) is a way for doctors to check whether there have been any abnormal changes to the cells of the cervix. If these abnormal changes are caught early, you can receive treatment to prevent the cancer from developing.  Depending on where you live, you may get a letter every three to five years inviting you to go for a cervical screening test.

Cervical screening is not a test for cancer; it is a way of checking if there have been any abnormal changes to cells that might become cancerous in the future, if left untreated.

Vaccines are now available in the UK to help protect you from being infected with the types of HPV that are commonly linked with cervical cancer. These vaccines are usually given at 12–13 years of age.

Who does it affect?

Cervical cancer is the most common cancer in females under the age of 35. However, it is much less frequently diagnosed in young women aged under 25 than it is for those in the 25–35-year age group.

What are the symptoms?

The most common symptom of cervical cancer is abnormal bleeding from the vagina, either between your periods or after sex. There may also be discomfort or pain during sex or abnormal discharge.

Your daughter may feel uncomfortable talking to her doctor about these things, but it’s better to get checked out as a number of different conditions could be causing these symptoms.

How is it diagnosed?

Abnormal cells on the cervix are usually picked up during the cervical screening process described above. Your daughter will then be referred to the hospital for a colposcopy or cone biopsy, where the specialist will examine her cervix and may remove any areas with abnormal cells. If cancerous cells are found on her cervix, your daughter may need further tests to determine whether the cancer has spread. These may include blood tests, CT or MRI scans or a pelvic examination under general anaesthetic.

How is it treated?

Cancer of the cervix is usually treated with surgery, radiotherapy or chemotherapy, or a combination of these treatments. Your daughter's individual treatment plan will be determined by the type and stage of her cancer, so it is best to talk to your specialist for more information.

Surgery

If the cancer cells haven’t spread beyond the surface of the cervix, your daughter's cancer may be treated with one of two operations: a cone biopsy or a radical trachelectomy. These surgery types leave the womb in place, which means it is possible for your daughter to have a baby later in life.

If the cancer has spread further or if it comes back, your daughter may need to have an operation to remove her womb and possibly her ovaries or lymph glands. This is called a radical hysterectomy.

Radiotherapy

If it is not possible to cure your daughter's cancer with surgery alone, she may be given radiotherapy. This involves targeting the cancer cells with high-energy waves, and can be given either externally or internally (or a combination of the two).

  • Internal radiotherapy is given through special tubes placed inside the vagina
  • External radiotherapy uses equipment similar to a large x-ray machine to target the cancer from outside the body.

Chemotherapy

Chemotherapy involves targeting the cancer cells with anti-cancer drugs. It may be given before surgery or radiotherapy to reduce the size of the tumour, or alongside other treatments.

What are the treatment side-effects?

Surgery

Recovery from surgery will depend on the type of operation. Talk to the specialist about whether your daughter will need to stay in hospital after her treatment and anything else she will need to know about the recovery process.

Radiotherapy

After radiotherapy your daughter may experience slight bleeding or discharge from the vagina. If this continues for more than a couple of weeks, or becomes heavy, let the specialist know. Other side-effects of radiotherapy include tiredness, diarrhoea and a burning sensation when passing urine. Most of these side-effects can be treated with medicine.

Chemotherapy

If your daughter is undergoing chemotherapy, she may experience side-effects such as tiredness, sickness, diarrhoea and temporary hair loss. She will also be at greater risk of infections. For more information about how side-effects can be managed, talk to the specialist/team looking after your daughter or see the side-effects section of our website.

After treatment

Fertility

Your specialists will do all they can to preserve your daughter's ability to have children, however the priority needs to be fighting the cancer. Surgery for early-stage cancer will not affect her fertility, but if your daughter has to have her womb removed, or if she has had radiotherapy to this area, she will no longer be able to become pregnant. This can be very difficult to deal with. It is worth talking to the specialist looking after your daughter before treatment starts about the options available, such as storing eggs or embryos for future use.

Follow up

After your daughter's treatment is complete she will still need to be seen regularly at an outpatient clinic. At this clinic, the specialist will be looking for any signs that the cancer has returned (this is known as a relapse).They will also check that your daughter's major organs, such as heart and lungs, are still functioning correctly and haven’t been affected by her cancer treatment.

Long-term follow up

Once the risk of relapse has reduced, the focus of on-going follow up changes to looking out for potential long term side effects of treatment. The risk of long term side effects depends on the type of cancer your daughter had and the treatment she received. A personalised surveillance plan is usually created that outlines the specific long term follow up and on-going investigations that your daughter requires.

Many people are at low risk of future health problems but some will have significant on-going health needs. Talk to the specialist about the potential long-term side-effects of your daughter's treatment.

Updated January 2015, next planned review 2017.

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