Cervical Cancer

Cervical cancer occurs when abnormal cells develop in the cervix — the lower part of the uterus that connects to the vagina — and grow out of control.

Cervical cancer types include:

• Squamous cell carcinoma – the most common form of cervical cancer, which begins in the lining of the outer part of the cervix
• Adenocarcinoma – begins in cells that line the cervical canal

The exact cause of cervical cancer isn't completely understood, but it is known that human papillomavirus (HPV) — a sexually-transmitted infection — plays a role. Many people have HPV, however, and not all develop cancer. This suggests that HPV infection alone isn't enough to cause cervical cancer and that lifestyle factors likely also play a role.

Cervical cancer risk factors include:

• Having HPV
• Early sexual activity
• Other sexually transmitted infections, including syphilis, gonorrhea, chlamydia or HIV/AIDS
• Having a weakened immune system
• Smoking

As part of your routine well-woman exam beginning in your early 20s, your OB-GYN will perform a Pap test. This test can detect the earliest signs of cervical cancer, as well as infections and abnormal cervical cells that may eventually become cancerous.

Learn more about cervical cancer screening >

Early stage cervical cancers usually cause no symptoms. This is why it's so important to follow cervical cancer screening guidelines.

If the cancer grows larger, you may notice one or more cervical cancer symptoms, including:

• Vaginal bleeding between regular menstrual periods or after menopause
• Bleeding after sexual intercourse or after a pelvic exam
• Abnormal menstrual periods (longer and heavier than usual)
• Vaginal discharge (which may contain blood) between periods or after menopause
• Pelvic pain or pain during intercourse

These symptoms can also indicate conditions other than cervical cancer. If you are experiencing any of the above, contact your doctor as soon as possible so the cause can be diagnosed and treated promptly.

If you are experiencing cervical cancer symptoms or if your Pap test results are abnormal, your doctor will first ask you some questions and perform a physical exam to look for any changes in the uterus, vagina, ovaries, fallopian tubes, cervix, bladder or rectum.

If your doctor finds abnormal results from the pelvic exam or a Pap test, the doctor may want to test for human papillomavirus (HPV). This test is similar to a Pap test and checks for strains of HPV that are seen more often in women with cervical cancer.

If the HPV test is positive, your doctor may recommend one of the following tests:

• Colposcopy – uses a colposcope (an instrument that magnifies the cells of the cervix and vagina, similar to a microscope) to obtain a lighted, magnified view of the tissues of the vagina and the cervix. The test should not be painful and can be done in your doctor's office.
• Biopsy – uses one of several methods to obtain a small tissue sample from the cervix so a pathologist can more closely examine it for cancer. This is the only way to get a definite diagnosis of cervical cancer.
• Imaging tests – includes X-rays, transvaginal ultrasound, computed tomography (CT) scan, magnetic resonance imaging (MRI) and positron emission tomography (PET)

Cervical cancer treatment options vary based on the type and stage of the cancer. At Houston Methodist, your cervical cancer care team will design the best treatment plan for your specific diagnosis and unique lifestyle needs.

Surgery for Cervical Cancer

A variety of surgeries are available to treat cervical cancer, including:

• Conization – a cone-shaped piece of tissue is removed from the cervix to remove the abnormal cells
• Hysterectomy – surgical removal of the uterus and cervix
• Radical hysterectomy – a procedure where the uterus, cervix, upper vagina and adjacent tissues are surgically removed
• Trachelectomy – the cervix and upper part of the vagina are removed, but the uterus is spared in order to preserve fertility
• Pelvic exenteration – treats recurrent cervical cancer by removing the same tissue and organs as with a radical hysterectomy, as well as potentially additional organs, including the bladder, vagina, rectum and part of the colon.
• Pelvic lymph node dissection – removal of the lymph nodes adjacent to the cervix to evaluate for spread of disease and for treatment planning. This is performed in combination with a radical hysterectomy.

Surgical oncologists at Houston Methodist perform radical hysterectomy or trachelectomy with pelvic lymph node dissection robotically, which results in a shorter overnight stay in the hospital.

Reconstructive Surgery After Cervical Cancer

Specialists at Houston Methodist are also experts at reconstructive surgery. This means we can often restore the structure and function of areas affected by cervical cancer and/or cervical cancer treatment.

Chemotherapy for Cervical Cancer

Chemotherapy kills cancer cells using drugs that are given intravenously by IV or orally. The way the chemotherapy is given depends on the type and stage of the cervical cancer being treated.

Chemotherapy is used to treat cervical cancer in several situations. Chemotherapy can help radiation work more effectively in a combined therapy called “concurrent chemoradiation.” Chemotherapy can also be given without radiation before or after chemoradiation therapy. If cervical cancer returns or spreads, chemotherapy may also be used for treatment.

Radiation Therapy

Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. Many different types of radiation can be employed, depending on the type of cervical cancer. Your care team will explain your options and help you make the best decision for your specific condition.