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Cervical Cancer

Everything you need to know about living well with cervical cancer

  • Introduction
  • Types
  • Symptoms
  • Daily Living
  • Support
  • Glossary

Introduction

If you or someone you know has been given a cervical cancer diagnosis, this guide may help you understand more about the condition.

You may be wondering, what is cervical cancer? NRS Healthcare are here to help explain this, as well as explore cervical cancer symptoms, treatments for cervical cancer, what causes cervical cancer, and types of cervical cancer. We hope you find this guide useful, and we hope it raises awareness of the signs of cervical cancer.

Introduction

What is cervical cancer?

This type of cancer develops in the cervix, which is part of the female reproductive system. It is the lowest part of the uterus (womb) which attaches to the vagina. The cancer begins to develop as abnormal cells on the surface of the cervix, which usually take many years to become cancerous. In the UK, cervical cancer screening is offered to women to detect these early cellular changes in order to help prevent the disease.

Cervical cancer symptoms usually only appear when cervical cells have become cancerous, which may take a decade or more to occur.

Cervical cancer is fairly common and it is the most commonly occurring cancer for younger women up to age 35. The survival rate is good, mostly due to early detection and treatment. Cancer Research UK reports that almost 100% of cervical cancer cases are preventable.

Read more about cervical cancer.

What causes cervical cancer?

Cervical cancer develops in the cells of the cervix and is most often caused by a common infection that the majority of adults contract, called the human papilloma virus (HPV). There are lots of different variations of the virus, which is spread through touch and often contracted through sexual activities. There are no symptoms of HPV, so people develop it without realising and pass it to others. Some types of HPV lead to a high risk of cervical cancer. Read more about what causes cervical cancer.

There are other potential cervical cancer risk factors which may make some women more susceptible to developing the disease, including:

• Smoking

• Long-term use of oral contraceptive pill

• Becoming a mother at age 17 or under

• Having a family history of cervical cancer

• Having had other cancers, particularly of the reproductive or renal systems

• Having 5 children or more

• Being the daughter of a woman who was prescribed diethylstilbestrol (DES) during her pregnancy (if you were born between 1938-1971)

Cancer Research UK provides a clear explanation of what causes cervical cancer.

Did you know... "Cervical cancer affects around 2,000 women in the UK each year."

Types of Cervical Cancer

Read on to find out more about the types of cervical cancer.

There are two main types of cervical cancer. Once a woman is given a diagnosis of cervical cancer, she will undergo tests to establish which type of cervical cancer is present, and the cancer will be graded according to how cancerous the cells look. The cancer may also be given a stage, which determines if and how far the cancer has spread. This part of cervical cancer diagnosis is important as it helps doctors to ascertain the best course of treatment for each individual.

Introduction

The two main types of cervical cancer are:

Squamous cell cancer – the majority of cervical cancer develops in the squamous cells which are found covering the cervix

Adenocarcinoma – the rarest cervical cancer type, this develops in glandular cells inside the endocervical canal

When a person is given a diagnosis of cervical cancer, the cancerous cells will be graded 1, 2 or 3, with grade 1 cervical cancer showing that cells are mostly normal with some cancerous cells, and grade 3 being the most advanced – showing cells look mostly abnormal/cancerous.

Cancer of the cervix is also described with the following stages:

Stage 1a – very small amount of cancer which has not spread

Stage 1b – a larger amount of cancer but no spread

Stage 2a – cancer has spread to the vagina

Stage 2b – cancer has spread to surrounding cervical tissue

Stage 3 – cancer has spread through the pelvis and may have spread to the urethra

Stage 4a – cancer has spread to organs in close proximity to the cervix e.g. the bladder

Stage 4b – cancer has spread to organs that are not close to the cervix e.g. the lungs

Did you know... "Cervical cancer is caused by cancerous cells developing in the cervix, located at the neck of the uterus (womb)."

Cervical Cancer Symptoms

Here we describe the most common symptoms of cervical cancer, explore what cervical cancer diagnosis entails and discuss the process of cervical screening (smear tests) to prevent cervical cancer.

Cervical cancer symptoms are rare in the early stages of the disease. If cervical cells are abnormal, it may take years for them to develop into cancer, which is why it is extremely important for women to attend their cervical screening appointments. Early detection of abnormal cells in the cervix, identified via this nationwide screening programme, can prevent cancer from ever developing.

However, there are symptoms of cervical cancer that may occur as the disease progresses, although they can often be overlooked by both the woman experiencing them and even by GPs. It is important to note that even if a woman has been regularly screened for cervical cancer, if she experiences any of the following symptoms she should still see her GP.

Introduction

Cervical cancer symptoms include:

• Bleeding from the vagina in between periods

• Bleeding from the vagina when having sex or afterwards

• Bleeding from the vagina if you are an older woman who has been through menopause already

• Pain during sex

• Vaginal discharge (may be smelly or look strange)

• Lower back pain

• Pelvic pain

There are lots of reasons why you may have these symptoms – they are not just symptoms of cervical cancer – but it’s really important you have them checked by your GP.

Advanced cervical cancer symptoms may also include:

• Issues with bowel movements i.e. constipation, diarrhoea

Incontinence (bowel or urinary)

• Swollen legs

• Severe pain (side of the body, back, pelvic areas)

Read more about cervical cancer symptoms.

What is a smear test?

All women (or people with a cervix who are registered as ‘female’) living in the UK are eligible to undergo cervical screening, commonly known as a ‘smear test’, from age 25 up to age 64. Women receive a letter from their GP surgery every 3 years (for those aged 25 – 49) or 5 years (for those aged 50 – 64) to attend a screening appointment. It is up to each person to contact their surgery and book their smear test/screening appointment.

A smear test takes a sample of cells from the cervix and analyses them to check whether the cells look normal, or if they show any changes that could potentially mean they may become cancerous. Sometimes, cervical cells are also tested for HPV, but it depends where in the UK a woman lives as to whether or not this is part of the test.

A smear test is usually carried out by a nurse in a private treatment room. The nurse could be male or female, so if you feel strongly that you would prefer a female nurse, you can request this upon booking your appointment. Alternatively, you may wish to ask for a female chaperone within the surgery. Occasionally, a nurse will have a student or assistant with them. You are welcome to take a friend or family member into the test with you if you would like support.

You will need to remove underwear and trousers – you can usually leave a skirt or dress on if this is comfortable and practical. There will be a bed and a curtain for your comfort and privacy. The nurse will ask you to lie back, usually with your feet together and knees flopped apart to the sides. If this is uncomfortable for you for any reason, the nurse may be able to advise an alternative position for you.

Some people feel embarrassed in this situation, but it’s important to remember that the nurse does this all the time, and the test is usually over within minutes, with the potential to save your life.

The nurse gently inserts a small device called a speculum into your vagina which opens your vagina more so that the nurse can see your cervix. Some people find this uncomfortable but it is rarely painful. Then the nurse uses a small brush that gently touches your cervix to take some of the cells for analysis. After this you can get dressed and the appointment is complete.

Read more about what happens at a smear test.

What do smear test results mean?

It may take a couple of weeks to receive your smear test results which will arrive as a letter through the post. Some people may feel anxious waiting for their results, but try not to worry. Statistically, it’s rare for anyone to be diagnosed with cervical cancer from their smear test result. Most people receive a ‘normal’ result and no further action or treatment is required.

If your results come back and say ‘abnormal’, this means that some of the cells on your cervix may show some changes. If these are mild changes, you may not need any treatment, or may require a more regular screening to keep an eye on the cell changes. Sometimes, smear test results show that cell changes are more severe, and if this is the case, you may be invited for a colposcopy.

Occasionally, your results may show that the test was not successful meaning you will need to rebook an appointment for another smear test.

If your cells were also tested for HPV, this will be recorded in your results. If your test shows you have HPV, the results will be analysed alongside any cellular changes, to plan the next step, which may be to have another test in a year or so, or you may be referred for a colposcopy. If you have any queries regarding your result, you can speak to your GP or the cervical screening centre.

Read more about smear test results.

There are several treatment options for abnormal cells so, after a colposcopy, you may need to have minor procedures to remove the abnormalities, in order to reduce the risk of the cells becoming cancerous in the future. Read more about treatment for abnormal cervical cells.

A smear test is the first step to understanding if you are at risk of developing cervical cancer. Having abnormal cervical cells does not mean that you have cervical cancer or will ever get cervical cancer. However, some women do develop cervical cancer. If you have been given a diagnosis of cervical cancer, read on to find out more about what this may mean for you.

Diagnosis of cervical cancer

If you visit your GP with symptoms of cervical cancer, your GP will ask lots of questions about your symptoms, how long you have had them and when they occur.

Your GP may physically examine your tummy and carry out an internal exam to check your cervix and vagina, and possibly your rectum. They may suggest you keep an eye on the symptoms and come back in a couple of weeks, or they may refer you to a specialist or for tests.

There are two tests used to check for cervical cancer called a colposcopy and a cone biopsy. A colposcopy magnifies the cervix and enables abnormal cells to be seen, allowing samples to be taken which can be examined in a lab. A colposcopy is used if a woman has undergone cervical screening and abnormal cells have been identified. It is also used if a woman presents with cervical cancer symptoms.

A cone biopsy is a procedure carried out under general anaesthetic, which removes a cone shaped area of cervical tissue before being tested for cancerous cells.

If the test results show you have cervical cancer, you are likely to require further testing to check if the cancer has spread elsewhere around the body, such as blood tests, CT scan, MRI scan, X-ray or PET scan.

Read more about diagnosis of cervical cancer.

Did you know... "Cervical cancer is highly preventable, and women aged 25 and over are eligible for free screening in the UK to test whether or not they are at risk of the disease."

Living with Cervical Cancer

Here, we explore the impact cervical cancer has on daily life.

Receiving a cervical cancer diagnosis is likely to be shocking and worrying, and can take some time to process. You are likely to need cervical cancer treatment and you may even be dealing with an advanced stage of cervical cancer. Each person experiences it differently, so here we explore some of the issues that may affect daily life, depending on the stage and grade of cervical cancer that a woman may have.

We discuss the impact of living with cervical cancer, cervical cancer treatments, and sources of cervical cancer help and support.

Introduction

Impact on daily living

Cervical cancer diagnosis inevitably affects a woman’s daily life in several ways.

Symptoms – cervical cancer symptoms may be painful to deal with and some people experience feelings of low mood or depression

Treatment – cervical cancer treatment can seem daunting and there are many ways in which cervical cancer treatment affects daily life. There may be a wait before treatment can commence, which can create anxiety. If surgery is required, this may have an effect on a woman’s fertility, which may be extremely difficult for some women. Surgery may require a long recovery period and other forms of treatment may result in side effects. However, there are lots of sources of cervical cancer support which may help women who are undergoing treatment. Some women find it helpful to talk to others who are in a similar situation

Sex – cervical cancer may impact how a woman feels about sex. Living with cancer can affect a person’s libido. Cervical cancer treatment and side effects may make sex feel different, however, once treatment has finished and a woman is healed, she may feel ready to experience sex

Lifestyle – women who have or who are recovering from cervical cancer may be advised to, or decide to, make some lifestyle changes to reduce their risk of developing cancer again such as quitting smoking

Fatigue – this is a common cancer symptom, because the body is constantly fighting the disease, and many women experience fatigue during and after cervical cancer treatments i.e. post-surgery or whilst undergoing chemotherapy and radiotherapy. Fatigue can be difficult to deal with. Some women may experience fatigue for a short time, whilst others experience it for many years after their cancer is treated. Read more about dealing with cervical cancer fatigue

Prognosis and survival – it is natural to worry about a cancer diagnosis, whatever stage or grade the cancer is at. Successful cervical cancer treatment may still mean that a woman has to have regular checks, which may cause anxiety and the feeling that the threat of developing cancer again is always at the back of their mind. Some women may be told that their cervical cancer is advanced and untreatable. These women are likely to need different support and this End of Life Guide from Macmillan Cancer Support may be useful

Cervical cancer treatments

Cervical cancer is highly treatable and curable. The earlier cervical cancer is diagnosed, the better the chances that the disease will be cured. In some cases, when cervical cancer is diagnosed at a later stage, the focus will be on treating symptoms and slowing down the progression of the disease.

There are different types of cervical cancer treatments that you may be offered and your care team will be able to explain the benefits and side effects of these in detail to help you decide how you wish to progress. The types of cervical cancer treatment you are recommended will differ according to how advanced the cancer is.

Early cervical cancer may be treated with large loop excision of the transformation zone, which removes cancerous cells with an electrical current. This only requires local anaesthetic. Alternatively, a person with early cervical cancer may be offered a cone biopsy, which removes affected tissue from the cervical area under general anaesthetic. These treatments for cervical cancer are highly successful in removing cancer.

Surgery is often a cervical cancer treatment option when cancerous cells are more advanced, or where cancer has spread to surrounding areas of the cervix, i.e. into the rest of the reproductive organs. Surgery may therefore cause a woman to no longer be able to get pregnant or carry a baby, and some operations will cause menopause. These can be extremely difficult for a woman to deal with. Cervical cancer operations include:

Trachelectomy – removal of cervix and part of vagina

Hysterectomy – removal of cervix and womb, and possibly fallopian tubes

Pelvic exenteration – removal of cervix, vagina, womb, ovaries, fallopian tubes, bladder and rectum

Read more about surgery for cervical cancer.

Radiotherapy and chemotherapy are both used as cervical cancer treatments. Some people may require both treatments. Chemotherapy and radiotherapy are used to kill cancerous cells, help stop the cancer spreading and relieve cervical cancer symptoms in advanced cases. Read more about cervical cancer treatments.

Women who have been successfully treated for cervical cancer will have regular checks every few months to find out whether or not treatment has been successful. After a certain period of time, if their cancer is cured, they will still require regular tests.

Cervical cancer products

Daily living aids can be useful products for cervical cancer patients. They can help make daily tasks easier for some women who may be recovering from treatment, have painful symptoms or have advanced cancer. Daily living aids could help make life more comfortable, help a woman to do everyday tasks that are causing pain or fatigue, and help women with mobility problems to get around more easily. Here, we list some of the activities daily living aids can help make easier.

Taking a bath

Having a shower

Using the toilet

Standing for long periods

Getting in and out of bed

Getting in and out of a chair

Mobility

If you are unsure what cervical cancer products may help you, contact our Occupational Therapist Product Advice team for free on 0345 121 8111, or by emailing [email protected]

Cervical cancer diet

Eating a healthy, balanced diet is important for somebody going through cancer and post-cancer treatment. A healthy diet for cervical cancer recovery is also important, as it may help the body to heal. Some women who have cervical cancer treatment may find their appetite is affected. Read more cervical cancer diet advice.

Exercise for cervical cancer

Exercise may be the last thing on a woman’s mind if she is dealing with a cervical cancer diagnosis, experiencing difficult symptoms or undergoing treatment for cervical cancer. However, gentle exercise can help recovery, reduce anxiety and stress, improve mood, and reduce fatigue. Read more about being active when you have cancer.

Cervical cancer and employment

Cervical cancer diagnosis may mean that a woman needs to take some time off work; this will be determined by how advanced the cancer is, and the cervical cancer treatment she undergoes. Many women are able to return to work if their treatment is successful. Read more information on cervical cancer and work.

Did you know... "Cervical cancer symptoms only usually appear when the cancer is more advanced, but may include unusual vaginal bleeding, pain during sex and lower back pain."

Support for Cervical Cancer

Remember, you are not alone!

We hope this cervical cancer explanation has been useful to you, whether you are living with cervical cancer yourself, think you have cervical cancer symptoms, or know somebody who has been given a cervical cancer diagnosis.

If you are reading this because you are concerned about having a smear test – please remember that having a smear test is the best way to check if you are at risk of developing cervical cancer. Most women are not at risk and there are options for early prevention procedures if you are deemed at risk.

For women with cervical cancer and their families, connecting to other people who are going through similar experiences can also help. Here, we point you to cervical cancer support groups and websites that provide further information and advice.

Introduction

Communities

Cervical Cancer and Pre-cancer Support Group – a Facebook support group for anyone who has cervical cancer or pre-cancerous cells, to discuss and share their experiences

Jo’s Cervical Cancer Trust Forum – an online community for people to share their experiences of living with cervical cancer

Resources

Cancer Research UK – the leading cancer charity, providing information and advice about all types of cancer, treatments and research projects, as well as a nurse-run helpline

Jo’s Cervical Cancer Trust – the only UK charity dedicated to supporting females with cervical cancer, and their families, providing online advice and information about all aspects of smear tests/cervical screening, cervical cancer and its treatment, as well as a helpline, real life stories, and a forum

Macmillan Cancer Support – charity supporting people with all types of cancer and their families, with online information and telephone helpline support regarding all aspects of living with cancer, as well as local support groups and ‘Macmillan nurses’ working in the NHS

Marie Curie – a UK charity supporting people with terminal illness and end of life care, providing lots of practical advice and tips on preparing for end of life, living with a terminal illness and a free support helpline

NHS – source of official medical advice and information about cervical cancer, symptoms, treatments and living with the condition

The Eve Appeal – a charity supporting women with gynaecological cancer such as cancer of the cervix, womb, ovary, vulva or vagina

Did you know... "There are lots of cervical cancer treatments such as surgery, chemotherapy and radiotherapy, and these are often successful in treating and curing the disease."

Glossary

Unsure what something means? Checkout our Glossary section below.

Although we always try to explain things as simply and as clearly as possible, sometimes it’s necessary to use the correct medical terminology. Medical terms are often known for being tricky to pronounce and if you’re not an expert in the subject, they can also be a little difficult to understand. Below, we’ve put together a list of terms used on this page along with a brief explanation of what they mean to help make your understanding of cervical cancer as straightforward as possible.

Introduction

Cells

– the building blocks of the body, involved in all biological aspects of life and keeping the human body functional

Cervix

– part of the female anatomy, the cervix is the end of the uterus and forms a narrow passage

Chemotherapy

– medication treatment for cancer which aims to stop cancer cells developing and spreading, which is widely used but has many side effects such as fatigue, hair loss and sickness

Colposcopy

– a procedure that looks closely at the cervix to check for signs of disease

Cone biopsy

– removal of bodily tissue in a cone shape for examination in a lab

CT scan

– a full body x-ray scan that helps identify disease within the organs, bones and other areas of the body

Diethylstilbestrol (DES)

– a form of hormone prescribed to women decades ago to help prevent miscarriage, which was later discovered to cause fertility problems, malformed reproductive organs and an increased risk of gynaecological cancers in female offspring

Endocervical canal

– the main section of the female cervix, which is a passage to the uterus

Fallopian tubes

– in the human body, these tubes carry eggs from the ovaries to the uterus

Human papilloma virus (HPV)

– a family of viruses that are transmitted by touch, which many adults contract and which may cause health issues such as genital warts or cervical cancer for some people

Menopause

– a part of ageing that all women go through, usually between 45 – 55 years, where oestrogen levels produced naturally by the body decline, resulting in periods stopping and being no longer able to have children

MRI scan

– a health scan that looks at the whole body using magnetic fields and radio waves

PET scan

– positron emission tomography (PET) uses dye and radiation in the body to produce 3D images which help explore how the body is working and diagnose disease

Rectum

– the last part of the intestine which signals the anus when the bowels need to open

Renal

– related to the kidneys

Reproductive system

– organs in the body that are involved in reproduction, i.e. creating offspring, and for a female involves organs such as ovaries, fallopian tubes, cervix, uterus, vagina

Speculum

– a plastic or metal hand held device that is inserted into the vagina to widen it and allow cervical screening to take place

Uterus

– otherwise known as the womb in females, which carries a foetus

Vagina

– a canal shaped part of the female anatomy which connects to the cervix


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