I'm Dr. Kristina Butler, a gynecologic oncologist at Mayo Clinic. In this video, we'll cover the basics of cervical cancer: What is it? Who gets it? The symptoms, diagnosis, and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. Cervical cancer happens when cells in the cervix, the lower part of the uterus that connects to the vagina, start to become abnormal. Small changes in the cell DNA tells them to multiply out-of-control, and cells accumulate in growths called tumors. Thankfully, advances in medical technology and specifically the use of Pap tests, have significantly helped us identify cervical cancer in patients earlier than ever before. What was once the most common cause of cancer death for American women is now caught sooner and therefore more curable.
Who gets it?
While it isn't perfectly clear what sparks the cervical cells to change their DNA, it is certain that human papilloma virus, or HPV, plays a role. HPV is spread by skin to skin contact often during sexual encounters. Over 85% of the general population has been exposed. But most people with HPV never develop cervical cancer. However, reducing your risk of one helps reduce your risk of the other. I recommend getting both the HPV vaccine and regular screening tests. Other risk factors for cervical cancer include multiple sexual encounters. But it only takes one to contract HPV, so it's important to always practice safe sex. A weakened immune system and also smoking are linked to higher risk. One drug called DES was popular in the 1950s as a miscarriage prevention drug. So if your mother took it while pregnant, you may have higher risk as well.
What are the symptoms?
Unfortunately, the early stages of cervical cancer generally show no signs or symptoms. And this is why we emphasize getting Pap smears every three to five years and yearly pelvic exams. Once the cancer has progressed, it can show these symptoms: Unusual vaginal bleeding, for example, after intercourse or between periods or after menopause. Watery, bloody vaginal discharge that may be heavy or have an odor. And pelvic pain or other pain can also occur during intercourse.
How is it diagnosed?
Most guidelines suggest starting regular screening for cervical cancer at age 21. And during these screenings, a provider collects cells from the cervix to be tested in the lab. HPV DNA tests examine the cell specifically for HPV that can lead to pre-cancer. A Pap test, or commonly called a Pap smear, tests the cells for abnormalities. The process of these tests are not painful but can be mildly uncomfortable. If your provider suspects cervical cancer, they may start a more thorough examination of the cervix. This may include a colposcopy, which is a special tool that shines light through the vagina into the cervix to magnify the view for your provider. During the colposcopy, your provider might take several deeper samples of cells to examine. This could include a punch biopsy that collects tiny samples of cells, or an endocervical curettage that uses a narrow instrument to take an internal tissue sample. And if after further examination, the sample tissue is worrisome, your doctor may run more tests or collect other tissue samples from deeper layers of the cells. This could use a LEEP or cone biopsy procedure to give the clearest picture possible.
How is it treated?
Treating cervical cancer isn't one-size-fits-all. Your doctor will consider the whole picture of your health and your personal preferences before making a recommendation. And this will include one or several treatment methods. For early cervical cancer, we typically treat with surgery to remove the abnormal growths. For more advanced cervical cancer, there's also chemotherapy, a drug that runs the body killing cancer cells in its path. Radiation therapy uses high-powered beams with energy focused on the cancer cells. There's also targeted drug therapy that blocks specific weaknesses present within the cancer cells. And immune therapy, a drug treatment that helps your immune system recognize cancer cells and attack them.
What now?
No one can be prepared for a cancer diagnosis. However, there are ways we can help reduce anxiety and feel more in control of the situation. Learning about the condition can make you feel more empowered and confident in the decisions about your care. So ask lots of questions and request additional resources. Find support. Ask for help from your family and friends. If you feel more comfortable expressing yourself in a support group, there are many available both online and in-person. Set goals that you can achieve and feel good about. And most importantly, take care of yourself. This time can be difficult and fatiguing. Eat well, relax and get enough rest. If you'd like to learn even more about cervical cancer, watch our other related videos or visit mayoclinic.org. We wish you well.