Cervical cancer develops in the cells that line the cervix, a cylinder-shaped connective tissue situated between the vagina and the uterus. The cervix has two parts: the exocervix, which is located at the top of the vagina and covered in squamous cells, and the endocervix, which is located at the bottom of the uterus and covered in glandular cells. The junction of the two cell types is known as the transformation zone, which is where the majority of cervical cancers begin.
Most cervical cancers develop gradually after normal cells in the transformation zone undergo precancerous changes. However, not all precancerous cells progress into cervical cancer. What’s more, when precancerous cells are detected and treated early, cervical cancer can often be prevented or cured.
How can cervical cancer be detected early?
The most common screening test for cervical cancer is a Pap smear, which is highly effective for detecting precancerous and cancerous cells in the cervix, often before noticeable symptoms occur. Therefore, Pap smears are recommended for many women and are usually performed at regular intervals determined by a physician.
Nearly all cervical cancers are caused by human papillomavirus (HPV), which is a sexually transmitted infection. Certain strains of HPV can trigger cellular DNA changes in the cervix that lead to the development of a tumor. As such, HPV testing also plays an important role in the early detection of cervical cancer and may be recommended for some women along with regular Pap smears.
What does cervical cancer feel like?
The cervix is shaped like a tiny donut, and it is possible to feel it by gently inserting one or two fingers about 3 to 5 inches into the vagina. A healthy cervix should feel smooth and firm—similar to the cartilage at the tip of the nose—with a slight indentation in the center. A possible warning sign of cervical cancer is a rough or bumpy cervix, which should be discussed with a physician. Most bumps on the cervix are benign (noncancerous) growths, such as polyps or cysts. For instance, nabothian cysts are common, harmless bumps that form when skin cells trap mucus inside the glands in the cervix. But only a physician can determine whether a bump or another cervical abnormality is caused by cancer.
An early-stage cervical tumor cannot be felt from outside the body by pressing on the stomach. However, advanced cervical cancer that has spread to the liver can cause stomach swelling due to fluid buildup (ascites).
Cervical cancer can sometimes cause a dull backache or a vague sensation of pressure or heaviness in the pelvis. However, any discomfort associated with an early-stage tumor may be very mild or even unnoticeable. As the cancer progresses and spreads to nearby tissues and organs, more pronounced pain may develop, particularly during urination and sexual intercourse. Over time, the pelvic pain may become continuous.
As a cervical tumor grows, it may begin to press on sensitive nerves in the pelvic wall, which can cause leg pain and swelling. Leg swelling on its own can have many causes unrelated to cancer, but if it is accompanied by persistent leg pain—which may be dull or sharp—it could be a warning sign of cervical cancer.
What does cervical cancer smell like?
While some vaginal odor is normal, a strong, persistent smell could be a sign of a health issue, such as a bacterial infection or, in rare cases, cancer. A tumor needs a steady supply of oxygen to survive and grow. If a cervical tumor does not receive enough oxygen, some cancerous cells may die off and infect the tumor. The infection can produce a foul-smelling vaginal discharge, which may contain pieces of tissue or necrotic material. Some people liken the smell of an ulcerating cervical tumor to that of rotting meat.
How to know if you have cervical cancer
Cervical cancer does not have many distinctive warning signs. Usually, the first symptoms appear at later stages and only after abnormal cells in the cervix build up, bind together and form tumors. At that point, a woman may begin to experience:
- Unexplained vaginal bleeding, which may occur between menstrual periods or after sexual intercourse, a pelvic examination or menopause
- Unusual vaginal discharge, which may be odorous, thick or watery, pale or brown or tinged with blood
- Pain during sexual intercourse
- Pelvic or low back pain
- Difficulty urinating
- Swollen legs
Many of the early signs of cervical cancer can also be caused by other, less serious medical conditions, such as a urinary tract infection or uterine fibroid, as well as conditions that affect other parts of the body. Therefore, it is important to promptly discuss any unusual changes with a physician. In addition to avoiding a misdiagnosis, that is the best way to ensure an optimal outcome and quality of life.
Symptoms of cervical cancer after menopause
In general, the risk of developing any type of cancer increases with age. As such, a woman who has gone through menopause—which occurs when her ovaries stop releasing eggs—has a greater chance of developing cancer simply because she is older. However, among women in the United States, the average age at the time of a cervical cancer diagnosis is 50. Therefore, researchers believe the overall risk of cervical cancer may decline after menopause.
With that said, older women need to be aware that some of the symptoms of menopause can mimic the symptoms of cervical cancer. For this reason, all post-menopausal women should learn about the similarities and differences in symptoms and promptly discuss any “red flag” with a physician instead of simply attributing it to menopause.
Early-stage cervical cancer often does not produce noticeable symptoms, which underscores the importance of cervical cancer screening for women of all ages. When symptoms do occur, one of the most common signs is abnormal vaginal bleeding. Therefore, bleeding after menopause—especially if many months or years have passed since the last menstrual period—is a warning sign of cervical cancer that should not be ignored.
Benefit from nationally recognized expertise at Moffitt Cancer Center
If you would like to discuss your cervical cancer symptoms with a specialist in the gynecological clinic at Moffitt Cancer Center, you can request an appointment by calling 1-888-663-3488 or completing our new patient registration form online. We provide every new patient with rapid access to a cancer expert within one day, which is faster than any other cancer hospital in the nation. If you are diagnosed with cervical cancer, we will help you get started on a personalized treatment plan as soon as possible.