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What is cervical cancer?

Cervical cancer is a tumor that affects the cervix, which is the lower, narrow part of the uterus located between the bladder and the rectum. The cervix forms a canal that opens into the vagina, which leads to the outside of the body. In its earliest stage, cervical cancer is not likely to cause any symptoms, but advanced cervical cancer may cause symptoms such as irregular vaginal bleeding and pelvic pain. 

Our approach

At Northwell Health Cancer Institute, our multidisciplinary team of experts specialize in the most advanced treatments and technologies to treat early-stage, advanced and recurrent cervical cancers, including minimally-invasive and fertility-sparing techniques and targeted radiation therapies. Upon being referred to the Northwell Cancer Institute, you will undergo comprehensive tests and your team will develop a personalized cancer treatment program just for you.

If you have been diagnosed with cervical cancer, your oncologist will explain all your treatment options and create a treatment plan tailored to your specific needs and goals. Because every cervical cancer diagnosis is unique, the physicians providing your treatment will meet on an ongoing basis to share ideas and review every step of your care. Convenience is also a primary focus throughout your treatment.

Every effort is made to provide services in one location. From diagnosis through treatment, you’re in the capable hands of experts every step of the way.

Research at Northwell

As part of your cervical cancer treatment plan, you may have opportunities to participate in clinical trials. These trials study new chemotherapy drugs, radiation technologies and surgical approaches. While not every patient is a candidate for clinical trials, your care team will work with you to determine eligibility. Learn more about clinical trials at Northwell Health.

Symptoms

Cervical cancer often develops slowly over several years. In very early stages, it may not cause any symptoms. Cervical cancer can be detected with a Pap test, which is why it is crucial to get checked routinely based on your gynecologist’s recommendation.

In later stages, cervical cancer may cause a variety of symptoms, including:

  • Irregular vaginal bleeding
  • Bleeding after sexual intercourse
  • Pain during intercourse
  • Abnormal vaginal discharge
  • Bleeding after menopause
  • Pelvic, back or leg pain
  • Weight loss

If you have one or more these symptoms, it doesn’t necessarily mean you have cancer. Consult with your doctor to determine what is causing your symptoms.

Causes

Cervical cancer can develop from abnormal cells in the cervix. In the vast majority of cases, normal cells are transformed into abnormal cells by a high-risk human papillomavirus (HPV) infection. However, some cells are constantly undergoing change, and in rare cases normal cells can transform into abnormal cells during this natural process.

Risk factors

Some factors can increase your risk of cervical cancer, including:

  • Ongoing HPV infection
  • Unprotected sex
  • Multiple partners
  • Smoking
  • Impaired immune system

Diagnosis

The first step to diagnosing any cancer, including cervical cancer, is usually a physical exam. A doctor will check your overall physical health while considering medical history, cervical cancer risk factors and any related medical or precancerous conditions. 

If your doctor suspects that you might be experiencing cervical cancer symptoms, you will be referred to a specialist who can give an accurate cervical cancer diagnosis.

Diagnostic tests for cervical cancer, as well as other gynecological cancers, usually include an examination of the vulva, vagina, cervix, uterus, ovaries, fallopian tubes and rectum. Your doctor may use a speculum, a tool that holds open the sides of the vagina, to examine the cervix.  

A Pap test may be performed to screen for cervical cancer. During a Pap test, your doctor or nurse scrapes a sample of cells from the outside of the cervix. The cells are then examined under a microscope in a lab. An HPV test uses the same cell sample and may be performed at the same time as a Pap test.

Some common tests for diagnosing cervical cancer include:

  • HPV DNA and HPV RNA testing to diagnose cervical cancer—To determine if you are at higher risk for the development of cervical precancer and cancer, Pap tests are combined with additional testing to detect strains of HPV that are most likely to cause invasive cervical cancer.
  • The ThinPrep imaging system—Northwell Health utilizes the ThinPrep Imaging System for cervical cancer screening. The system combines revolutionary imaging technology with human interpretive expertise to improve cervical cancer screening efficiency and performance.
  • Biopsy to diagnose cervical cancer—A biopsy is an important step in diagnosing cervical cancer. During a biopsy, usually an outpatient procedure, a small amount of tissue is removed by your doctor and sent to a lab for examination.

Types of biopsies to diagnose cervical cancer include:

  • Punch biopsy—A punch biopsy uses a small tool that pinches off small samples of tissue in specific areas.
  • Loop electrosurgical excision procedure (LEEP) biopsy—A LEEP biopsy uses an electric (but low-voltage) wire loop to obtain a piece of tissue that will be examined in a lab.
  • Cold knife cone biopsy—A cold knife cone biopsy is similar to a LEEP cone biopsy, but the tool used is a surgical scalpel.
  • Colposcopy—A colposcopy uses a tool that resembles a microscope with a bright light to examine the cervix for abnormal tissues and direct the biopsy.
  • Endocervical curettage—An endocervical curettage, which is usually performed in conjunction with a colposcopy, uses a narrow instrument called a curette to scrape the lining of the cervical canal.

Treatment types

Your treatment for cervical cancer depends on the type and stage of your cancer. Your treatment may be a single therapy or a combination of therapies that include surgery, radiation therapy and chemotherapy. Upon diagnosis, your care team will recommend treatment options based on your specific needs and goals.

There are several types of treatment for cervical cancer. For cervical cancer that hasn’t spread beyond the cervix, these surgical procedures are often used:

  • Conization—A cone biopsy to remove all of the abnormal tissue
  • LEEP—the use of an electrical current passed through a thin wire hook to remove cancerous tissue
  • Radical trachelectomy—Removal of just the cervix
  • Hysterectomy—Removal of the uterus and cervix

If cervical cancer has spread beyond the cervix, removal of the uterus, vagina, lower colon, rectum or bladder may be necessary.

Other treatments include: 

  • Chemotherapy—For early stage cervical cancer, a combination of radiation therapy and low-dose chemotherapy is often used to destroy any cancer that remains after surgery. Chemotherapy is also used in higher doses if cervical cancer is recurrent or has spread beyond the pelvis.
  • Radiation therapy—The most common type of radiation treatment for cervical cancer is external-beam radiation therapy, given from a machine outside the body. Radiation therapy may be given alone before surgery to shrink a tumor. It also is used in conjunction with chemotherapy following cervical cancer surgery.

Living with

  • Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You may get medicine for nausea and vomiting if you have these side effects.
  • Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss. Drink liquid meal replacements for extra calories and protein. Try to eat your main meal early.
  • Get some physical activity every day, but do not get too tired. Keep doing the hobbies you enjoy as your energy allows.
  • Take steps to control your stress and workload. Learn relaxation techniques.
    • Share your feelings. Stress and tension affect our emotions. By expressing your feelings to others, you may be able to understand and cope with them.
    • Consider joining a support group. Talking about a problem with your spouse, a good friend, or other people with similar problems is a good way to reduce tension and stress.
    • Express yourself through art. Try writing, dance, art, or crafts to relieve tension. Some dance, writing, or art groups may be available just for people who have cancer.
    • Be kind to your body and mind. Getting enough sleep, eating a healthy diet, and taking time to do things you enjoy can contribute to an overall feeling of balance in your life and help reduce stress.
    • Get help if you need it. Discuss your concerns with your doctor or counselor.
  • If you are vomiting or have diarrhea:
    • Drink plenty of fluids (enough so that your urine is light yellow or clear like water) to prevent dehydration. Choose water and other caffeine-free clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
    • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
    • Take care of your urinary tract to prevent problems such as infection, which can be caused by cervical cancer and its treatment. Limit drinks with caffeine, drink plenty of fluids, and urinate every 3 or 4 hours.
  • If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.
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