Cervical cancer

Overview

Cervical cancer is a tumor that affects the cervix, which is the lower, narrow part of the uterus (womb) 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 as it advances, cervical cancer may cause symptoms such as irregular vaginal bleeding and/or pelvic pain. 

Causes and risks

Abnormal cells in the cervix cause cervical cancer. 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.

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

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

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

Diagnosis and testing

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 at Long Island Jewish Medical Center to diagnose cervical cancer — 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.

Multidisciplinary cervical cancer treatment

Highlights of cervical cancer treatments and services include:

  • The latest technology to diagnose and treat early-stage, advanced and recurrent cervical cancers
  • The latest surgical innovations with an emphasis on minimally invasive and fertility-sparing techniques
  • Innovative cervical cancer treatments, including targeted therapies
  • An extensive clinical trials program

Each cervical cancer diagnosis is unique, so our team meets regularly to discuss the individual treatment approach for your specific case. Physicians participate in weekly multidisciplinary treatment planning conferences allowing specialists to share ideas and best practices for delivering the optimal treatment. Each phase of your treatment is reviewed to ensure that treatment milestones are reached.

From the moment you are diagnosed with cervical cancer to remission, your specialist will keep you informed of your options and answer any questions or concerns you or your family may have. 

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