A rare cancer with symptoms often solely being vaginal spotting or bleeding. An accurate, efficient diagnosis is key to treatment.
What is cervical cancer?
Cervical cancer is a rare cancer of the cervix, which is the lowest part of the uterus and connects the uterus with the vagina. Often, vaginal spotting or abnormal bleeding is the only symptom. A quick, precise diagnosis is the first step to developing an effective treatment plan.
A cervical cancer diagnosis can be overwhelming. At the AHN Cancer Institute, we have extensive experience diagnosing and treating this rare cancer. You can expect personalized treatment and support throughout all aspects and steps in your care.
At the Cancer Institute, our focus is on patient-centric, cutting edge, interdisciplinary cancer care. You typically meet with your devoted oncology team within three days of your diagnosis. We review every aspect of your diagnosis and discuss a treatment plan with you, which we implement right away.
Throughout treatment, you regularly meet with your dedicated AHN care team to monitor your progress and response to treatment, and determine if a change in treatment is needed.
At AHN, we want to ensure our patients’ whole health is taken into consideration. That means catering to your emotional needs after diagnosis. We know the logistics of cancer treatment can be daunting, and we are here to support you by providing you access to:
- Navigation Team: The Navigation Team coordinates appointments, answers questions, and provides guidance. Learn more about the Navigation Team.
- Social workers: An oncology social worker helps patients and families cope with the emotional aspects of living with cancer. There are opportunities to be connected to a financial navigator who can help you manage the financial impact of cancer treatment.
- Support services: We provide a range of support services to treat the whole person, such as support groups and palliative care. Find out more about support services.
AHN Gynecologic Oncology Center of Excellence
The AHN Gynecologic Oncology Center of Excellence is a specialized center dedicated to the comprehensive care and treatment of gynecologic cancers and complex gynecologic conditions. We focus on cancer care from diagnosis to treatment to ringing the bell. We collaborate with specialists within the cancer center and hospital system for customized treatment plans and exceptional care.
Why choose AHN for cervical cancer treatment?
At the Cancer Institute, we take a collaborative approach to your care. You meet with a devoted team of cancer specialists, typically within three days of diagnosis. Your team quickly works to design a treatment plan for you. We meet routinely to discuss your progress and determine if we need to change the treatment plan to better meet your needs. At the Cancer Institute, you can expect:
- Patient-centered care: We meet with you and your family to discuss the details of your treatment plan, so you feel confident and informed. You’ll see the same team of physicians throughout your care. Your doctors get to know you, your family, and your personal preferences. We also offer robust support services to keep you living the best quality of life during treatment.
- Sophisticated treatment: Your specific treatment will largely depend on if, and how far, the cancer has spread. We offer an array of options to stop the cancer in its tracks. Treatments may include surgery, radiation therapy, and chemotherapy, alone or in combination.
- Access to clinical trials: We participate in many clinical trials, keeping you at the forefront of the latest treatment options.
Cervical cancer symptoms and signs
Cervical cancer often doesn't cause noticeable symptoms in its early stages. The most common sign is abnormal vaginal bleeding. It can include bleeding between periods, heavier or longer periods than usual, or bleeding after sexual intercourse, douching, or a pelvic exam. Bleeding after menopause is also a potential sign. Abnormal bleeding doesn’t necessarily indicate cervical cancer, as it can be a symptom of other health conditions. This is why regular screening (Pap smear and HPV testing) is so important. Other symptoms and signs of cervical cancer can include:
- Unusual vaginal discharge: The discharge may be copious, watery, thick, and/or have a foul odor.
- Pelvic pain: Pain in the pelvic region, which can be persistent or intermittent.
- Pain during intercourse: Discomfort or pain during sexual intercourse.
- Leg pain: Pain in one or both legs, and leg swelling can be a sign of cervical cancer.
- Changes in bowel or bladder habits: This might include blood in the urine or stool, or difficulty urinating or having a bowel movement.
- Back pain
- Fatigue
- Unexplained weight loss
Causes and risk factors
The vast majority of cervical cancer is caused by persistent infection with certain high-risk types of human papillomavirus (HPV). HPV is a common virus that spreads through skin-to-skin contact, most often during sexual activity. In most cases, the body clears HPV infection on its own. However, if a high-risk HPV infection persists, it can cause changes in the cervical cells over time that may lead to cancer. There are many different types of HPV. HPV types 16 and 18 cause about 70% of cervical cancers. Other risk factors for developing cervical cancer include:
- HPV infection: As mentioned above, this is the primary cause and therefore the most significant risk factor.
- Smoking: Smoking damages the DNA of cervical cells and makes them more likely to develop cancer if infected with HPV.
- Weakened immune system: Conditions that weaken the immune system, such as HIV/AIDS, or medications that suppress the immune system (e.g., after an organ transplant), increase the risk of HPV infection becoming persistent and leading to cervical cancer.
- Chlamydia infection: Some studies have suggested a link between Chlamydia infection and an increased risk of cervical cancer. It's not fully understood why.
- Long-term use of oral contraceptives (birth control pills): Long-term use (five years or more) has been linked to a slightly increased risk. The risk appears to decrease after stopping oral contraceptives.
- Having multiple sexual partners: Increases the risk of HPV infection.
- Becoming sexually active at a young age: Increases the risk of HPV infection.
- History of sexually transmitted infections (STIS): Increases the risk of HPV infection.
- Multiple pregnancies: The reason for this link is not fully understood.
- Family history of cervical cancer: Having a mother or sister who had cervical cancer may slightly increase your risk.
- Diethylstilbestrol (DES) exposure: Women whose mothers took DES during pregnancy (between the 1940s and 1971) have an increased risk of a rare type of cervical cancer called clear cell adenocarcinoma.
- Lack of regular Pap tests (cervical screening): Regular Pap tests can detect precancerous changes in the cervix, allowing for early treatment and prevention of cancer.
Cervical cancer screening and diagnosis
Our oncology team has in-depth experience diagnosing cervical cancer. We offer the latest testing options, including Pap tests, colposcopy with biopsies, and cervical excisional procedures such as loop electrosurgical excision procedure (LEEP) or cold knife conization (CKC) to make a rapid diagnosis. We also offer cutting-edge screening programs for cervical cancer by testing for the human papillomavirus (HPV), which causes cervical cancer.
Our cancer specialists have the expertise to get you the right diagnosis so you can begin treatment. We diagnose cervical cancer by examining your cervix for abnormal cells. Initial tests for cervical cancer include:
- Pap test or Pap smear: This diagnostic screening involves analyzing the fluids collected from your cervix. We use it to detect changes that may be cancerous or may lead to cancer.
- Colposcopy: For this test, we use a specialized lighted magnifying scope to examine an area of abnormal tissue on your cervix, vagina, or vulva. Directed biopsies may be taken of the abnormal areas of tissue.
- Cervical excisional procedures: Options include a loop electrosurgical excision procedure (LEEP), where we use an electric wire loop to obtain a piece of tissue, or a cold knife conization (CKC) procedure where we remove a wedge-shaped piece of cervix with a blade. We then examine the tissue under a microscope to look for abnormal cells.
Once we have diagnosed cervical cancer, a team of experts will review your results and formulate a personalized treatment plan. Treatment options could include surgery, radiation therapy, or systemic therapy, such as chemotherapy and immunotherapy.
Types and stages of cervical cancer
Cervical cancer begins when cells in the cervix undergo changes that cause them to grow and multiply uncontrollably. There are several types of cervical cancer, with the most common types being:
- Squamous cell carcinoma: This is the most common type, accounting for about 80% to 90% of cervical cancers. It starts in the squamous cells, which are the thin, flat cells that line the outer surface of the cervix (the ectocervix). Squamous cell carcinomas are often associated with HPV (human papillomavirus) infection.
- Adenocarcinoma: This type accounts for about 10% to 20% of cervical cancers. It develops from the glandular cells that produce mucus in the lining of the cervical canal (the endocervix). Like squamous cell carcinoma, adenocarcinomas are often linked to HPV infection.
Once the type of cervical cancer is diagnosed, the oncologist will determine what stage the cancer is at. The staging is based on physical exams, imaging tests (like CT scans, MRI, and PET scans), and sometimes surgical findings. This will help your care team decide what treatment is best. The staging system used for cervical cancer is the FIGO (International Federation of Gynecology and Obstetrics) staging system. The staging describes the extent of the cancer's spread. Here’s a breakdown of cervical cancer staging:
- Stage 0 (Carcinoma in situ): Cancer cells are present only in the surface layer of the cervix. This is a precancerous condition. It is also called high-grade squamous intraepithelial lesion (HSIL) or adenocarcinoma in situ (AIS).
- Stage 1: Cancer is confined to the cervix.
- Stage 2: Cancer has spread beyond the cervix but has not reached the pelvic wall or the lower third of the vagina.
- Stage 3: Cancer has spread to the pelvic wall and/or the lower third of the vagina, and/or causes kidney problems due to blockage of the ureters (tubes that carry urine from the kidneys to the bladder), and/or involves pelvic lymph nodes.
- Stage 4: Cancer has spread beyond the pelvis or to distant organs.
Cervical cancer treatment
The specialists at the Cancer Institute treat cervical cancer with the latest technologies, so you are receiving the most effective care possible. You often begin treatment shortly after diagnosis. The type of treatment will be tailored to your specific cancer case, its progression, and your overall health. Your care team is here to help and deliver the cancer treatment you need.
Our goal is to treat cancer in the most effective way possible while aiming to minimize side effects from therapy.
Surgery
For some patients with early-stage cervical cancer, treatment may begin with surgery to remove the cancer along with the uterus, cervix, fallopian tubes, and potentially the ovaries (also called a hysterectomy). In some situations, surgical removal of lymph nodes will be required. This is all dependent on the stage of the cancer. The type of hysterectomy and manner in which surgery is performed (minimally invasive versus open approach) is highly dependent on the specific details of your cancer and the recommendations of your gynecologic oncologist.
Radiation therapy
Our radiation oncologists are specifically trained in gynecologic cancer care, so they’re highly skilled at treating cervical cancer aggressively and efficiently. Our radiation oncology program is the only one in western Pennsylvania that offers treatment centers accredited by both the American Society for Radiation Oncology and American College of Radiology. These accreditations mean that the Cancer Institute’s facilities meet specific guidelines for patient safety, quality control, and efficiency of equipment.
Chemotherapy
These medicines directly kill cancer cells, much like antibiotics kill bacteria. Because the medicines also damage normal cells, side effects can occur, such as hair loss, nausea, or lowered blood counts. Fortunately, the body’s normal cells are more resilient and recover much better than cancer cells, so the side effects are usually temporary. We monitor you carefully and calculate your dose of chemotherapy to maximize effectiveness and minimize side effects. Our oncology social workers and a Navigation Team are available to answer questions and provide support.
Cervical cancer treatment could include low-dose chemotherapy designed to strengthen radiation treatments, or the use of chemotherapy alone or in combination with immunotherapy.
Some chemotherapy drugs can damage the ovaries, leading to temporary or permanent infertility. The risk depends on the specific drugs used, the dose, and the patient's age. Chemotherapy can also cause menopausal symptoms like vaginal dryness, hot flashes, and decreased libido, which can impact sexual function.
Clinical trials
Our oncology team meets monthly to discuss new clinical trials, ensuring you have access to the latest treatment options. Ask your gynecologic oncologist or medical oncologist for more information about active or upcoming clinical trials. The availability of a clinical trial is dependent on your cancer type and how advanced it is.
Fertility preservation for women
Certain treatments for cervical cancer can affect your fertility and damage your eggs. If you wish to preserve your fertility, your oncology team, as well as AHN’s high-risk pregnancy doctors and fertility treatment specialists at our Center for Reproductive Medicine, can discuss these options with you:
- Surgical removal of the cervix: This hysterectomy alternative, called a radical trachelectomy, may help women with early-stage cervical cancer keep their uterus.
- Egg banking: This procedure involves harvesting and freezing (cryopreservation) unfertilized eggs for later use in conception.
- Embryo banking: This procedure freezes fertilized embryos for later use in conception.
Cervical cancer FAQs
A cervical cancer diagnosis can bring about a lot of questions and it might feel overwhelming. Your AHN care team is here to help and will be your resource to find answers. To get started, we’ve compiled some frequently asked questions that patients usually have that you can use in your conversations with your care team.
Is cervical cancer deadly?
Cervical cancer can be deadly, but the prognosis is much better when it's detected and treated early. Regular screening through Pap tests and HPV testing is crucial for early detection.
How do you get cervical cancer?
Most cases of cervical cancer are caused by persistent infection with certain types of human papillomavirus (HPV). HPV is a common virus that spreads through sexual contact. While many people clear HPV infections on their own, some high-risk types can lead to cell changes that can eventually develop into cervical cancer.
How to prevent cervical cancer?
There are several ways to help prevent cervical cancer:
- HPV vaccination: Vaccination against HPV is highly effective in preventing infection with the types of HPV that cause most cervical cancers. It's recommended for both girls and boys, ideally before they become sexually active.
- Regular screening: Regular Pap tests and/or HPV tests can detect precancerous cell changes, allowing for early treatment and preventing cancer from developing.
- Safe sex practices: Using condoms during sexual activity can reduce the risk of HPV transmission.
- Avoid smoking: Smoking weakens the immune system and increases the risk of cervical cancer.
How to know if you have cervical cancer?
In its early stages, cervical cancer may not cause any symptoms. As it progresses, symptoms can include:
- Abnormal vaginal bleeding (between periods, after intercourse, or after menopause)
- Unusual vaginal discharge
- Pelvic pain
It's important to note that these symptoms can also be caused by other conditions. If you experience any of these symptoms, it's crucial to see a doctor for evaluation.
How often should I get Pap smears or Pap tests?
The recommended frequency of Pap smears or Pap tests varies depending on your age, health history, and the type of test performed (Pap test alone or Pap test with HPV testing). It's best to discuss the appropriate screening schedule with your health care provider. However, general guidelines are:
- Ages 21 – 29: A Pap test is recommended every three years.
- Ages 30 – 65: A Pap test every is recommended every three years, an HPV test is recommended every 5 years, or co-testing (Pap test and HPV test together) every five years.
- Over 65: Consult with your doctor; screening may no longer be necessary if you've had regular normal results in the past.
Contact us
Call 412-578-HOPE 412-578-4673 to speak with an AHN Cancer Institute scheduling coordinator, schedule your appointment online, or connect with a nurse navigator.
Cancer screening
We hold weekly and monthly cancer screening clinics throughout western Pennsylvania to make it easy to screen for seven different types of cancer, including cervical cancer. Doctors recommend annual Pap smears for women and those assigned female at birth starting at age 21. Schedule a screening to help detect cancer early, before symptoms begin.
Second opinions
If you want a second opinion regarding a cancer diagnosis, treatment options, or prognosis, our team of oncology specialists can review your medical records at AHN. To get started, fill out our Second Opinion Request form. Our Navigation Team will contact you within the next 24 – 48 hours to discuss next steps and schedule.
Our locations
Visit our locations page to find a Cancer Institute location near you.