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Cervical cancer begins in the cervix the part of the uterus or womb that opens to the vagina. It was once the leading cause of death from cancer in women. Today screening saves the lives of 70% of women who might have died from cervical cancer without the Pap smear test. Still some 1350 Canadian women are diagnosed with cervical cancer each year and about one third of them will die of the disease. Recent advances in screening and work on a vaccine could help the effort to wipe out cervical cancer.

There are usually no symptoms at all when cervical cancer is in its earliest stage. This is another reason why screening is so important as this is the stage when cervical cancer is most treatable. When there are symptoms they may include:

• Persistent vaginal discharge which may be pale watery pink brown blood streaked or dark and foul-smelling
• Abnormal vaginal bleeding especially between menstrual periods after intercourse or douching and after menopause which gradually becomes heavier and longer

When cervical cancer is advanced symptoms may include:

• Loss of appetite weight loss fatigue
• Pelvic back or leg pain
• Leaking of urine or feces from the vagina
• Bone fracture

Nobody knows the exact cause of cervical cancer. However scientists know that the human papillomavirus or HPV·is a big factor. HPV is a common sexually transmitted virus. There are two types of HPV·"low risk" and "high risk." In most women the cells in the cervix return to normal after the body's immune system destroys the HPV infection. However some low risk HPV infections can cause genital warts and sometimes the high-risk type cause abnormal or pre-cancerous cells to form. If these abnormal cells are not found and treated they may become cancerous.

Other contributing factors include engaging in sexual intercourse before age 19 having multiple sex partners or having AIDS. Smoking using oral contraceptives for a long period of time or having a mother who took the drug diethylstilbestrol (DES) while pregnant can also increase your risk of developing cervical cancer.

Imaging examinations like ultrasound CT (computerized axial tomography) scans X-rays and MRIs (magnetic resonance imaging) allow organs and tissues to be examined in more detail.

Blood tests will allow your doctor to determine if the different types of blood cells are normal in quantity and appearance. This will show how well your organs are functioning and may suggest that cancer is present.

Biopsies are usually required to make a definite diagnosis of cancer. Cells or tissues are taken from the body and then examined under a microscope. In the case of cervical cancer a specimen of your tissue may be removed during a procedure called a colposcopy. Your doctor will use a special speculum with a built-in microscope to clearly see the tissue before removing it. Sometimes cone biopsies are performed. This happens when your doctor removes a cone-shaped piece of your cervix.

If your doctor diagnoses cervical cancer there are a variety of treatments available depending on its type and how aggressive it is. Many factors will be taken into consideration before you and your doctor decide on what method of treatment will be best for you. Be sure to ask your doctor if your treatment will affect your ability to have children. Remember eggs and embryos can be stored for use after treatment.

Your treatment could include one or a combination of the following:

Surgery: This procedure is designed to remove part or the entire tumour and some surrounding tissue. A decision to have surgery depends on where the tumour is i.e. how close it is to vital organs. In the earliest stages of cervical cancer the removal of tissue during a cone biopsy may be all the treatment necessary. In more advanced cases it may be necessary to remove the entire uterus also known as a hysterectomy.

Laser Surgery: A narrow beam of high-energy light is used to remove abnormal cells or lesions. The laser gets rid of the cancerous cells with little or no damage to surrounding healthy tissue. Recovery time is very quick and it's less likely to affect your fertility or future pregnancies than ordinary surgery.

Electrosurgery: An electrical current is used to remove abnormal tissue. This could be uncomfortable but it's usually painless.

Cryosurgery: This method of treatment kills cancer cells by freezing them. A local anaesthetic is used and liquid nitrogen is sprayed on to freeze the tumour and a bit of surrounding tissue. The process is repeated until the treated area eventually dies and falls off.

Chemotherapy: This procedure uses drugs or medications that hinder the cancer cell's ability to grow and spread. Healthy cells can be affected during treatment so it's possible you could feel nauseated lose your appetite and hair feel tired and have an increased risk of infection. Most people handle chemotherapy fairly well and the side effects can usually be reduced or controlled.

Radiotherapy: This is also known as radiation therapy. High energy X-rays are used to destroy cancer cells. In external radiotherapy the rays are carefully aimed at the tumour avoiding surrounding healthy tissue. In internal radiotherapy or brachytherapy radioactive material is placed directly into a tumour.

You can lower your chances of getting cervical cancer by reducing risk factors and leading a healthy lifestyle.

• Have regular pelvic examinations with a Pap test. If every woman had a Pap test at least once a year the incidence of cervical cancer would almost be eliminated.
  
  
• Use latex condoms during intercourse. This helps prevent transmission of HPV as well as other sexually transmitted diseases like chlamydia gonorrhea Herpes or syphilis.
  
  
• Don't smoke! The use of tobacco products increases your risk for cervical cancer.
  
  
• Maintain a normal body weight. Obesity is associated with an increased risk of cervical cancer especially in older women.
  
  
• Eat a low fat well balanced diet. You should eat mostly foods that are high in fibre vitamins and minerals. Research has shown that antioxidants and certain vitamins such as vitamin A C and E may decrease your risk of developing cervical cancer.
  
  
• Eat 5 to 10 servings of fruits and vegetables each day. Choose more whole-grain breads and cereals. Also cut down on fatty foods such as eggs high-fat meats dairy products (such as whole milk butter and most cheeses which are high in fat) salad dressings margarine and cooking oils.
  
  
• Exercise regularly. You should engage in a total of at least four hours of regular moderate aerobic exercise per week.

Additional Resources:

Cervical Cancer Screening - Frequently Asked Questions

Cancer Care Ontario

Canadian Cancer Society