Cervical cancer develops in a woman’s cervix, which is the passageway that connects the lower part of the uterus to the vagina and, along with the vagina, forms the birth canal. This type of gynecological cancer begins with abnormal changes in the healthy cells that line the cervix. If left untreated, the abnormal cells may begin to grow uncontrollably, bind together and form cancerous tumors on the cervix.
When detected early, cervical cancer can often be prevented or successfully treated. Therefore, having regular screenings for cervical cancer, such as routine Pap smears, is the most important step a woman can take to protect herself against cervical cancer. A Pap smear can detect precancerous abnormal cells on the cervix as well as early-stage cervical cancer.
Signs & symptoms
Early-stage cervical cancer does not usually produce symptoms. As the cancer progresses and spreads beyond the cervix, symptoms may start to become noticeable. Some common signs of cervical cancer, which can vary depending on the organs and tissues affected, include:
- Light bleeding or spotting in between menstrual periods
- Menstrual bleeding that is heavier than normal
- Menstrual periods that are longer in duration than usual
- Vaginal bleeding after sexual intercourse or a pelvic examination
- Unusual vaginal discharge
- Pain during sexual intercourse
- Vaginal bleeding after menopause
- Persistent pelvic or low back pain
It is important to understand that many cervical cancer symptoms can also be caused by other, less serious conditions, such as infection. Therefore, the best course of action is to promptly discuss any unusual changes with a physician who can provide a proper diagnosis and appropriate treatment, if necessary.
The human papillomavirus (HPV)—a very common sexually transmitted infection—is the leading cause of cervical cancer. However, there are more than 200 types of HPV, and the majority are harmless and resolve on their own. Only a few high-risk strains of HPV, including HPV-16 and HPV-18, can persist and cause healthy cells in the cervix to undergo abnormal changes and become cancerous.
Usually, a healthy immune system will effectively target and destroy any type of HPV—including the high-risk strains—within a few months. However, individuals with a weakened immune system who are exposed to HPV have a heightened risk of developing cervical cancer. The immune system may be weakened due to a primary or acquired immune deficiency, an allergic reaction, an autoimmune condition, tobacco use or excessive consumption of alcoholic beverages.
The two main types of cervical cancer, which can be distinguished by the appearance of the cancerous cells when viewed under a microscope, are:
- Squamous cell carcinoma – Accounting for approximately 80% of all cervical cancers, squamous cell carcinomas originate in the thin, flat, skin-like cells that line the bottom of the cervix.
- Adenocarcinoma – Accounting for approximately 20% of all cervical cancers, adenocarcinomas develop in the glandular, mucus-producing cells that line the upper portion of the cervix.
In some cervical cancer cases, both squamous and glandular cancer cells are found. These relatively uncommon cancers are known as adenosquamous carcinomas. Very rarely, other types of cancer can develop in the cervix, such as small cell cancers, lymphomas and sarcomas. Another type of cervical cancer is metastatic cervical cancer, which begins in the cervix and spreads to other parts of the body.
After cervical cancer is diagnosed, a physician will typically order one or more tests, such as a biopsy or imaging scan, to determine whether cancerous cells have spread within the cervix or to other parts of the body. The information gathered from this process, which is known as cervical cancer staging, is used to plan treatment.
The main stages of cervical cancer are:
- Stage 0 – Also known as carcinoma in situ, stage 0 cervical cancer is characterized by the presence of precancerous abnormal cells on the surface of the cervix.
- Stage 1 – Cancerous cells have advanced beyond the surface of the cervix and grown into deeper layers of cervical tissue, the uterus or nearby lymph nodes.
- Stage 2 – Cancerous cells have spread beyond the cervix and uterus but not into the lower third of the vagina or the pelvic wall.
- Stage 3 – Cancerous cells have reached the lower third of the vagina or the pelvic wall.
- Stage 4 – Cancerous cells have invaded the bladder or rectum or spread beyond the pelvis.
Moffitt's approach to treating cervical cancer
At Moffitt Cancer Center, our gynecological clinic provides comprehensive care for patients with cervical cancer and other gynecologic cancers in a single location. Our multispecialty team includes doctors and experts from all disciplines, including gynecologic oncology, radiology, pathology, radiation oncology, plastic surgery, nursing and social work. During a weekly interactive session, or tumor board review, this cohesive team meets to discuss each new patient’s treatment plan.
Using evidence-based clinical pathways, our multispecialty team identifies the specific needs of each patient and her family and then uses that knowledge—along with the latest diagnostic tools and technology—to create a highly individualized treatment plan.
The gynecological clinic at Moffitt offers the very latest cervical cancer treatments, including:
- Radiation therapy
- Surgical procedures of wide-ranging complexity, from common surgeries to the latest robotic-assisted procedures
Our cervical cancer services are available to patients at every step of the cancer journey, including those who:
- Have not been diagnosed but are interested in regular screenings for cervical cancer
- Are newly diagnosed with cervical cancer
- Would like a second or third opinion regarding a cervical cancer diagnosis or treatment plan
- Are experiencing a recurrence of cervical cancer and would like to consult with a new physician
- Require a complex surgical procedure
- Have other conditions that may complicate cervical cancer treatment
- Are experiencing difficulties in finding appropriate care
As a National Cancer Institute-designated Comprehensive Cancer Center, Moffitt performs extensive research and has a robust portfolio of clinical trials. We are proud of the progress we have made to date, and we continue to make great strides in redefining how cervical cancer and other gynecological cancers are diagnosed and treated.