The prognosis is grimmer if detected late. It’s not an automatic death sentence, but if the cancer has spread to the immediate area of the cervix, the five-year survival rate plummets to 57 percent. If it has spread to an area outside of the reproductive region, the survival rate is 16 percent.
Cervical Cancer: The Basics
Cervical cancer happens when normal cells on the surface of the cervix begin to change and grow, causing a tumor to form. The tumor can be benign, but if it is cancerous (or malignant) there is the danger of its cells spreading to other parts of the body.
The formation of abnormal cells – which are not cancerous but can become so – is usually considered the precursor to cervix cancer. Some go away without any treatment, but others remain and can morph into cancer. This condition is called dysplasia, and the precancerous tissue should be removed.
Sometimes the dysplasia tissue can be taken out without harm to other areas, but sometimes it requires a hysterectomy to remove the cervix and uterus. Whether this step is necessary depends on the size of the cell area and whether any changes have occurred, the woman’s desire for child-bearing, her age and overall health, and the doctor’s opinion on the state of the condition. If the cells spread, the condition can be fatal, so most doctors err on the conservative side when evaluating the condition.
The two types of cervical cancer are named for the type of cells located where the cancer originates. They are squamous cell carcinoma, which is the most common and can be anywhere from 80 percent to 90 percent of all cervical cancers; and adenocarcinoma, which is the remaining 10 percent to 20 percent of cancers.
Cervical Cancer Prevention
Screening tests and a vaccine against the cause of cervical cancer have improved the odds of preventing the disease. Particularly when discovered early, cervical cancer is treatable.
The human papillomavirus (HPV) is the cause of most cervical cancers. This is a virus that can be transmitted during sex. There are several types of HPV, some of them causing changes that lead to cancer, others generating skin or genital warts.
Most people will get HPV at some point in their lives. The trouble is that it typically has no symptoms, leaving little clue as to its presence. In some cases, HPV goes away on its own. But it can survive for years without symptoms, and particularly for those who have higher risk factors, it can develop into cancer.
Risk factors include HIV infection, smoking, using birth control pills for more than five years, having given birth to three children or more, or the patient or his or her partner having many sexual partners. Other factors that can affect the potential for cervical cancer include early onset of sexual activity; a past history of other sexually transmitted diseases like gonorrhea, chlamydia, syphilis and HIV/AIDS.
Early screening tests are recommended as the one indispensable tool to help in the fight against cervical cancer. While early-stage cervical cancer has no signs, the later stages include vaginal bleeding that occurs post-sexual intercourse, after menopause or between periods; a bloody and watery vaginal discharge that may have a foul odor; or pain in the pelvis, particularly if it happens during intercourse.
Diagnosing Cervical Cancer
A doctor will do a full physical checkup to determine whether the patient has cervical cancer, including an examination of the cervix with a colposcope, a magnifying tool that looks for abnormal cells and can capture a few for examination via a punch biopsy, which can pinch off some tissue; or via an endocervical curettage, which uses a spoon-shaped instrument or brush to scrape the cervix for a tissue sample.
Other options during the screening can include a pap test, wherein the doctor brushes and scrapes cells from the cervix to be examined in a laboratory for abnormalities; and an HPV DNA test, which will take cells from the cervix and test them for HPV types that may lead to cancer. This is usually done with women age 30 and older but may be recommended for younger women who show abnormal test results.
Doctors may opt for an electrical wire loop, which uses a low-voltage wire to obtain tissue samples (this can be done in the doctor's office using local anesthesia), or a cone biopsy, which is typically performed in a hospital and obtains deeper samples of tissue for examination.
Once it is determined that cervical cancer is present, the next step is to determine the progression of the disease. This is done through a determination called staging, and it will determine the course of the treatment.
The levels of staging include:
Stage I – The cancer is found only in the cervix
Stage II – The cancer is found in the cervix and upper portion of the vagina
Stage III – The cancer has progressed to the lower portion of the vagina or the pelvic side wall
Stage IV – Cancer has spread to the bladder or rectum or can be found in other areas of the body.
Imaging tests, including X-rays, CT scans, MRI exams and PET scans can help with diagnosing where in the body the cancer is located. There are also scopes that can help examine the bladder and rectum.
Depending on the levels discovered, treatment can include radiation, surgery, chemotherapy or a combination of all three. Again, cervical cancer is usually highly treatable if it hasn’t spread, and the prognosis for survival is high.