Cervical Cancer

Cervical cancer develops in the cervix, the lower part of the uterus that connects to the vagina. It primarily affects women under the age of 45.

Almost all cases of cervical cancer are caused by infection with certain high-risk types of human papillomavirus (HPV).

Cervical cancer is often preventable through regular screening (Pap test, colposcopy), which aims to detect and treat precancerous changes before they turn into cancer.

Cervical cancer progresses slowly, and its severity depends on the size of the tumor and whether it has spread to nearby or distant tissues.

Symptoms of Cervical Cancer

The most common symptoms include:

• Unusual vaginal bleeding, including:
  • Bleeding during or after sex
  • Bleeding between periods
  • Postmenopausal bleeding
  • Heavier or longer periods than usual
• Changes in vaginal discharge
• Pain during sexual intercourse
• Pain in the lower back, pelvis, or lower abdomen

Women with fibroids or endometriosis may experience similar symptoms regularly, which can lead to overlooking potential warning signs. However, any change, worsening symptoms, or unusual discomfort should be checked by a doctor.

These symptoms are common and may be caused by other conditions. However, if caused by cervical cancer, early detection significantly increases treatment success.

Causes of Cervical Cancer

Almost all cases of cervical cancer result from infection with high-risk HPV types.

HPV can be transmitted through:

• Genital skin-to-skin contact
• Vaginal, anal, or oral sex
• Sharing sex toys

Who is at Higher Risk of Developing Cervical Cancer?

Cervical cancer primarily affects women under 45 years old.

You cannot develop cervical cancer if you have had a total hysterectomy, meaning both the uterus and cervix were removed.

Other factors that increase the risk include:

• Being under 45 years old
• A weakened immune system, such as from HIV or AIDS
• Having multiple pregnancies or giving birth before age 17
• Exposure to the drug Diethylstilbestrol (DES) while in the womb
• A history of cancer in the vagina, vulva, kidney, or bladder

How to Reduce Your Risk of Cervical Cancer

Cervical cancer cannot always be prevented, but there are ways to reduce your risk.

1. Regular Cervical Screening (Pap Smear & HPV Testing)

Regular cervical screening detects abnormal cell changes before they become cancerous.

• Women aged 25–64 should have routine cervical screening to identify and treat any precancerous changes.

2. HPV Vaccination

• All children aged 12–13 are offered the HPV vaccine, which protects against cancers caused by HPV, as well as genital warts.
  Learn more about HPV vaccination (link to the HPV vaccination section).

3. Safe Sexual Practices

• Using condoms reduces the risk of HPV transmission but does not offer full protection, as HPV can infect areas not covered by condoms.

4. Quitting Smoking

• Smoking weakens the immune system and contains chemicals that can contribute to cervical cancer.

5. A Balanced Diet

• A nutritious diet supports immune system health, helping your body fight infections, including HPV.

Diagnosing Cervical Cancer

The primary test for diagnosing cervical cancer is a colposcopy.

If abnormal cervical cells are detected during a Pap test, you will likely be referred for a colposcopy to examine the cervix more closely.

Read more about colposcopy (link to the colposcopy section).

Further Tests if Cancer is Diagnosed

If cervical cancer is confirmed, additional tests help determine its size and spread (staging).

These may include:

• Blood tests
• Imaging tests, such as:
  • CT scan
  • MRI
  • PET scan
  • Chest X-ray
• Gynecological examination under general anesthesia, allowing a more detailed assessment of the vagina and cervix.

Treatment for Cervical Cancer

Cervical cancer is often treatable, especially when detected early.

The treatment approach depends on:

• The size and type of cancer
• Whether it has spread
• Your overall health
• Your desire to preserve fertility

Treatment usually involves surgery, chemotherapy, or radiotherapy, and in some cases, targeted drug therapy.

A gynecologic oncologist will:

• Explaintreatment options, benefits, and side effects
• Develop apersonalized treatment plan
• Discussfertility preservation options
• Monitor your progress withregular follow-ups, tests, and scans

If you have concerns about symptoms or side effects, consult your specialist immediately—do not wait for your next scheduled appointment.

Treatment Options

1. Surgery

Surgery is often the primary treatment, particularly for early-stage cervical cancer.

Different surgical procedures include removing:

• A small part of the cervix (Cone biopsy) – used for very early-stage cancer
• The cervix and upper vagina (Trachelectomy) – preserves fertility
• The cervix and uterus (Hysterectomy) – may also include removal of ovaries and fallopian tubes
• The cervix, uterus, ovaries, fallopian tubes, bladder, part of the colon, or rectum (Pelvic Exenteration) – only for recurrent cancer after other treatments.

Lymph nodes may also be removed as part of treatment (Sentinel lymph node biopsy or pelvic lymphadenectomy).

Recovery time varies depending on the surgical procedure. Your specialist will discuss the benefits and possible side effects with you.

2. Chemotherapy

Chemotherapy uses drugs to destroy cancer cells.

It may be recommended:

• In combination with radiotherapy (chemoradiation) as the main treatment
• Before surgery to shrink the tumor
• After surgery (often with radiotherapy) to prevent recurrence
• For advanced, recurrent, or metastatic cancer

3. Radiotherapy

Radiotherapy uses high-energy radiation to destroy cancer cells.

It may be used:

• As the main treatment if the tumor is large or has spread
• After surgery, usually with chemotherapy (chemoradiation), to prevent recurrence
• To manage symptoms, such as bleeding

Radiotherapy can be delivered:

• Externally (external beam radiation therapy)
• Internally (brachytherapy) – where radiation is placed inside the vagina.

4. Targeted Drug Therapy

For advanced or recurrent cervical cancer, a targeted drug called Bevacizumab (Avastin) may be used.

Its goal is to slow cancer growth, but it does not cure the disease.

Expert Gynecologic Oncology Care at Thely Clinic

The gynecologic oncology team at Thely Clinic has extensive experience and training from leading UK cancer centers. We specialize in the prevention, early detection, and treatment of cervical cancer and precancerous conditions.

If you have any concerns or would like to schedule a consultation, feel free to contact our clinic today.