Diagnosis and Treatment

It is hard for someone to tell if they have cervical cancer or not because in pre-cancers, there are usually no symptoms. It isn’t until the cancer has progressed enough and has moved into nearby tissues that there are finally symptoms. This is usually when someone would go in to see their doctor, and this usually means you’re in past stage I.

Now, doctors suggest getting tested, and the first step is getting regular Papanicolaou, or Pap tests. The Pap test looks for any abnormalities in the cervical cells. The normal squamous epithelial cells are pale blue to orange in color and are plate-like. The cancerous epithelial cells will look smaller overall, with darker and more irregular nuclei.

If the Pap test shows the abnormal epithelial cells, then your doctor will want to do a colposcopy. This is a procedure that allows the doctor to examine the cervix with more detail and actually see if there are any irregularities on the cervix. A colposcope is the instrument that they use. It uses lens like a binoculars to zoom in on the cervix.

 

This picture is showing both a normal cervix and one that has some abnormal growth.

Once they have examined the cervix, they'll do a biopsy if they see any irregular growth on the cervix and remove a small piece of tissue to run tests. 

Cervical Cancer Stages

This shows the regions for each stage of cancer.

There are five stages of cervical cancer, starting at 0 and progressing to 4, with each new stage getting more severe. The first stage is 0. This means that the cancer cells are found on the surface of the cervix, and nowhere else. When the cancer has localized to the cervix, it’s a stage I cancer. In stage II, the cancer has spread up the cervix and into the upper part of the vagina. When it reaches the lower part of the vagina, it’s a stage III cancer. Stage IV is very severe and has spread from the cervix and vagina into the bladder and/or rectum. It could even progress into the lymph nodes and lymphatic vessels.

This is the anatomical progression of cervical cancer.

This is a diagram of the progression of the cancer. Notice how the cells and the nucleus become irregular in shape.

Symptoms

Cervical cancer may spread to the bladder, intestines, lungs, and liver. Often there are no problems until the cancer is advanced and has spread. Symptoms of advanced cervical cancer may include:

• Back pain
• Bone pain or fractures
• Fatigue
• Leaking of urine or feces from the vagina
• Leg pain
• Loss of appetite
• Pelvic pain
• Single swollen leg
• Weight loss

Treatment

The treatment of cervical cancer greatly depends on which stage of the cancer you are in and is therefore based on the individual circumstance. Age, overall health, quality of life, and the desire to have children are all factors that people have to look at in their own predicament. With that being said, there are different treatment choices one can make to try and eliminate the cancer.

• Surgery
• Radical Trachelectomy
• This procedure is fairly new. They can now remove the cervix and part of the vagina, and then connecting the uterus to the remaining part of the vagina. This allows people to still have children, which is important because most women have cervical cancer around the age of 30.
• Radiation Therapy
• This is the use of high-energy X-rays to kill cancer cells in a targeted area.
• Chemotherapy
• This is the use of drugs to reach the cancer wherever it is in the body. 
• It targets cells that divide rapidly, anywhere in the body. This can be risky because there are other cells besides cancer cells that divide rapidly. i.e. cells in the bone marrow, digestive tract, and hair follicles.
• Chemoradiation Therapy
• This is the combination of radiation and chemotherapy.