Cervical cancer can be diagnosed by an abnormal Pap smear or during a pelvic exam. On exam, the cervix is enlarged and bleeds easily on contact. When the cervical cancer is small and confined to the cervix, it can be treated surgically by radical hysterectomy with pelvic lymph node dissection via laparotomy. In more advanced cases, cervical cancer is treated with a combination of radiation therapy and chemotherapy.

Is it true that a virus causes cervical cancer?

Yes. Most cervical cancers occur as a result of long-term exposure to the human papillomavirus, also known as HPV. Men and women are exposed to this virus through intimate sexual contact. Most individuals develop immunity to the virus, but about 10 percent of the population fails to develop immunity, allowing it to remain in the genital tract. As a result, precancerous and cancerous tissue changes can occur in the cervix and other genital tissues. Pap smears, pelvic exams and viral testing can detect these changes.

Can the virus be prevented?

In most cases, yes. A vaccine against the most common types of HPV has been developed. This vaccine prevents the development of many precancerous and cancerous cervical changes. The vaccine works best when a woman is vaccinated before sexual contact.

The Centers for Disease Control and Prevention (CDC) recommends girls get it at ages 11-12, but it can be administered from ages 9 through 45. View the CDC recommendations.

Can invasive cervical cancer be cured?

Yes. If detected early, most cervical cancer can be cured with surgery or radiation therapy.

Treatment for cervical cancer

Gynecologic cancer surgery

Gynecologic patients have surgery performed through the abdomen, vagina, or both. Abdominal surgery is done under general anesthesia. Abdominal surgery can be performed through a vertical incision that extends from the pubic bone upward toward the breast bone or through a horizontal incision located above the pubic bone. If a telescope or laparoscope is used, the incision can be limited to multiple small incisions in the abdominal wall.

Vaginal surgery is performed through the vagina under general or spinal anesthesia. This approach allows the vulva, vagina and cervix to be carefully examined. Patients are placed on their backs with their feet in stirrups during surgery. Common vaginal procedures include uterine dilation and curettage (D&C), a procedure to remove tissue from inside the uterus, hysteroscopy, vaginal hysterectomy and some pelvic support procedures.

In general, it takes four to six weeks to resume normal activities after major abdominal surgery. Recovery time from vaginal surgery is typically shorter than that of abdominal surgery.

Radiation therapy

Radiation therapy consists of a high-energy, invisible electromagnetic field created by a machine called a linear accelerator and directed to a specific part of the body within a treatment field called a port. Treatments are usually given in an outpatient setting, five days a week for approximately six weeks.

During this time, patients may experience fatigue and increased stool and urinary frequency. Occasionally, radiation may cause skin irritation and redness.

Intracavitary or brachytherapy involves insertion of a device into the vagina and uterus and then placement of radiation sources into these devices. Patients are given general anesthesia in an operating room setting for the insertion of the radiation applicator.

The radiation sources are subsequently placed into the applicator later, when patients are returned to their private rooms. The radiation sources and applicator are removed in the patient's room within 24 to 48 hours. Normally, two intracavitary radiation treatments are planned for cervical or vaginal cancers.

Once medical specialists have treated an area of the body, they cannot treat the same area again without risking serious tissue damage.

After radiation is complete, the effects of treatment on tissues may persist for up to six months. Long-term side effects of radiation may include vaginal narrowing, chronic diarrhea or constipation, and an increase in urinary frequency. Some patients have no long-term side effects, and some have only a few.

Chemotherapy

Chemotherapy involves the administration of chemical agents that poison cancer cells and, to a lesser degree, normal cells. There are many different chemotherapy agents. These can be administered intravenously, intramuscularly, intraperitoneally, or orally. Most IV and intraperitoneal regimens are given every 3 to 4 weeks. Most oral regimens consist of daily medication for two to four weeks each month.

Chemotherapy agents may cause nausea, vomiting, hair loss, skin reactions, or low blood counts. These side effects can often be controlled with additional medication. The side effects stop when treatment has ended.

Some of the drugs used for chemotherapy in gynecologic oncology include Taxol, Carboplatin, Cisplatin, Doxal, Topotecan, Cytoxan, and methotrexate.