Cervical Cancer

Screening

Screening tests play a vital role in detecting cervical cancer early, as well as identifying precancerous cells that may develop into cancer over time. Most healthcare organizations recommend starting screening at age 21. Tests are typically repeated every few years based on age, health history, and previous results.

Common screening tests include:

• Pap test: During this test, a healthcare professional collects cells from the cervix using a small brush or spatula. The cells are examined in a lab to detect abnormalities or precancerous changes that may lead to cervical cancer.

• HPV DNA test: This test checks cervical cells for infection with high-risk types of human papillomavirus (HPV), which are most likely to cause cervical cancer.

Discuss with your healthcare team to determine the right screening schedule for you based on your medical history and risk factors.

Diagnosis

If screening results or symptoms suggest possible cervical cancer, diagnostic testing begins with a thorough examination of the cervix. A magnifying instrument called a colposcope is used to closely inspect the cervical tissue.

During a colposcopic exam, small samples of tissue may be collected for laboratory testing. Diagnostic procedures include:

• Punch biopsy: Uses a sharp tool to remove small samples of cervical tissue.

• Endocervical curettage: Uses a small, spoon-shaped instrument or brush to scrape cells from the cervical canal.

• Electrical wire loop: Also known as a loop electrosurgical excision procedure (LEEP), this uses a thin electrified wire to remove tissue. The procedure is usually done under local anesthesia.

• Cone biopsy or conization: Involves removing a cone-shaped section of tissue from deeper layers of the cervix, often performed under general anesthesia in a hospital setting.

These tests help confirm whether cancer cells are present and determine the extent of abnormal cell growth.

Staging

If cervical cancer is diagnosed, staging tests are performed to determine how far the disease has spread. Staging information helps guide treatment decisions and predict outcomes.

Common tests used for staging include:

• Imaging tests such as X-ray, MRI, CT scan, or PET scan to visualize the size and spread of cancer.

• Visual examination of the bladder and rectum using scopes to detect cancer involvement in nearby organs.

Cervical cancer is categorized into stages 1 through 4. Stage 1 indicates that the cancer is confined to the cervix, while stage 4 means the cancer has spread to distant organs or tissues.

Treatment

Treatment for cervical cancer depends on the cancer’s stage, size, and the patient’s overall health and preferences. Common treatments include surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy. In many cases, a combination of these treatments provides the best results.

Surgery

Surgery is often used to treat early-stage cervical cancer that has not spread beyond the cervix. The type of surgery depends on tumor size and whether the patient wishes to preserve fertility.

Surgical options include:

• Removal of cancerous tissue only: For very small cancers, a cone biopsy may remove all affected tissue while preserving the cervix.

• Trachelectomy: This procedure removes the cervix and nearby tissue but leaves the uterus intact, allowing for the possibility of future pregnancy.

• Hysterectomy: Involves removing the cervix, uterus, part of the vagina, and nearby lymph nodes. This is often recommended when cancer is larger or more advanced.

Minimally invasive hysterectomy, which uses smaller incisions, may be an option for very small, localized cancers. However, research suggests that traditional open surgery may have better long-term outcomes in some cases. Patients should discuss all benefits and risks with their surgeon.

Radiation Therapy

Radiation therapy uses high-energy beams, such as X-rays or protons, to destroy cancer cells. It may be used alone or combined with chemotherapy for more advanced cases. Radiation can also be administered after surgery to reduce the risk of recurrence.

Types of radiation therapy include:

• External beam radiation therapy: Delivers radiation from a machine outside the body.

• Internal radiation therapy (brachytherapy): Involves placing a radioactive device inside the vagina for a short duration.

• Combined therapy: Uses both external and internal radiation methods for better outcomes.

Radiation may cause menopause in women who have not yet gone through it. Discuss fertility preservation options with your doctor before starting treatment.

Chemotherapy

Chemotherapy uses medications to kill cancer cells throughout the body. It is often used alongside radiation therapy to enhance its effects, especially in cancers that have spread beyond the cervix.

In more advanced cases, higher doses of chemotherapy may help control symptoms and slow disease progression. Sometimes, chemotherapy is given before surgery to shrink the tumor and make it easier to remove.

Targeted Therapy

Targeted therapy works by blocking specific molecules that cancer cells use to grow and survive. These medications attack cancer cells while minimizing damage to healthy tissue. Targeted therapy is typically used in combination with chemotherapy for advanced or recurrent cervical cancer.

Immunotherapy

Immunotherapy helps the body’s immune system recognize and destroy cancer cells. It may be recommended for advanced cervical cancer when other treatments have not been effective. By enhancing immune response, this therapy can slow or stop cancer growth and improve survival in select patients.

Palliative Care

Palliative care focuses on improving comfort and quality of life for individuals with serious illnesses like cervical cancer. It helps manage symptoms such as pain, fatigue, or nausea while supporting emotional and mental well-being.

A palliative care team may include doctors, nurses, social workers, and other professionals who work alongside your oncology team. Palliative care can be provided at any stage of illness and may be combined with active cancer treatments such as surgery, radiation, or chemotherapy.

Receiving palliative care alongside medical treatment can help patients feel better, experience fewer symptoms, and improve overall well-being during and after cancer care.