Cervical Cancer

The lifetime risk of Cervical Cancer is 1:90 and it is the third most common gynaecologic malignancy after uterine and ovarian cancers. Cervical cancer can involve the outer covering of the cervix (squamous cells) or the gland cells of the cervix.

Risk factors include the Human Papilloma Virus (HPV), smoking and immunosuppression. With the advent of a National Screening Program for Cervical Cancer (PAP Smear) and the HPV vaccine, the rates of cervical cancer have declined over time.

Symptoms

Abnormal vaginal bleeding, bleeding after intercourse, vaginal discharge, pelvic pain, and kidney problems can indicate cervical cancer. However, many women have no symptoms and cancer is diagnosed at the time of a routine PAP Smear. Some women have a precursor lesion to cancer called Cervical Intra-epithelial Neoplasia (CIN). More information on CIN can be found in the section on Abnormal PAP Smears.

Diagnosis and Investigations

Cervical Cancer is diagnosed from a biopsy of the cervix. A colposcopy (examination under the microscope) may be performed in order to obtain this biopsy. In some cases a precursor lesion is being treated with a LLETZ or Cone Biopsy and a cancer is found. Once a diagnosis has been made further investigations include cystoscopy (camera into the bladder), CT scan of chest abdomen and pelvis, MRI of pelvis and PET scan. Routine blood tests will also be performed.

Treatment

The treatment of cervical cancer can be divided into two main groups. After investigations have been performed your disease is staged. For women with early stage disease treatment is surgery comprising a radical hysterectomy (with removal of the parametrium), removal of both tubes and ovaries and removal of bilateral pelvic lymph nodes. For women with more advanced disease treatment is primary chemotherapy and radiation therapy. You will be referred to the medical and radiation oncologists for this treatment.

Follow Up

Some women will require post-operative radiation or chemotherapy and will be referred to the appropriate specialist for this. Once you have completed treatment for Cervical Cancer you will be monitored regularly over the next several years. In some cases your cancer may recur. Further imaging and blood tests will be performed at that time and management options will be discussed. These include further surgery, radiation therapy or chemotherapy.

Staging and Prognosis

The Stage of disease describes how advanced your cancer is and to what organs it has spread to at the time of diagnosis. Your stage is determined clinically for cervical cancer although further prognostic information is gained from the surgical procedure. Once your disease is staged we have a better idea about prognosis or outlook. This will be discussed with you once we have all the necessary information. 

Further information can be obtained from the websites listed in the Links Section or by contacting the Queensland Cancer Council.