Cervical cancer is when malignant cells are found in the cervix (the neck of the uterus). It is associated with the human papilloma virus (HPV), a virus that is transmitted by sexual contact. Every sexually active woman can get HPV, although consistent condom use can reduce the risk of getting the virus.
Women who are most at risk from this type of cancer are those with multiple sexual partners, those who have had several children (the more children who are born, the greater the chance), smoking, taking immuno-suppressant medication or having an immune deficiency, as well as women who have been taking the contraceptive pill for more than five years.
If a woman is in one of the at risk categories, she can choose to have a HPV test to assess her actual risk of developing cancer. Rather than worrying unnecessarily, this test will be able to identify whether she has the HPV virus in her body. Based on that information she can have closer monitoring if she wants it.
Symptoms of cervical cancer are:
If any woman experiences any unusual vaginal bleeding or pain, they should have a gynaecological check up. Abnormal bleeding is common and usually down to something else, such as an infection, but because it does have some rare and serious causes, it is worth getting an examination to rule them out or so that treatment can begin quickly.
During a pelvic examination, the external genitals will be checked for signs of infection. A speculum will then be inserted into the vagina to hold it open so that the vaginal canal and the cervix can be observed. A small sample of cells can be removed from the cervix (a smear test). These can be analysed to see if they contain pre-cancer or cancerous cells.
An ultrasound scan can provide a view inside the uterus so that the source of any unexpected bleeding is identified. For a closer look, the scan can be performed trans-vaginally using a probe to give a better picture.
If a woman’s smear test results are abnormal or inconclusive and cancer is suspected, this can be confirmed via a colposcopy. This is a more detailed examination of the cervix in which a colposcope (a small microscope with a light on the end) is used to look at the cervix. A biopsy (removal of a small amount of tissue) can then be carried out. The tissue can be studied under a microscope for the presence of cancer.
Cervical cancer is treated by hysterectomy (removal of the uterus) and radiotherapy or chemotherapy. For women who are of child-bearing age who would still like to preserve their fertility, an operation called a radical trachelectomy can be done as an alternative to a full hysterectomy. This is normally only possible if the woman’s cancer is detected at a very early stage – another reason why timely gynaecological appointments and regular smear tests are vital.
A radical trachelectomy is a surgical procedure to remove the cervix and the upper vagina. The uterus is then stitched to the remaining portion of the vagina.