Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus (womb) that opens into the vagina, which then leads to the outside of the body. Typically, women are most at risk for cervical cancer in theifr 30s and 70s.
Our team of gynecologic oncologists uses an advanced approach to the treatment of cervical cancer. Depending on your diagnosis, our physicians may recommend surgery, chemotherapy or radiation.
Our specialized gynecologic cancer surgeries
If surgery is recommended, your surgeons will discuss different surgical options, which can be performed through either an open abdominal procedure (through the stomach area) or a minimally invasive robotic procedure.
Fertility sparing surgeries
Our surgeons may offer the option of fertility sparing surgery if it is appropriate for you. The gynecologic oncologists at Washington Cancer Institute are experts in fertility sparing surgeries, which treat the cancer, and leave the uterus in place, so the possibility of having a baby in the future remains.
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Causes of cervical cancer
Worldwide, cervical cancer is the third most common type of cancer in women. It is much less common in the United States because of the routine use of Pap smears. A Pap smear collects tissue from the cervix, allowing the doctors to examine it closely and check for the presence of cancer cells.
Cervical cancers start in the cells on the surface of the cervix. The development of cervical cancer is usually very slow. It starts as a precancerous condition called dysplasia (an abnormal growth of cells). This precancerous condition can be detected by a Pap smear and is 100 percent treatable. That is why it is so important for women to get regular Pap smears. Today, most women that are diagnosed with cervical cancer have not had regular Pap smears, or they have not followed up on abnormal results.
Undetected, precancerous changes can develop into cervical cancer and spread to the bladder, intestines, lungs and liver. It can take years for precancerous changes to turn into cervical cancer. Patients with cervical cancer do not usually have symptoms until the cancer is advanced, and has spread.
HPV and cervical cancer
Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that is spread through sexual intercourse. There are many different types of HPV. Some strains lead to cervical cancer. (Other strains may cause genital warts, while others do not cause any problems at all.)
Other risk factors for cervical cancer include:
Symptoms of advanced cervical cancer may include:
Diagnosis of cervical cancer
Regular Pap smears screen for cancer and precancerous conditions, but do not confirm a final diagnosis of cervical cancer. If abnormal changes are seen, the cervix is usually examined under magnification. This is called colposcopy. Pieces of tissue are surgically removed (biopsied) during this procedure and sent to a laboratory for examination.
Other tests or treatments for cervical pre-cancers may include:
If the diagnosis of cervical cancer is confirmed, the health care provider may order more tests to find out how far the cancer has spread. This is called staging. Tests may include:
Treatment of cervical cancer depends on the stage of the cancer, the size and shape of the tumor, the age and general health of the woman, and her desire to have children in the future.
Treatment for early cervical cancer may include:
Treatment of recurrent disease
Recurrent disease is when the cancer recurs, or continues to come back, after treatment. A larger surgery may be necessary to rid the body of the cancer.
Pelvic exenteration is an extreme surgical procedure in which many pelvic organs involved in the recurrent tumor are removed. During the procedure, your surgeons will also reconstruct the necessary organs. Learn more about recurrent cervical cancer exenteration and radical pelvic reconstruction.
Radiation and chemotherapy for cervical cancer
Radiation may be used to treat larger tumors, cancers that have spread beyond the pelvis, or cancer that has returned. Radiation therapy is either external or internal.
Chemotherapy uses drugs to kill cancer. Sometimes, radiation and chemotherapy are used before or after surgery. Learn more about chemotherapy at the Cancer Institute.
Precancerous conditions are curable with proper treatment and follow-up. The chance of being alive in five years (five-year survival rate) for cancer that has spread to the inside of the cervix walls, but not outside the cervix area, is about 92 percent.
However, the five-year survival rate falls steadily as the cancer spreads into other areas.
Prevention of cervical cancer
There are now two vaccines available (Gardasil® and Cervarix®) which prevent infection against the most frequent HPV subtypes (a virus that causes cervical cancer). These viruses are responsible for the majority of cervical cancer cases. Studies have shown that the vaccines appear to prevent early-stage cervical cancer and precancerous lesions.
Practicing safe sex (using condoms) also reduces your risk of HPV and other sexually transmitted diseases. HPV infection causes genital warts. These may be barely visible or several inches wide. If a woman sees warts on her partner's genitals, she should avoid intercourse with that person.
To further reduce the risk of cervical cancer, women should limit their number of sexual partners and avoid partners who participate in high-risk sexual activities.
Getting regular Pap smears can help detect precancerous changes, which can be treated before they turn into cervical cancer. Pap smears work very well in spotting such changes, but they must be done regularly. Annual gynecologic examinations should start when a woman becomes sexually active, or by the age of 20 in a woman who is not sexually active. Pap smear testing should begin at the age of 21. If abnormal changes are seen, a colposcopy with biopsy should be performed. A colposcopy is a painless procedure in which your doctor uses a lighted microscope to view your cervix.