Cervical cancer

Cervical cancer is when abnormal cells in the lining of the cervix grow out of control. Different types of cervical cancer begin in different kinds of cells. The 2 main types are:

• squamous cell carcinoma (most common)
• adenocarcinoma (less common).

A woman’s reproductive system

The picture below shows a woman’s reproductive system. This is the part of the body that helps make a baby. The cervix is part of the reproductive system.

Ovaries – Two small, oval-shaped organs. Eggs are made in the ovaries.

Uterus – Also called the womb. This is where a baby grows.

Fallopian tubes – Thin tubes that go from the uterus to the ovaries. Every month, one of the ovaries sends an egg into the fallopian tube next to it.

Cervix – This connects the lower part of the uterus to the vagina.

Vagina (birth canal) – This connects the uterus to the outside of the body. It is where a baby comes out when born, sex happens and period blood flows.

You can have cervical cancer without noticing anything is wrong.

Warning signs may include:

• bleeding between periods, after menopause or after sex
• pain during sex.

These signs do not always mean you have cervical cancer, but it’s important to see your doctor if you have these or other unusual symptoms. Sometimes, a cervical screening test (which used to be called a Pap test) will show that you have a higher risk of cervical cancer. This does not mean you have cancer, but you will need to have some other tests to check.

The earlier cervical cancer is found, the easier it is to treat.

You may have one or more tests. These include:

• Colposcopy – The doctor uses a special tool to look closely at the cervix and vagina and check for changed cells. A device (called a speculum) is used to open the vagina a little bit. This may feel strange or cold but shouldn’t hurt.
• Biopsy – A tiny piece of tissue is taken out and sent to a lab for checking.
• Imaging scans – Special scans might be used to take pictures inside your body.
• Examination under anaesthetic (EUA) – If you need this test, you’ll have some medicine to make you sleep (called a general anaesthetic), so the doctor can check your cervix, vagina, uterus and bladder (see next page). This is done in hospital and you can usually go home the same day.

If you feel uncomfortable having a test, ask a nurse, Aboriginal and Torres Strait Island health professional or someone from your family or mob to be in the room with you.

The test results will tell the doctor what type of cervical cancer you have, and if the cancer has spread (the stage). This information helps the doctors work out the best treatment for you.

There are different types of treatment for cervical cancer. You may have one or more of these treatments:

Surgery (operation)

• Surgery may be needed to remove the part of the cervix with cancer, and sometimes nearby lymph nodes (small glands). Other organs, like the uterus, may also be removed (called a hysterectomy).

Radiation therapy

• Also called radiotherapy, radiation therapy uses x-rays to destroy cancer cells.
• It may be given from outside the body (external beam radiation therapy) or inside the body (brachytherapy). Both types may be used.

Chemotherapy

• Sometimes called chemo, chemotherapy is strong medicine that can destroy the cancer cells.

Other medicines

• Special medicines called targeted therapy or immunotherapy may be used to treat cervical cancer.
• Sometimes they are used along with chemo.

Going to all your treatment sessions gives you the best chance of a good result.

Treatment for cervical cancer can cause problems. These are called side effects. Here are some of the common ones:

• Problems with weeing and pooing – You may need to wee a lot and it might burn when you wee. Try to drink plenty of water because this can help. You may also get watery poos (diarrhoea).
• Periods stop – Women who have their ovaries or uterus removed and who have not been through menopause will no longer have periods (sometimes called monthlies or bleeds).
• Swollen legs – This might be a condition called lymphoedema. It may happen if you’ve had lymph nodes taken out. Let your doctor know if you notice any swelling in your legs. It’s best to treat lymphoedema early.

Other side effects may also happen. Talk to your doctor if you notice anything unusual or have other concerns.

This information was adapted for Aboriginal and Torres Strait Islander people by Menzies School of Health Research in consultation with a clinical advisory group and an Indigenous consultation group. Cancer Council NSW has updated this fact sheet in consultation with cancer experts and Aboriginal people with an experience of cancer. We thank all reviewers and the generous sharing of cultural knowledge by: Lisa Fletcher, Ngarabul and Kamilaroi woman and Aboriginal Liaison Nurse, Mid North Coast Cancer Institute, NSW; Kirsty Glanville, Wiradjuri woman and Aboriginal and Torres Strait Islander Service Design Lead, Cancer Council Australia; Kristy Stewart, Jaru woman and Consumer. We also thank Dr Antonia Jones, Gynaecological Oncologist, Royal Women’s Hospital and Mercy Hospital for Women, Melbourne, VIC.