Cervical cancer

Alternative names:

cancer of the cervix; cervical neoplasm

Symptoms:

• abnormal vaginal bleeding
  • between menstrual periods
  • after intercourse
  • after douching
  • after menopause

• persistent vaginal discharge - pale, watery, pink, brown or blood streaked, may be dark and foul-smelling

Advanced disease symptoms include:

• anorexia (loss of appetite)
• weight loss
• fatigue
• back pain or leg pain
• involuntary loss of urine or rectal contents from the vagina through an abnormal tube-like passage (fistula) that connects the vagina with the bladder or rectum

Signs and tests:

A physical exam may show the cervix to be irregular, enlarged, firm, or friable (bleeds easily) in the later stages of cervical cancer. However, the cervix almost always looks normal in the early stages of the disease.

• Pap smear shows abnormal cells, dysplasia, or cervical cancer.
• Colposcopy suggests cervical cancer and pinpoints areas of concern.
• Cervical biopsy (colposcopy-directed biopsy or cone biopsy) confirms cervical cancer.

STAGES OF CERVICAL CANCER DETERMINED BY BIOPSY

• 0. carcinoma in situ: the tumor is non-invasive, involving only the superficial surface of the cervix
• 1a. tumor penetrates no more than 3 mm below the cervical lining boundary
• 1b. tumor involves the cervix and uterus only
• 2. tumor extends to the upper vagina and/or supporting structures alongside the uterus
• 3. tumor extends to the pelvic wall
• 4. tumor extends to the bladder, rectum and/or distant sites (metastases)