HOME  •  HEALTH  •  LIBRARY  •  AREAS  •  CENTERS  •  BOARDS  •  CHATS  •  JOIN FREE

Cervical Cancer
MDAdvice.com Home > Health Topics > Informative Material >

Cervical Cancer

What is Cancer of the Cervix?

Cancer of the cervix, a common kind of cancer in women, is a disease in which cancer (malignant) cells are found in the tissues of the cervix. The cervix is the opening of the uterus (womb). The uterus is the hollow, pear-shaped organ where a baby develops. The cervix connects the uterus to the vagina (birth canal).

Cancer of the cervix usually grows slowly over a period of time. Before cancer cells are found on the cervix, the tissues of the cervix go through changes in which cells that are not normal begin to appear (known as dysplasia). A Pap smear will usually find these cells. Later, cancer cells start to grow and spread more deeply into the cervix and to surrounding areas.

Since there are usually no symptoms associated with cancer of the cervix, you must be sure your doctor does a series of tests to look for it. The first of these is a Pap smear, which is done by using a piece of cotton, a brush, or a small wooden stick to gently scrape the outside of the cervix in order to pick up cells. You may feel some pressure, but you usually do not feel pain.

If cells that are not normal are found, your doctor will need to cut a sample of tissue (this procedure is called a biopsy) from the cervix and look at it under a microscope to see if there are any cancer cells. A biopsy that needs only a small amount of tissue may be done in your doctor's office. If your doctor needs to remove a larger, cone-shaped biopsy specimen (conization), you may need to go to the hospital.

Your prognosis (chance of recovery) and choice of treatment depend on the stage of your cancer (whether it is just in the cervix or has spread to other places) and your general health. 

Stages of Cancer of the Cervix

Once cancer of the cervix is found (diagnosed), more tests will be done to find out if cancer cells have spread to other parts of the body. This testing is called staging. To plan treatment, your doctor needs to know the stage of your disease. The following stages are used for cancer of the cervix.

Stage 0 or carcinoma in situ
Carcinoma in situ is very early cancer. The abnormal cells are found only in the first layer of cells of the lining of the cervix and do not invade the deeper tissues of the cervix.

Stage I
Cancer involves the cervix but has not spread nearby.
Stage IA: a very small amount of cancer that is only visible under a microscope is found deeper in the tissues of the cervix Stage IB: a larger amount of cancer is found in the tissues of the cervix

Stage II
Cancer has spread to nearby areas but is still inside the pelvic area.
Stage IIA: cancer has spread beyond the cervix to the upper two thirds of the vagina
Stage IIB: cancer has spread to the tissue around the cervix

Stage III
Cancer has spread throughout the pelvic area. Cancer cells may have spread to the lower part of the vagina. The cells also may have spread to block the tubes that connect the kidneys to the bladder (the ureters).

Stage IV
Cancer has spread to other parts of the body.
Stage IVA: cancer has spread to the bladder or rectum (organs close to the cervix)
Stage IVB: cancer has spread to faraway organs such as the lungs

Recurrent
Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the cervix or in another place.

How Cancer of the Cervix is Treated

There are treatments for all patients with cancer of the cervix. Three kinds of treatment are used:

1. surgery (removing the cancer in an operation)
2. radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)
3. chemotherapy (using drugs to kill cancer cells).

Your doctor may use one of several types of surgery for carcinoma in situ to destroy the cancerous tissue:

• Cryosurgery kills the cancer by freezing it.
• Laser surgery is the use of a narrow beam of intense light to kill cancerous cells.

Your doctor may remove the cancer using one of these operations:

• Conization is the removal of a cone-shaped piece of tissue where the abnormality is found. Conization may be used to take out a piece of tissue for biopsy, but it can also be used to treat early cancers of the cervix.
• Alternatively, your doctor may perform a loop electrosurgical excision procedure (LEEP) to remove the abnormal tissue. LEEP uses an electrical current passed through a thin wire loop to act as a knife.
• A laser beam can also be used as a knife to remove the tissue.
• A hysterectomy is an operation in which the uterus and cervix are taken out along with the cancer. If the uterus is taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus is taken out through a cut (incision) in your abdomen, the operation is called a total abdominal hysterectomy. Sometimes the ovaries and fallopian tubes are also removed, which is called a bilateral salpingo-oophorectomy.
• A radical hysterectomy is an operation in which the cervix, uterus, and part of the vagina are removed. Lymph nodes in the area are also removed. This is called lymph node dissection. (Lymph nodes are small bean-shaped structures that are found throughout the body. They produce and store cells that fight infection).
• If the cancer has spread outside the cervix or the female organs, your doctor may take out the lower colon, rectum, or bladder (depending on where the cancer has spread) along with the cervix, uterus, and vagina. This is called an exenteration. Fortunately, this operation is rarely needed. You may need plastic surgery to make an artificial vagina after this operation.

Radiation therapy is the use of x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes into the area where the cancer cells are found (internal radiation). Radiation may be used alone or in addition to surgery.

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle inserted into a vein. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells outside the cervix.

Treatment by Stage

Treatments for cancer of the cervix depend on the stage of your disease, the size of your tumor, your age, your overall condition, and your desire to have children.

Treatment for cervical cancer during pregnancy may be delayed depending on the stage of your cancer and how many months you have been pregnant.

You may receive treatment that is considered standard based on its effectiveness in a number of patients in past studies, or you may choose to go into a clinical trial. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are going on in most parts of the country for most stages of cancer of the cervix. If you wish to know more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Stage 0 Cervical Cancer

Stage 0 cervical cancer is sometimes called carcinoma in situ.

Your treatment may be one of the following:

1.Conization.
2.Laser surgery.
3.Loop electrosurgical excision procedure (LEEP).
4.Cryosurgery.
5.Surgery to remove the cancerous area, cervix, and uterus (total abdominal or vaginal hysterectomy) for those women who cannot or no longer want to have children.

Stage I Cervical Cancer

Treatment may be one of the following depending on how deep the tumor cells have invaded into the normal tissue:

For stage IA cancer:

1.Surgery to remove the cancer, uterus, and cervix (total abdominal hysterectomy). The ovaries may also be taken out (bilateral salpingo- oophorectomy), but are usually not removed in younger women.
2.Conization.
3.For tumors with deeper invasion (3-5 mm): Surgery to remove the cancer, the uterus and cervix, and part of the vagina (radical hysterectomy) along with the lymph nodes in the pelvic area (lymph node dissection).
4.Internal radiation therapy.

For stage IB cancer:

1.Internal and external radiation therapy combined.
2.Radical hysterectomy and lymph node dissection with or without
radiation therapy.

Stage II Cervical Cancer

Your treatment may be one of the following:

For stage IIA cancer:

1.Internal and external radiation therapy combined.
2.Radical hysterectomy and lymph node dissection followed by radiation therapy.

For stage IIB cancer:

1.Internal and external radiation therapy combined.
2.Clinical trials of new forms of radiation therapy with or without
chemotherapy.

Stage III Cervical Cancer

Your treatment may be one of the following:

1.Internal and external radiation therapy combined.
2.Internal and external radiation therapy plus chemotherapy.
3.Clinical trials that include surgery to determine your stage of disease with removal of lymph nodes that are thought to contain cancer followed by external radiation therapy.

Stage III Cervical Cancer

Your treatment may be one of the following:

1.Internal and external radiation therapy combined.
2.Internal and external radiation therapy plus chemotherapy.
3.Clinical trials that include surgery to determine your stage of disease with removal of lymph nodes that are thought to contain cancer followed by external radiation therapy.

Stage IV Cervical Cancer

Your treatment may be one of the following:

For stage IVA cancer:

1.Internal and external radiation therapy combined.
2.Surgery to take out the lower colon, rectum, or bladder (depending on where the cancer has spread) along with the cervix, uterus, and vagina (exenteration).
3.Radiation therapy plus chemotherapy.
4.Clinical trials of surgery to determine your stage of disease followed by external radiation therapy.

For stage IVB cancer:

1.Radiation therapy to relieve symptoms such as pain.
2.Chemotherapy.

Recurrent Cervical Cancer

If the cancer has come back (recurred) in the pelvis, your treatment may be one of the following:

1.Surgery to take out the lower colon, rectum, or bladder (depending on where the cancer has spread) along with the cervix, uterus, and vagina (exenteration).
2.Radiation therapy and chemotherapy.

If the cancer has come back outside of the pelvis, you may choose to go into a clinical trial of systemic chemotherapy.

To Learn More

To learn more about cancer of the cervix, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, you can speak with someone who can answer your questions.

The Cancer Information Service can also send you booklets. The following booklet about cancer of the cervix may be helpful to you:

• What You Need To Know About Cancer of the Cervix

The following general booklets on questions related to cancer may also be helpful:

• What You Need To Know About Cancer
• Taking Time: Support for People with Cancer and the People Who Care About Them
• What Are Clinical Trials All About?
• Chemotherapy and You: A Guide to Self-Help During Treatment
• Radiation Therapy and You: A Guide to Self-Help During Treatment
• Eating Hints for Cancer Patients
• Advanced Cancer: Living Each Day
• When Cancer Recurs: Meeting the Challenge Again

There are many other places you can get information about cancer treatment and services to help you. You can check the social service office at your hospital for local and national agencies that help with your finances, getting to and from treatment, care at home, and dealing with your problems. The American Cancer Society, for example, has many free services. Their local offices are listed in the white pages of the telephone book.

You can also write to the National Cancer Institute at this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Source: National Cancer Institute

 Home  |  Help  |  Feedback  |  Privacy Policy  |  Register  |  Contact Us  |  Visitor Survey  |  Subscribe to HealthMail  |  Advertising  |  About MDAdvice.com

Copyright © The Online Medical Network Inc. All rights reserved. All material provided by MDAdvice.com is intended for informative purposes only and is not a substitute for professional medical advice. Please consult your physician with any questions or concerns you may have regarding your health. Use of this site indicates your agreement with the Terms of Use.