Cervical cancer - Prevention

Prevention

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Cervical cancer

Contents

1. Overview
2. Symptoms
3. Causes
4. Diagnosis
5. Treatment
6. Living with
7. Complications
8. Prevention

There's no single way to completely prevent cervical cancer, but there are things that can reduce your risk.

Cervical screening

Regular cervical screening is the best way to identify abnormal changes in the cells of the cervix at an early stage.

Women aged 25 to 49 are invited for screening every 3 years. Women aged 50 to 64 are invited every 5 years. For women who are 65 or over, only those who have not been screened since they were 50, have had recent abnormal tests or have never been screened before are still eligible for screening.

Make sure your GP surgery has your up-to-date contact details so you continue getting screening invitations.

It's important to attend your cervical screening tests, even if you've been vaccinated for HPV, because the vaccine does not guarantee protection against cervical cancer.

If you've been treated for abnormal cervical cell changes, you may be invited for screening more frequently for several years after treatment. How regularly you need to go will depend on how severe the cell changes are.

Although it can identify most abnormal cell changes in the cervix, cervical screening is not 100% accurate. This means you should report any symptoms, such as unusual vaginal bleeding, to your GP, even if you've recently had screening.

Cervical cancer - Complications

Complications

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Cervical cancer

Contents

1. Overview
2. Symptoms
3. Causes
4. Diagnosis
5. Treatment
6. Living with
7. Complications
8. Prevention

Complications of cervical cancer can occur as a side effect of treatment or as the result of advanced cervical cancer.

Side effects

Early menopause

If your ovaries are surgically removed or are damaged during treatment with radiotherapy, it will trigger an early menopause if you haven't already been through it. Most women experience the menopause naturally in their early fifties.

Symptoms of the menopause include:

• no longer having monthly periods or your periods becoming much more irregular
• hot flushes
• vaginal dryness
• loss of sex drive
• mood changes
• leaking urine when you cough or sneeze (stress incontinence)
• night sweats
• thinning of the bones, which can lead to brittle bones (osteoporosis)

These symptoms can be relieved by taking a number of medications that stimulate the production of the hormones oestrogen and progesterone. This treatment is known as hormone replacement therapy (HRT).

Cervical cancer - Living with

Living with

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Cervical cancer

Contents

1. Overview
2. Symptoms
3. Causes
4. Diagnosis
5. Treatment
6. Living with
7. Complications
8. Prevention

The effect cervical cancer has on your daily life will depend on the stage of cancer and the treatment you're having.

Many women with cervical cancer have a radical hysterectomy. This is a major operation that takes time to recover from. Most women will need 6 to 12 weeks off work after a radical hysterectomy.

During recovery, try to avoid strenuous tasks and lifting, such as lifting children or heavy shopping bags. You probably will not be able to drive for at least 3 to 6 weeks after the operation, but you should check with your insurance company what their rules are.

Some of the treatments for cervical cancer can make you very tired, particularly chemotherapy and radiotherapy. Because of this, you may need to take a break from some of your normal activities for a while.

You should not be afraid to ask for practical help from family and friends if you need it. Practical help may also be available from your local authority. Ask your doctor or nurse about who you should contact.

Cervical cancer - Treatment

Treatment

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Cervical cancer

Contents

1. Overview
2. Symptoms
3. Causes
4. Diagnosis
5. Treatment
6. Living with
7. Complications
8. Prevention

Treatment for cervical cancer depends on how far the cancer has spread.

As cancer treatments are often complex, hospitals use multidisciplinary teams (MDTs) to treat cervical cancer and tailor the treatment programme to the individual.

MDTs are made up of a number of different specialists who work together to make decisions about the best way to proceed with your treatment.

Your cancer team will recommend what they think the best treatment options are, but the final decision will be yours. In most cases, the recommendations will be:

• for early cervical cancer – surgery to remove the cervix and some or all of the womb, or radiotherapy, or a combination of both
• for advanced cervical cancer – radiotherapy with or without chemotherapy, and surgery is also sometimes used

Cervical cancer is often curable if it's diagnosed at an early stage.

When cervical cancer is not curable, it's often possible to slow its progression, prolong lifespan and relieve any associated symptoms, such as pain and vaginal bleeding. This is known as palliative care.

The different treatment options are discussed in more detail in the following sections.

Cervical cancer - Diagnosis

Diagnosis

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Cervical cancer

Contents

1. Overview
2. Symptoms
3. Causes
4. Diagnosis
5. Treatment
6. Living with
7. Complications
8. Prevention

If cervical cancer is suspected, you will be referred to a specialist in treating conditions of the female reproductive system (a gynaecologist).

Colposcopy

If you've had an abnormal cervical screening test result, or any symptoms of cervical cancer, you will usually be referred for a colposcopy. This is an examination to look for abnormalities in your cervix. It's normally done by a nurse called a colposcopist.

If you have had abnormal bleeding, your GP may first recommend a chlamydia test before being referred for a colposcopy.

The colposcopist will use a device called a speculum to open your vagina, just like they do during cervical screening. A small microscope with a light at the end (a colposcope) will be used to look at your cervix. This microscope stays outside your body.

As well as examining your cervix, they may remove a small tissue sample (biopsy) so it can be checked for cancerous cells. After a biopsy, you may have some vaginal bleeding for up to 6 weeks. You may also have period-like pains.

In most cases, the abnormalities do not mean you have cervical cancer, but you may be referred to a gynaecologist for further tests.

Treatment to remove abnormal cells can sometimes be done at the same time as a colposcopy.

Cervical cancer - Causes

Causes

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Cervical cancer

Contents

1. Overview
2. Symptoms
3. Causes
4. Diagnosis
5. Treatment
6. Living with
7. Complications
8. Prevention

Almost all cases of cervical cancer are caused by the human papillomavirus (HPV).

Human papillomavirus (HPV)

Almost all cervical cancer cases occur in women who have been previously infected with HPV.

HPV is a group of viruses, rather than a single virus. There are more than 100 different types.

HPV is spread during sexual intercourse and other types of sexual activity, such as skin-to-skin contact of the genital areas or using sex toys, and is very common.

Most women will get some type of HPV infection at some point in their lives.

Some types of HPV do not cause any noticeable symptoms and the infection will pass without treatment.

Others can cause genital warts, although these types are not linked to an increased risk of cervical cancer.

But at least 15 types of HPV are considered high-risk for cervical cancer. The 2 highest risk are HPV 16 and HPV 18, which cause the majority of cervical cancers.

High-risk types of HPV are thought to stop the cells working normally, which can eventually cause them to reproduce uncontrollably, leading to the growth of a cancerous tumour.

As most types of HPV do not cause any symptoms, you or your partner could have the virus for months or years without knowing it.

See preventing cervical cancer for more information about reducing your chances of developing an HPV infection.

Cervical cancer - Symptoms

Symptoms

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Cervical cancer

Contents

1. Overview
2. Symptoms
3. Causes
4. Diagnosis
5. Treatment
6. Living with
7. Complications
8. Prevention

The symptoms of cervical cancer are not always obvious, and it may not cause any at all until it's reached an advanced stage.

This is why it's very important to you attend all your cervical screening appointments.

Unusual bleeding

In most cases, abnormal vaginal bleeding is the first noticeable symptom of cervical cancer.

This includes bleeding:

• during or after sex
• between your periods
• after you have been through the menopause

Visit your GP for advice if you experience any type of abnormal vaginal bleeding.

Cervical cancer - Overview

Overview

-

Cervical cancer

Contents

1. Overview
2. Symptoms
3. Causes
4. Diagnosis
5. Treatment
6. Living with
7. Complications
8. Prevention

Cervical cancer develops in a woman's cervix (the entrance to the womb from the vagina). It mainly affects sexually active women aged between 30 and 45.

Symptoms of cervical cancer

Cancer of the cervix often has no symptoms in its early stages. If you do have symptoms, the most common is abnormal vaginal bleeding, which can occur during or after sex, in between periods, or new bleeding after you have been through the menopause.

Abnormal bleeding doesn't mean you have cervical cancer, but you should see your GP as soon as possible to get it checked out.

If your GP thinks you might have cervical cancer, you should be referred to see a specialist within 2 weeks.