Causes of Cervical Cancer

Almost all cases of cervical cancer are caused by persistent high risk HPV. HPV is a very common infection that four out of five sexually active adults will come into contact with in their lives, without any symptoms. This is why it is so important to attend your regular cervical screening.

See our section on HPV

Cervical cancer is not caused by promiscuity or infidelity, however, it makes sense that the more sexual partners you have and the younger you are when you have your first sexual encounter, the more likely you are to come into contact with the more dangerous types of HPV these are called high risk types. Whilst these factors are considered to increase your risk of developing cervical cancer, many women who have only had one sexual partner in their lifetime become infected with high risk HPV and may go on to develop abnormal cell changes/CIN or cervical cancer.

Similarly, as with most cancers, smoking can also pose an increased risk. Smoking stops your body’s immune system from working properly, leaving you more likely to get infections and therefore can cause abnormalities in the cells of the cervix.

Other risk factors involved with cervical cancer:

  • Weakened immune system
  • Having children at a very young age
  • Giving birth to many children
  • If your mother was given DES (infertility drug) when pregnant with you
  • Long term use of the contraceptive pill (more than 10 years) can slightly increase the risk of developing cervical cancer but the benefits of the pill outweigh the risks for most women.

Symptoms of Cervical Cancer

There are usually no symptoms with abnormal cervical cells and sometimes there are no symptoms with early stage cervical cancer. However, there are some recognised symptoms associated with cervical cancer. These include;

  • Abnormal bleeding: during or after sexual intercourse, or between periods
  • Post menopausal bleeding, if you are not on HRT or have stopped it for six weeks
  • Unusual and/or unpleasant vaginal discharge
  • Discomfort or pain during sex
  • Lower back pain.

If you are experiencing any or all of these symptoms or are concerned about any new symptom you should make an appointment to see your GP as soon as possible. Remember, these symptoms can be associated with many other conditions that are not cancer related.

Not all women diagnosed with cervical cancer experienced symptoms this means attending regular cervical screening is even more important. As cancer develops, it can cause further symptoms;

  • Frequency of urine
  • Blood in the urine
  • Rectal bleeding
  • Diarrhea
  • Incontinence
  • Lower limb lymphoedema.

Types of Stages of Cervical Cancer

If, after receiving the results of your biopsy, you are diagnosed with cervical cancer, your consultant will order more tests to find out to what type of cervical cancer you have, the extent the cancer has progressed and if the cancer cells have spread to other parts of the body.

There are two main types of cervical cancer:

  • Squamous cell – eight out of 10 (80%) cervical cancers are diagnosed as squamous cell. Squamous cell cancers are composed of the flat cells that cover the surface of the cervix and often begin where the ectocervix joins the endocervix.
  • Adenocarcinoma – more than one in 10 cervical cancers are diagnosed as adenocarcinoma (15 – 20%). The cancer develops in the glandular cells which line the cervical canal. This type of cancer can be more difficult to detect with cervical screening tests because it develops within the cervical canal.

Adenosquamous cancers are tumours that contain both squamous and glandular cancer cells. Other rare types of cervical cancer can include clear cell, small cell undifferentiated, lymphomas and sarcomas.

Cervical cancer staging

You may be asked to have various diagnostic test which help understand your cancer better. These could include: a pelvic examination, an MRI or PET-CT, chest x-ray or blood tests. Your consultant needs information to understand the extent your cancer has progressed and if the cancer cells have spread to other parts of the body. This process is called staging. Knowing the stage of the disease helps your consultant plan treatment.

Carcinoma of the cervix: staging cervical cancer (primary tumour and metastases)

The following stages are used to describe cancer of the cervix:

  • Stage 1a: Cancer involves the cervix but has not spread to nearby tissue. A very small amount of cancer that is only visible under a microscope is found deeper in the tissues of the cervix.
  • Stage 1b: Cancer involves the cervix but has not spread nearby. A larger amount of cancer is found in the tissues of the cervix.
  • Stage 2a: Cancer has spread to nearby areas but is still inside the pelvic area. Cancer has spread beyond the cervix to the upper two thirds of the vagina.
  • Stage 2b: Cancer has spread to nearby areas but is still inside the pelvic area. Cancer has spread to the tissue around the cervix.
  • Stage 3: Cancer has spread throughout the pelvic area. Cancer cells may have spread to the lower part of the vagina. The cells also may have spread to block the tubes that connect the kidneys to the bladder (the ureters).
  • Stage 4a: Cancer has spread to other parts of the body, such as the bladder or rectum (organs close to the cervix).
  • Stage 4b: Cancer has spread to distant organs such as the lungs.

Cervical Cancer Treatments

In most hospitals a team of specialists will work together to decide which treatment is best for you. This multidisciplinary team (MDT) will include:

  • a surgeon who specialises in gynaecological cancers (gynaecologist or gynae-oncologist)
  • a clinical oncologist (chemotherapy and radiotherapy specialist)
  • a pathologist
  • a radiologist

and may include a number of other healthcare professionals such as:

  • a nurse specialist
  • dietician
  • physiotherapist
  • psychologist or counsellor.

Depending on what stage your cancer is and your specific needs, your team will consider the following treatments. In order to fully understand which treatment will be right for you, you will need to discuss this with your consultant at your next appointment.

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