Cervical cancer

Alternative names:

cancer of the cervix; cervical neoplasm

Treatment:

Options for treatment depend on the extent of disease, the type of cancer, the age and general health of the woman, and the desire for future childbearing. Surgery may range from very localized for surface cancer (carcinoma in situ) up to a radical hysterectomy (removal of the uterus and surrounding pelvic lymph nodes) for invasive cancer that extends beyond the cervix. A cone biopsy, which is the removal of a wedge of the cervix for biopsy, is sometimes enough to remove all of the malignant cells of a surface cancer. Cryosurgery (destruction of tissue by freezing it) is also used frequently to treat preinvasive cancer. A hysterectomy is still the choice of many, but for those women with the desire to have children in the future, these alternate methods frequently allow them to do so.

Since invasive cervical cancer frequently spreads to the adjacent pelvic lymph nodes, more intense treatment is recommended. Radiation therapy, which is commonly done either before or after surgery, chemotherapy, radical hysterectomy or a combination of the three have all been used for successful treatment.

Expectations (prognosis):

Many factors influence the outcome of cervical cancer:

• age of the woman
• general physical condition and health
• specific features of the type of cancer
• stage of the disease
• skill of the provider

The 5 year survival rates (number of people who live for at least 5 years) for women with cervical cancer with appropriate treatment are approximately:

• 80 to 85% for stage 1
• 50 to 65% for stage 2
• 30 to 40% for stage 3
• up to 12% for stage 4

In women with untreated or unresponsive cervical cancer, death occurs 95% of the time within 2 years of the onset of symptoms.

Complications:

• Some types of cervical cancer are less responsive to treatment.
• There may be a recurrence of cancer.
• Women who are treated with either a cone biopsy or cryosurgery are at a high risk of possible recurrence.

Calling your health care provider:

Call for an appointment with your health care provider if you are a woman who is sexually active or you are at least 20 years old and have never had a pelvic examination and Pap smear.

Call for an appointment with your health care provider if a subsequent Pap smear has not been obtained at recommended intervals of:

• every year initially.
• for women up to age 35 or 40: every 2 to 3 years after having 3 negative, consecutive annual Pap smear tests and a single sexual partner or no sexual partner.
• every year for women over 35 or 40.
• every year for women who have had multiple sexual partners.
• every year for women who are taking oral contraceptives (birth control pills).
• every 6 months for women who have a history of HPV (genital warts).
• every 6 months for women who were prenatally exposed to DES.
• the frequency recommended after an abnormal Pap smear.