- More than 12,000 cases of cervical cancer are diagnosed in the United States each year (most under age 55), and over 4,000 women die from the disease annually.
- One- and five-year survival rates for cervical cancer patients are 87 percent and 70 percent, respectively; 91 percent of patients with localized disease live five or more years beyond diagnosis.
- The incidence of cervical cancer has declined over the past several decades, largely due to the widespread use of the Pap test. This simple office test can detect precancerous cervical changes, which can be treated before they progress to cancer.
- Today cervical cancer is less common in developed countries, due to wider access to the Pap test. Incidence is higher in nations with limited medical resources.
- Human papilloma virus (HPV) is the primary cause of cervical cancer. There are now two vaccines approved for the prevention of the most common strains of HPV linked to cervical cancer. The vaccines are recommended for use in girls ages 9 to 26 (and in boys as well, to prevent HPV infection).
What is cervical cancer?
- The cervix is the lower, narrow part of the uterus. It is the passageway through which a woman's menstrual flow travels. It remains closed during pregnancy and dilates when a baby is ready to be born.
- Cervical cancer begins in cells on the surface of the cervix. Over time, cancerous cells can grow (invade) more deeply into the cervix and nearby tissues.
- When cervical cancer spreads, it most commonly travels to the nearby lymph nodes in the pelvis, and may spread (metastasize) to the lungs, liver, or bones.
What causes cervical cancer?
- HPV is the most common cause of cervical cancer. Women who had sex at an early age and those who had many sexual partners are at increased risk for HPV infection and cervical cancer. However, HPV infection is common in healthy women and only rarely causes cervical cancer.
- Cigarette smoking, a suppressed immune system, and having given birth many times increases the risk of cervical cancer in women infected with HPV.
- Long-term use of oral contraceptives (birth control pills) raises the risk of cervical cancer.
What are the signs and symptoms of cervical cancer?
Early-stage cervical cancer may not cause obvious symptoms. But as the cancer grows, a woman may experience:
- Abnormal vaginal bleeding, especially after sexual intercourse or a pelvic exam
- Menstrual periods that are longer or heavier than usual
- Vaginal bleeding after menopause
- Increased vaginal discharge
- Pelvic pain or pain during intercourse
How is cervical cancer diagnosed?
- Most cases of cervical cancer are detected using the Pap test.
- A biopsy is performed to remove a sample of cervical tissue to be analyzed for cancer cells and confirm a diagnosis. The tissue is removed with the aid of colposcopy, which makes it easier to see the cervix.
Additional tests used to determine the stage (extent of growth) of cervical cancer include:
- Chest x-ray
- CT scan
- PET scan
How is cervical cancer treated?
Cervical cancers that have not yet grown deeply into the cervix may be treated with:
- electrocoagulation (use of an electric current to destroy diseased tissue)
- cryotherapy (killing diseased tissue using extreme cold)
- laser ablation
- surgery to remove the tissue
Invasive cervical cancers may be treated with surgery, radiation therapy, or both. Some patients may need chemotherapy.
- Surgery: Some women with early-stage disease, including those who desire to have more children, may choose radical trachelectomy (where only the cervix, part of the vagina, and the lymph nodes in the pelvis are removed). Other women may opt for a hysterectomy to remove the cervix and the rest of the uterus. In many cases, surgery can be performed using minimally invasive techniques. The doctor will discuss each patient's surgical options depending on the stage of her disease.
- Radiation therapy: Women with early-stage disease can be treated with radiation therapy instead of surgery; others have it after surgery, to kill any remaining cancer cells. Concurrent chemotherapy and radiation therapy are recommended for women with more advanced cervical cancer. Radiation treatments are applied both externally (delivered using a machine called a linear accelerator, five days a week for several weeks) and internally ("brachytherapy," in which a cylinder containing a radioactive source is placed inside the vagina for several minutes, a few days a week for several weeks).
- Chemotherapy: Patients with more advanced cervical cancer, including those that spread to other sites, may need chemotherapy after surgery or in combination with radiation therapy. The anticancer drugs most commonly used to treat cervical cancer include cisplatin, gemcitabine, fluorouracil, ifosfamide, and topotecan.
Cervical Cancer Diagnosis and Treatment at White Plains Hospital
Women who come to White Plains Hospital for cervical cancer care benefit from a number of services designed to enhance their experience, including:
- State-of-the-art diagnostic radiology and pathology services.
- Surgery performed by board-certified gynecologic oncologists, including minimally invasive approaches whenever possible.
- Chemotherapy infusions in the Lowenthal Infusion Center, which offers private rooms as well as more open spaces where staff and patients can interact.
- Chemotherapy directed by board-certified physicians.
- Radiation therapy delivered with precision, using the latest technologies.
- A team approach, where gynecologic oncologists collaborate with medical and radiation oncologists and other members of a woman's healthcare team to provide coordinated, compassionate care.
- Clinical trials for patients at White Plains Hospital or other collaborating institutions.
- Support groups and other psychosocial support for patients and families to ease them through the cancer experience.