The cervix is the lower part of the uterus (womb). The uterus has two parts. The upper part, called the body of the uterus, is where a fetus grows. The cervix, in the lower part, connects the body of the uterus to the vagina, or birth canal.
Cancer of the cervix (also called cervical cancer) begins in the cells lining the cervix. These cells do not suddenly change into cancer. Instead, the normal cells of the cervix first slowly change into pre-cancer cells that can then turn into cancer. These changes may be called dysplasia. The change can take many years but sometimes happen faster. The Pap test can find These changes and treated to prevent cancer.
There are two main types of cancer of the cervix. About 8 to 9 out of 10 are squamous cell carcinomas. Under the microscope, this type of cancer is made up of cells that are like squamous cells that cover the surface of the cervix.
Most of the rest are adenocarcinomas. These cancers start in the gland cells that make mucus. Less often, cancer has features of both types and is called adenosquamous or mixed carcinoma.
Other types of cancer also can develop in the cervix. These other types (such as melanoma, sarcoma, and lymphoma) happen most often in other parts of the body. If you have cervical cancer, ask your doctor to explain exactly what type of cancer you have.
This information is only of the more common types of cervical cancer, not the rare ones.
How many women get cancer of the cervix?
The American Cancer Society’s estimates for cancer of the cervix in the United States for 2015 are:
- About 12,900 new cases of invasive cervical cancer (cancer that has spread beyond the cervix)
- About 4,100 deaths from cervical cancer
Cervical pre-cancers are much more common than true, invasive types of cancer.
Most cases of cervical cancer are seen in women younger than 50. Women over 50, however, still get cervical cancer.
Cervical cancer was once one of the most common causes of cancer death for American women. But the death rate from cervical cancer has gone down a lot over the last 30 years. The main reason for this change is the use of screening to find cervical cancer early.
Signs and symptoms of cervical cancer
Early cervical pre-cancers or cancers often have no signs or symptoms. That’s why it’s important for women to have regular screening for a Pap test (which may be combined with a test for HPV). Symptoms often do not start until the cancer is further along and has spread to nearby areas. You should report any of the followings to your doctor right away:
- Abnormal vaginal bleeding, such as bleeding after sex, bleeding after menopause, bleeding and spotting between periods, or having periods that are longer or heavier than usual. Bleeding after douching or after a pelvic exam may also occur.
- An unusual discharge from the vagina (not your normal period)
- Pain during sex
Of course, these symptoms do not mean that you have cancer. They can also be caused by something else. But you must check with a doctor to find out.
Survival rates for cancer of the cervix,
Some people with cancer may want to know the survival rates for their type of cancer. Others may not find the numbers helpful, or may even not want to know them.
The 5-year survival rate refers to the percent of patients who live at least five years after their cancer is found. Many of these patients live much longer than five years. Also, these rates look at deaths from any cause. People with cancer may die from things other than cancer, and these rates don’t take that into account.
To get 5-year survival rates, doctors have to look at people who were treated at least 5 years ago. Better treatments since then may mean a better outlook for people now found to have cervical cancer.
The numbers below come from the National Cancer Data Base as published in the 7th edition of the AJCC Cancer Staging Manual, and are based on people diagnosed between 2000 and 2002.
|Stage||5-Year Observed Survival Rate|
The treatment options for cervical cancer depend mostly on the stage of cancer. After your cancer is staged, the doctor will tell you what choices you have. If there is anything you don’t understand, ask for it to be explained. Factors other than the stage of cancer that might have an impact on your treatment decision include your age, your overall health, and your preferences.
Common treatments for cervical cancer include:
- Radiation therapy
- Targeted therapy
Some very early cervical cancers are treated with surgery alone. Most cervical cancers, though, are treated with radiation combined with chemotherapy.
Surgery for cancer of the cervix
Surgery is most often used to treat very early cancers of the cervix.
A metal probe cooled with liquid nitrogen is put in the vagina and on the cervix. It kills the abnormal cells by freezing them. Cryosurgery is used to treat stage 0 cancers (carcinoma in situ), but it is not used for invasive cancer.
A laser beam is used to burn off cells or to remove a small piece of tissue for study. Laser surgery is used for stage 0 cancers (carcinoma in situ), but it is not used for invasive cancer.
A cone-shaped piece of tissue is removed from the cervix. It is done using a surgical or laser knife (cold knife cone biopsy) or using a thin wire heated by electricity (sometimes called a LEEP or LEETZ procedure).This approach can be used to find or to treat very early stage (0 or I) cancer.
In a hysterectomy, the uterus and cervix are removed. The ovaries and fallopian tubes or pelvic lymph nodes may be taken out during the same operation, but this isn’t a part of every hysterectomy.
For a simple hysterectomy, only the cervix and uterus are removed. ItThis is sometimes also called a total hysterectomy. The vagina and the tissue next to the uterus are left intact. The uterus can be taken out through either a cut (incision) in the front of the belly (abdomen) or through the vagina. Laparoscopy can be used with either of these methods. A laparoscope is a long, thin tube with a small camera on end. It is put into the belly through small cuts in the skin to let the surgeon see inside and use small tools to remove organs. Because the cuts are small, the patient may recover faster.
Some very early stage I cervical cancers are treated with a hysterectomy. A hysterectomy is also used for some stage 0 cancers if the cone biopsy didn’t remove all cancer. General or epidural (regional) anesthesia is used for this operation.
Radical hysterectomy: For this operation, the surgeon removes more than just the uterus. The tissues next to the uterus and the upper part of the vagina next to the cervix are removed. This surgery, along with a pelvic lymph node dissection (see below), is the usual treatment for stages I and, less often, some stage II cervical cancers, especially in young women.