Cervical Cancer

Cervical cancer develops in the cervix, the mouth of the womb or uterus that extends from the top of the vagina, and is most commonly found in reproductive age women.

Additionally, it has been found to be attributable to a sexually transmitted virus, Human Papillomavirus (HPV). There are over 80 subtypes of HPV but types 16 and 18 are most commonly found in cervical cancers.

Seventy percent of cervical cancers arise from the cells covering the cervix called squamous cells.

Another, less common type of cervical cancer, called adenocarcinoma, can develop in the glandular cells lining the cervical canal.

Risk factors include smoking, multiple sexual partners, early age of first sexual activity, a high-risk partner and HPV. Patients often develop vaginal bleeding-especially after intercourse, and sometimes urinary frequency, and pelvic pain or pressure.

The diagnosis is many times made by Pap smear which may show abnormal cells. A biopsy of any abnormal appearing area will then be performed, often times using a colposcope which magnifies the cervix to better show these abnormalities. The biopsy may reveal dysplasia or pre-cancer or a cancer. Dysplasia, if untreated can progress to invasive cervical cancer. Treatment of dysplasia involves removing or destroying the abnormal tissue, most commonly by using a wire electrode.

The treatment for cervical cancer is very stage dependant. Stage I disease is limited to the cervix and is most often treated by radical hysterectomy and removal of the lymph nodes similar to that above. The “radical” part of the hysterectomy involves removing more of the tissues that attach to and support the uterus, where the cancer is know to first spread. In general, stages II, III and IV are treated with a combination of radiation and chemotherapy.

Chemotherapy, which is typically given in a small dose once each week and is well tolerated by patients, makes the tumor more sensitive to destruction by the radiation and may also destroy cancer cells that may be outside the radiation field. Early diagnosis through a yearly Pap smear and reporting symptoms is very important.

A new vaccine is available in our office that may prevent HPV.