The volunteers of Woman to Woman share their own experiences and offer support and guidance to other women going through cancer therapy.
Cervical cancer begins in the cervix, which is the lower, narrow end of the uterus, also called the womb. The cervix connects the vagina (birth canal) to the upper part of your uterus and is where a baby grows if you are pregnant.
Almost all cervical cancers are caused by human papillomavirus (HPV), a common virus that can be passed from one person to another during sex. There are more than 80 types of human papillomavirus. About 30 types can infect the cervix and about half of them have been linked to cervical cancer. Some HPV types can cause genital warts.
HPV is so common that most people get it at some point in their lives. It usually causes no symptoms, so you can't tell whether you have it.
Likewise, cervical cancer may not cause signs and symptoms early on. Advanced cervical cancer, however, may cause abnormal vaginal bleeding or discharge, such as bleeding after sex. If you have either of these symptoms, see your doctor. The symptoms may be caused by something other than cancer, but you won't know unless you see your doctor
For most women, HPV will go away on its own. However, if it does not, there is a chance that over time it may cause cervical cancer.
Risk factors for cervical cancer
Although HPV infection is the main cause of cervical cancer, your risk of developing the disease may increase if:
- You have given birth to three or more children
- You have HIV/AIDS or another condition that makes it hard for your body to fight off health problems
- You smoke
- You use birth control pills for five or more years
Secondhand smoke increases your risk of cervical cancer, although the risk is lower than active smoking.
Cervical cancer is highly preventable in most Western countries because screening tests and a vaccine are available. When cervical cancer is found early enough, it is highly treatable and associated with long survival and good quality of life.
HPV infection is the main cause of cervical cancer. You can lower your risk of HPV infection by:
- Avoiding sexual activity: HPV infection of the cervix is the most common cause of cervical cancer. Avoiding sexual activity decreases your risk of HPV.
- Using barrier protection or spermicidal gels: Some methods used to prevent sexually transmitted diseases (STDs) decrease your risk of HPV infection. The use of barrier methods of birth control, such as a condom or spermicide, helps protect against HPV infection.
- Getting vaccinated: The HPV vaccine can prevent infection by the two types of HPV that cause most cervical cancers. The vaccine protects against infection for six to eight years. It is unknown if protection lasts.
The most important measure you can take to help prevent cervical cancer is to have regular screening tests:
- The Pap test (or Pap smear) looks for precancers — cell changes on the cervix that may become cervical cancer if left untreated.
- The human papillomavirus (HPV) test looks for the virus that can cause these cell changes.
Through regular testing, cervical cancer is the easiest gynecologic cancer to prevent.
Two vaccines are available to protect you against the types of HPV that cause most cases of cervical, vaginal, and vulvar cancers. Both vaccines are recommended for 11- and 12-year-old girls and for females 13-26 years of age who did not get any or all of their shots when they were younger. The vaccines can also be given to girls as young as 9 years of age. Even if you have been vaccinated against HPV, however, you still need to have regular Pap tests to screen for cervical cancer.
Mount Sinai has gynecologic oncologists available to treat cervical cancer. Gynecologic oncologists are doctors trained in treating cancers of the female reproductive system. Your gynecologic oncologist will work with you to create a treatment plan.
Treatment options for cervical cancer depend on the following:
- The stage of your cancer
- The size of your tumor
- Your desire to have children
- Your age
If you are pregnant, treatment of cervical cancer during pregnancy depends on the stage of the cancer and the stage of your pregnancy. For cervical cancer found early or for cancer found during the last trimester of pregnancy, treatment may be delayed until after you give birth.
The extent of your cancer is referred to as the stage. Information about the size of the cancer or how far it has spread is often used to determine the stage. Doctors use this information to plan treatment and to monitor progress.
Three types of standard treatment are used:
Mount Sinai offers the following means of surgically removing the cancer:
- Bilateral salpingo-oophorectomy: Surgery to remove both ovaries and both fallopian tubes.
- Conization: A procedure to remove a cone-shaped piece of tissue from the cervix and cervical canal. A pathologist views the tissue under a microscope to look for cancer cells. Conization may be used to diagnose or treat a cervical condition. This procedure is also called a cone biopsy.
- Cryosurgery: A treatment that uses an instrument to freeze and destroy abnormal tissue, such as carcinoma in situ. This type of treatment is also called cryotherapy.
- Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.
- Loop electrosurgical excision procedure (LEEP): A treatment that uses electrical current passed through a thin wire loop as a knife to remove abnormal tissue or cancer.
- Modified radical hysterectomy: Surgery to remove the uterus, cervix, upper part of the vagina, and ligaments and tissues that closely surround these organs. Nearby lymph nodes may also be removed. In this type of surgery, not as many tissues and/or organs are removed as in a radical hysterectomy.
- Pelvic exenteration: Surgery to remove the lower colon, rectum, and bladder. In women, the cervix, vagina, ovaries, and nearby lymph nodes are also removed. Artificial openings (stoma) are made for urine and stool to flow from the body to a collection bag. Plastic surgery may be needed to make an artificial vagina after this operation.
- Radical hysterectomy: Surgery to remove the uterus, cervix, part of the vagina, and a wide area of ligaments and tissues around these organs. The ovaries, fallopian tubes, or nearby lymph nodes may also be removed.
- Total hysterectomy: Surgery to remove the uterus, including the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.
Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
- External radiation therapy: A machine outside the body is used to send radiation toward the cancer.
- Internal radiation therapy: A radioactive substance is sealed inside needles, seeds, wires, or catheters that are placed directly into or near the cancer.
The type of radiation therapy you receive depends on the stage of your cervical cancer.
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are conducted to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials.
Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment that may improve the way cancer is treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or new ways to reduce the side effects of cancer treatment.
Ask your doctor about clinical trials underway at Mount Sinai or visit our clinical trials page. Enter "cervical cancer" in the field to see a list of our clinical trials on that topic.
Some of the tests we perform to diagnose cancer or determine its stage may need to be repeated. Some will be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Even after treatment has ended, we may need to repeat some tests from time to time. The results of these tests can show if your condition has changed or if your cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
To make an appointment with a Mount Sinai gynecologic oncologist, please contact 212-427-9898 or 212-241-1111.
To make an appointment with a Mount Sinai gynecologic oncologist, please contact us at 212-427-9898.
January is cervical cancer awareness month. As an extremely common and contagious sexually transmitted disease, HPV is a virus that can lead to cell transformation and eventually cancer. "HPV is shorthand for human papilloma virus, a sexually transmitted pathogen that causes disease in the oral and ano-genital tract of both men and women," says Dr. Konstantin Zakashansky from The Mount Sinai Health System. Learn More
January is cervical cancer awareness month, part of a global initiative to promote regular pap smears and to eradicate cervical cancer. "This is a cancer that we can prevent and eventually wipe out through early detection," says Dr. Linus Chuang from The Mount Sinai Health System. Learn More