Cervical Cancer

Common symptoms may be:

• Bleeding after sexual intercourse or vaginal examination
• Spotting or light between or following periods
• Increased vaginal discharge

Other symptoms may include:

• Menstrual bleeding that is longer and heavier than usual
• Pain during intercourse
• Unexplained or persistent pelvic or back pain. 

It is important to remember that cervical cancer is very rare especially in women who have had regular smears.

A colposcopy is often performed following an abnormal smear, for assessment of certain symptoms such as bleeding after sex OR persistent vaginal discharge OR if a GP is concerned about the appearance of the cervix. It allows the specialist to assess the cervix and grade any abnormalities if present.

The examination may show a normal cervix or low grade or high grade changes. The specialist will explain the findings. Depending on the clinical circumstances, women may or may not need treatment.

If women are diagnosed with cervical cancer, their specialist may recommend an examination under anaesthesia with a camera test to look into the urinary bladder (water bag) and the rectum (back passage). Special tests such as MRI scan and CT scan may be needed to diagnose the extent of the cancer.

More than half the cervical cancers diagnosed in the UK are very early (microinvasive or stage 1A) and are treated by local treatment by removing the cells. This treatment can be carried out either under local or a short general anaesthesia.

If the stage of cancer is stage 1B or more, more extensive surgery may be needed. This will depend on exact circumstances and other factors such as a desire for further fertility. If the cancer cells have gone outside the cervix, additional treatment with chemotherapy and radiation may be needed.

Cervical cancer survival in the United Kingdom has improved over the last 40 years. Survival is related to the stage of cervical cancer diagnosed. Most patients are diagnosed in stage 1 or 2. More than 96% of women survive at 5 years after the diagnosis and treatment of stage 1 cervical cancer.

The Eve Appeal is a charity dedicated to gynaecological cancers, for more information on cervical cancer and the support offered, click here 

In the UK the HPV vaccine is offered to girls in year 8 (age 12 and 13) to protect them against cervical cancer. The vaccine provides a high degree of protection against cervical cancer however it does not provide full protection. The new vaccine (Gardasil 9) prevents 90% and the old vaccine prevents 70% of all cervical cancer.

Therefore, it is very important that women still attend regular screening even if they have been vaccinated to reduce their risk and have maximum protection.

Smear tests identify potentially harmful cells before they become cancerous and ensure women get the correct treatment as soon as possible. Because of this, regular screening can help stop cervical cancer before it starts.

Women over the age of 25 should have a smear test every 3 years. Cervical cancer takes a long time to develop (approximately 15 years) which means that one would have five opportunities (smear tests) for detecting any abnormalities. This makes it safe to have a smear test every three years.

Having said that, sometimes a smear test can be falsely negative as it is a screening test and not a diagnostic test. A negative smear test means ‘low risk’ and not ‘no risk’. It is therefore important that women see their GP, gynaecologist or practice nurse if they have any of the symptoms mentioned above.

Cervical cancer is classified in stages from 1 to 4.

• Stage 1: Cancer is confined to the cervix.

• Stage 2: It has spread beyond the cervix but not to the pelvic wall or lower vagina.

• Stage 3: It has spread to the lower vagina or pelvic wall.

• Stage 4: It has spread to nearby organs or distant parts of the body.
  Early detection is key, treatment is most effective when cancer is caught in the early stages.

Some treatments, such as hysterectomy or pelvic radiotherapy, may affect fertility. If preserving fertility is important to you, speak to your consultant early about options such as fertility-sparing surgery or egg freezing. Sexual function may also change during or after treatment, and support is available for physical and emotional recovery.