Cervical Cancer

City of Hope is at the forefront of some of the nation’s most promising cervical cancer treatment and research programs.
Our comprehensive and aggressive approach to cervical cancer involves:

  • screening to facilitate early detection
  • vaccine and/or surgical prevention
  • surgical treatments including minimally-invasive robotic surgery
  • advanced medical therapies including intense-modulated-light radiotherapy, and investigational chemotherapy drugs
  • supportive care

Our Gynecologic Oncology Program delivers these services using the latest technology, providing the most effective, strategic and targeted care.
About Cervical Cancer
  • Cervical cancer is one of the more common cancers of the female reproductive system. Most cervical cancers are linked to infection by HPV (human papillomavirus).
  • Cervical cancer is defined as a disease in which cells of the cervix, the lower part of the uterus adjoining the vagina, become malignant, forming a tumor or tumors. It is usually a slow-growing cancer that may not have symptoms but can be found with regular Pap tests (a procedure in which cells are scraped from the cervix and viewed under a microscope).
  • Approximately 80 percent of cervical cancers are classified as squamous cell carcinomas, which arise from cells in the exocervix (the part closest to the vagina), while about 15 percent are adenocarcinomas, which arise from a different type of cell in the endocervix (the part further away from the vagina). In rare circumstances, cervical cancers may exhibit involvement of both cell types; these are known as adenosquamous carcinomas.
Risk Factors
Studies suggest the following may be risk factors for developing cervical cancer:

  • Human papillomaviruse (HPV) infection is the main risk factor for cervical cancer.
  • HPV is a group of viruses that can infect the cervix.
  • HPV infections are very common and can be passed from person to person through sexual contact. Most adults have been infected with HPV at sometime in their lives.
  • Some types of HPV can cause changes to cells in the cervix. These changes can lead to genital warts, cancer and other problems. Doctors may check for HPV even if there are no warts or other symptoms.
  • If a woman has an HPV infection, her doctor can discuss ways to avoid infecting other people. The Pap test can detect cell changes in the cervix caused by HPV.
  • Treatment of these cell changes can prevent cervical cancer. There are several treatment methods, including freezing or burning the infected tissue. Sometimes medicine also helps.
  • Lack of regular Pap tests: Cervical cancer is more common among women who do not have regular Pap tests. The Pap test helps doctors find precancerous cells. Treating precancerous cervical changes often prevents cancer.
  • Weakened immune system: Women with HIV (the virus that causes AIDS) infection or who take drugs that suppress the immune system have a higher-than-average risk of developing cervical cancer. For these women, doctors suggest regular screening for cervical cancer.
  • Age: Cancer of the cervix occurs most often in women over the age of 40.
  • Sexual history: Women who have had many sexual partners have a higher-than-average risk of developing cervical cancer. Also, a woman who has had sexual intercourse with a man who has had many sexual partners may be at higher risk of developing cervical cancer. In both cases, the risk of developing cervical cancer is higher because these women have a higher-than-average risk of HPV infection.
  • Other sexually transmitted diseases (STDs): Infection with other STDs such as chlamydia, syphilis or gonorrhea makes infection with HPV more likely.
  • Smoking cigarettes: Women with an HPV infection who smoke cigarettes have a higher risk of cervical cancer than women with HPV infection who do not smoke.
  • Using birth control pills over a long period: Using birth control pills over a long period (five or more years) may increase the risk of cervical cancer among women with HPV infection.
  • Having many children: Studies suggest that giving birth to many children may increase the risk of cervical cancer among women with HPV infection.
  • Diethylstilbestrol (DES) may increase the risk of a rare form of cervical cancer and certain other cancers of the reproductive system in daughters exposed to this drug before birth. DES was given to some pregnant women in the United States between about 1940 and 1971. (It is no longer given to pregnant women.)

Preventing Cervical Cancer

In addition to avoiding the established risk factors wherever possible, prophylaxis of cervical cancer with a new vaccine provides powerful protection. The vaccine, commercially marketed as Gardasil, protects females against the four types of HPV that cause most cervical cancers and genital warts.
  • The HPV vaccine is recommended for 11 and 12 year-old girls. It is also recommended for girls and women age 13 through 26 who have not yet been vaccinated or completed the vaccine series.
  • Prophylactic (preventive) hysterectomy may be indicated for extremely high-risk patients.

Symptoms of Cervical Cancer

Precancerous changes and early cancers of the cervix generally do not cause pain or other symptoms. It is important not to wait to feel pain before seeing a doctor. When the disease progresses, women may notice one or more of these symptoms:
  • Abnormal vaginal bleeding
  • Bleeding that occurs between regular menstrual periods
  • Bleeding after sexual intercourse, douching or a pelvic exam
  • Menstrual periods that last longer and are heavier than usual
  • Bleeding after menopause
  • Increased vaginal discharge
  • Pelvic pain
  • Pain during sexual intercourse