Your cervix is a strong muscle that connects your womb and vagina. Normally it is closed tight, but it opens up during labour to let the baby out.
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.
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 changes to the cells of your cervix. If these 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.
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.
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.
The most common symptom of cervical cancer is abnormal bleeding from your vagina, either between your periods or after sex. You may also notice that you have discomfort or pain during sex or abnormal discharge.
You might feel uncomfortable talking to your doctor about these things, but it’s better to get checked out as a number of different conditions could be causing these symptoms.
Abnormal cells on your cervix are usually picked up during the cervical screening process described above. You will then be referred to the hospital for a colposcopy or cone biopsy, where the specialist will examine your cervix and may remove any areas with abnormal cells. If cancerous cells are found on your cervix, you 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.
Cancer of the cervix is usually treated with surgery, radiotherapy or chemotherapy, or a combination of these treatments. Your individual treatment plan will be determined by the type and stage of your cancer, so it is best to talk to your specialist for more information.
If the cancer cells haven’t spread beyond the surface of the cervix, your cancer may be treated with one of two operations: a cone biopsy or a radical trachelectomy. These surgery types leave your womb in place, which means it is possible for you to have a baby later in life if you want to.
If your cancer has spread further or if it comes back, you may need to have an operation to remove your womb and possibly your ovaries or lymph glands. This is called a radical hysterectomy.
If it is not possible to cure your cancer with surgery alone, you 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 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.
Your recovery from surgery will depend on the type of operation you had. Talk to your specialist about whether you will need to stay in hospital after your treatment and anything else you need to know about the recovery process.
After radiotherapy you may experience slight bleeding or discharge from your vagina. If this continues for more than a couple of weeks, or becomes heavy, let your specialist know. Other side-effects of radiotherapy include tiredness, diarrhoea and a burning sensation when you pass urine. Most of these side-effects can be treated with medicine.
If you are undergoing chemotherapy, you may experience side-effects such as tiredness, sickness, diarrhoea and temporary hair loss. You will also be at greater risk of infections. For more information about how side-effects can be managed, talk to your specialist or see the side-effects section of our website.
Your specialists will do all they can to preserve your ability to have children, however the priority needs to be fighting your cancer. Surgery for early-stage cancer will not affect your fertility, but if you have your womb removed, or if you have had radiotherapy to this area, you will no longer be able to become pregnant. This can be very difficult to deal with. It is worth talking to your specialist before you start treatment about the options available for you, such as storing eggs or embryos for future use.
After your treatment is complete you will still need to be seen regularly at an outpatient clinic. At this clinic, your specialist will be looking for any signs that your cancer has returned (this is known as a relapse). They will also check that your major organs, such as your heart and lungs, are still functioning correctly and haven’t been affected by your cancer treatment.
Long-term follow up
Once your 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 you had and the treatment you received. A personalised surveillance plan is usually created that outlines the specific long term follow up and on-going investigations that you require.
Many people are at low risk of future health problems but some will have significant on-going health needs. Talk to your specialist about the potential long-term side-effects of your treatment.
Updated December 2014, next review planned 2017.