What is cervical cancer?
Cervical cancer is a type of cancer that develops in a woman’s cervix, the opening to her uterus. Though cervical cancer is fairly uncommon - in 2012, 919 women died from cervical cancer, while 11,643 died from breast cancer - and has a good rate of survival, especially if caught early enough, it is still important for women to familiarise themselves with the disease and its symptoms.
The majority of cervical cancer cases are caused by two strains of the human papillomavirus: types 16 and 18. HPV is generally contracted during sexual intercourse, meaning that most women will only be at risk of cervical cancer if they are sexually active. The NHS offers free cervical smear tests - which detect abnormal cells on the cervix, and therefore can indicate the presence of cells which may become cancerous - for any women over the age of 25 (or 20 in Scotland).
It is important to note that even if abnormal cells are found on your cervix, this does not necessarily mean that you a) have cervical cancer, or b) will ever develop cervical cancer. Some women can contract a strain of HPV that is known to cause cervical cancer and never suffer ill health as a result.
However, if you are between cervical smear tests or are below the age limit to have one, you should familiarise yourself with cervical cancer symptoms and seek medical advice if you recognise them in yourself.
You can also help to protect yourself by getting vaccinated with Cervarix or Gardasil, both of which can prevent the contraction of the relevant strains of HPV.
How many types of cervical cancer are there?
There are two main types of cervical cancer, named after the kinds of cell that become cancerous:
- squamous cell cancer - squamous cells are flat, skin-like cells that cover the outer surface of the cervix. Squamous cell cancer makes up 70 to 80% of all cervical cancer cases.
- adenocarcinoma - adenomatous cells are mucus-producing glands that sit in the passageway from the cervix to the womb. Adenocarcinoma makes up 10 to 15% of cervical cancer cases and can be more difficult to detect.
In rare cases, other types of cancer such as lymphoma can occur in the cervix.
What are the symptoms of cervical cancer?
First off, it is important to note that the two types of HPV that cause most cases of cervical cancer typically have no symptoms. For this reason, it is not possible to detect on your own whether or not you may have contracted one of these strains.
Similarly, in its early stages, cervical cancer does not always have symptoms. However, some indications can include:
- vaginal bleeding after sex
- vaginal bleeding between periods
- vaginal bleeding after the menopause
- unusual vaginal discharge (i.e. unpleasant smelling, or bloody)
Some women also experience pain or discomfort during sex, but as an isolated symptom this can point to many different problems or conditions - therefore it is not always an indicator of cervical cancer specifically.
If you are having any unusual vaginal bleeding, such as the three types listed above, then you should visit your GP for advice. As with pain during sex, vaginal bleeding is not always a symptom of cervical cancer (it can often be caused by a urinary tract infection or the sexually transmitted infection chlamydia), however it can still be cause for concern.
Even if you are experiencing none of the symptoms listed above, it is still important to attend your scheduled smear tests - you may have ‘dangerous’ cells, which have the potential to become cancerous, and simply be unaware of it.
Symptoms indicating the spread of cervical cancer
If the cancerous cells spread into the surrounding tissue and organs (including the bladder, bowel and liver) this can lead to other symptoms.
Symptoms of this spread can include:
- bloody urine
- unusual changes to your bowel movements
- bone pain
In some cases, a tumour on the cervix can block and interfere with your kidney function, leading to swelling and thus severe pain in your back and sides.
Again, these symptoms in isolation do not necessarily point to cancer, however it is still important to visit your doctor if you have any concerning symptoms.
How is cervical cancer diagnosed?
If abnormal cells are found on the cervix during a smear test, or if you have unusual symptoms (such as vaginal bleeding) or a growth in the surrounding area, then it is very likely that you will be referred to a gynaecologist. In the case of abnormal bleeding, your doctor may want to first have you tested for other conditions such as chlamydia.
If your doctor suspects that the abnormal cells in your cervix have the potential to become cancerous, they may carry out a colposcopy, in which a small microscope is inserted into the vagina. This allows the doctor to examine the cervix more closely. They may also remove a small amount of tissue to check it for cancerous cells.
A cone biopsy is another way to check for cervical cancer. It is a minor operation carried out under local anaesthetic that involves cutting out a small, cone-shaped area of your cervix and testing it for cancerous cells.
If cancerous cells are found in your cervix, then it is likely that other tests will need to be carried out to determine whether the cancer has spread to surrounding tissue and organs.
What should I do if I am experiencing cervical cancer symptoms?
If you are experiencing unusual vaginal bleeding, you should always visit your doctor for advice. Bleeding does not necessarily indicate cervical cancer, but it is one of the recognised symptoms. It could also point towards other serious conditions such as:
- cancer of the womb
- cancer of the ovaries
- ectopic pregnancy or miscarriage
- endometritis (inflammation of the womb lining)
How can I protect myself against cervical cancer?
There is no sure-fire way to avoid contracting cervical cancer, however being vaccinated with Gardasil 9 has been proven to effectively prevent the contraction of HPV strains 6, 11, 16, 18, 31, 33, 45, 52 and 58. Being vaccinated after contracting HPV is very unlikely to give any protection against cervical cancer.