Cervical cancer is a disease in which malignant (cancer) cells form in the tissues of the cervix. The cervix is the lower, narrow end of the uterus (the hollow, pear-shaped organ where a fetus grows). The cervix leads from the uterus to the vagina (birth canal).

Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes known as dysplasia, in which abnormal cells begin to appear in the cervical tissue. Over time, the abnormal cells may become cancer cells and start to grow and spread more deeply into the cervix and to surrounding areas.

Signs & Symptoms

Early cervical cancer may not cause signs or symptoms. Women should have regular check-ups, including tests to check for human papillomavirus (HPV) or abnormal cells in the cervix. The prognosis (chance of recovery) is better when the cancer is found early.

These and other signs and symptoms may be caused by cervical cancer or by other conditions. Check with your doctor if you have any of the following:

  • Vaginal bleeding (including bleeding after sexual intercourse)
  • Unusual vaginal discharge
  • Pelvic pain
  • Pain during sexual intercourse

Treatment

Four types of standard treatment are used: surgery, radiation therapy, chemotherapy and targeted therapy. One of our gynecologic cancer specialists, Marcia C. Bowling, MD, Ajit Gubbi, DO or Dené C. Wrenn, MD, MS, can help you determine the best care plan for you.

  • Surgery (removing the cancer in an operation) is sometimes used to treat cervical cancer. The following surgical procedures may be used:
    • 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. Conization may be done using one of the following procedures:
      • Cold-knife conization: A surgical procedure that uses a scalpel (sharp knife) to remove abnormal tissue or cancer.
      • Loop electrosurgical excision procedure (LEEP): A surgical procedure that uses electrical current passed through a thin wire loop as a knife to remove abnormal tissue or cancer.
      • 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.
      • The type of conization procedure used depends on where the cancer cells are in the cervix and the type of cervical cancer.
    • Total hysterectomy: Surgery to remove the uterus, including the cervix.
    • 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.
    • 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.
    • Radical trachelectomy: Surgery to remove the cervix, nearby tissue and lymph nodes, and the upper part of the vagina. The uterus and ovaries are not removed.
    • Bilateral salpingo-oophorectomy: Surgery to remove both ovaries and both fallopian tubes.
    • Pelvic exenteration: Surgery to remove the lower colon, rectum, bladder, uterus, cervix, vagina, fallopian tubes and ovaries, and nearby lymph nodes. 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.
  • Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.
  • Chemotherapy and biological therapy are used to introduce drugs into the bloodstream so they can destroy or control the cancer.
  • Targeted therapy uses drugs or other substances to identify and attack specific cancer cells while minimizing effects on normal cells.

Sentinel lymph node mapping may be used to detect whether cells have escaped a tumor and spread to the sentinel nodes. The sentinel nodes are the first lymph nodes into which the cancer is likely to have spread. Sentinel lymph node mapping and biopsy is performed as part of the surgery to remove the tumor. First, a dye is injected into the cervix. The first lymph nodes that absorb the solution are identified as sentinel lymph nodes, because they are the first lymph nodes most likely to contain cancer cells if any spreading has occurred. The surgeon removes the sentinel nodes and sends them to a lab where a pathologist will look for cancer cells. If no cancerous cells are found, it’s a good sign that the cancer hasn’t spread outside of the cervix. If cancer cells are found, it will change the stage and treatment.