Cervix Cancer Symptoms

Cervix Cancer Symptoms

This article describes the symptoms that might indicate the presence of cancer of the cervix. Cervical cancer may have few to no symptoms, thus the emphasis on early detection shifts towards screening. It is important for a woman to know what she should be screened for cervical cancer. Any concerning or “red flag” symptoms should prompt notification of your doctor for further investigation to see if cervical cancer may be present. There are several different kinds of cancer that can affect the cervix. Fortunately the risk factors and symptoms are similar for all of these.

A list of the major categories of cervical cancer is as follows:

  • Squamous Cell Carcinoma
    • Verrucous
    • Large cell type
    • Small cell type
  • Adenocarcinoma
    • Clear Cell
    • Endometrioid
    • Usual endocervical type
  • Mixed Carcinomas
    • Glassy Cell
    • Adenosquamous

A key part of detecting cervical cancer is to know who might be at risk for it. The practical component of maintaining health of the cervix (and thus helping to prevent a future cancer) is to be aware of risk factors for cervical cancer.

Almost all cases of cervical cancer result from infection with a sexually transmitted virus called human papillomavirus. There are several different kinds of human papillomavirus (HPV) but types 16 and 18 are more commonly associated with the development of cervical cancer. A vaccine is available to prevent HPV infection with these strains.

There are now vaccines available and recommended for both teenage girls (Gardasil® and Cervarix®) and boys (Gardasil®) that can prevent most cases of HPV that lead to cervical cancer. It is highly recommended that these vaccines be given before a girl becomes sexually active There is nothing more effective than these vaccines in preventing cervical cancer. By the time girls are into their twenties they have usually been exposed if they are sexually active. The vaccine is not indicated in older women.

Risk factor for cervical cancer includes:

  • Early onset of sexual activity
  • Multiple sexual partners
  • Sexual partners who have high risks themselves
  • Cigarette smoking
  • Having had many children
  • Weakness of the immune system
  • Low socioeconomic status (high risk mainly due to limited access to health care)
  • Extended use of oral contraceptive medications
  • Having had a prior cancer of the reproductive system
  • Infection with Human Papilloma Virus

Symptoms of cervical cancer are often absent early on. When the cancer is small or pre-invasive cervical cancer is often clinically silent. This is why screening, identification of those at high risk, and early detection is so important. When cervical cancer does cause symptoms, these are the most common ones:

  • Abnormal Vaginal Bleeding: Irregular menstruation is not uncommon and occurs more frequently in adolescents. Other factors such as weight gain or loss, recent pregnancy or some types of birth control can interfere with normal menstrual patterns.
  • Vaginal Bleeding after intercourse: This is always abnormal and should prompt discussion with your doctor.
  • Abnormal Vaginal Discharge: Occasionally, cervical cancer will cause clear or unusual types of vaginal discharge. This symptom is very non-specific and most episodes of vaginal discharge do not indicate cancer.

The above symptoms are fairly non-specific and can occur with many other types of conditions. Less common symptoms of cervical cancer that suggest a more advanced stage and aggressive disease includes:

  • Pelvic Pain
  • Back Pain
  • Passage of urine from the vagina
  • Passage of stool from the vagina
  • Blood in the stool
  • Blood in the urine
  • Change in bowel habits such as severe constipation

Cancer of the cervix is a major health concern for women as it is not uncommon. Overall, about one in 10,000 women will be found to have cervical cancer each year. The average age of diagnosis with cervical cancer is 48 but it can occur in women much younger. Death from cervical cancer is rare also and occurs in about one in 50,000 women. The rates of cervical cancer and death from it are higher in persons of African descent or Hispanic.

About 50% of women are diagnosed with cervical cancer at an early stage when the cancer is fond only at the cervix. At this stage, the cancer is quite curable and greater than 90% have long term survival. When the cancer has spread outside of the cervix to regional lymph nodes or other areas of the body, the cancer becomes more difficult to treat and the risk of dying from the cancer rises dramatically.

 

Beyond the HPV vaccine, the best chance of cure and preventing complications of cervical cancer occur with early detection. This emphasizes the importance of understanding signs of cervical cancer and what can be done to help prevent or detect it.

Another key part of maintaining cervical health is to undergo routine Pap smears. A Pap smear is a test usually performed in a doctor’s office that takes a sample of cells from the cervix for examination under a microscope. If abnormal cells are found this might indicate the presence of cervical cancer. Screening is very important because there are few symptoms of cervical cancer and they are quite non-specific. Many women have some type of vaginal discharge from time to time and it does not always signify cancer. Having vaginal bleeding in unusual times or after intercourse may be a sign of cervical cancer but is also fairly non-specific. Abnormal vaginal bleeding sometimes occurs as a sign of endometrial or uterine cancer. It is very common for teenage women to have irregular menstruation and it also might occur with obesity as well. The lack of specific symptoms makes screening a key part of helping to prevent the spread of this common cancer.

Some cancers such as ovarian cancer have few if any symptoms and do not have any accurate and specific screening test. Fortunately, cervical cancer does have an accurate screening test known as a Pap smear test. The test should begin routinely at the age of 21 or when a woman begins to have sexual intercourse. Thereafter she should have one every 2 years until the age of 30 and then yearly thereafter. Most doctors also test for HPV. An abnormal Pap smear along with HPV infection with one of the cancer-causing subtypes is cause for concern. Women who have certain risk factors that place them at a higher risk such as HPV infection or prior pre-cancerous findings on a Pap smear should have more frequent testing performed.

Once cervical cancer has been diagnosed, the treatment depends upon what stage the cancer is and whether or not there is evidence that it has spread to surrounding areas or elsewhere in the body. Often, a pre-cancer area can be treated by destroying those cells without surgery by something such as cryotherapy. When a cancer has been deemed to have grown large or spread elsewhere in the body, often multimodal therapy with a combination of surgery and chemotherapy is needed.

REFERENCES:

  1. www.cancer.gov/cancertopics/types/cervical
  2. seer.cancer.gov/statfacts/html/cervix.html
  3. www.cancer.gov/cancertopics/factsheet/cancer-advances-in-focus/cervical
  4. Carey WD. (2010) Cleveland Clinic: Current Clinical Medicine, 2nd ed. Section 14. Cleveland, OH: Saunders.
  5. Goldman L, Schafer, AI; (2011) Goldman: Goldman’s Cecil Medicine, 24th ed. Chapter 205. New York, NY: Elsevier
  6. This article was originally published on September 3, 2012 and last revision and update was 9/4/2015.