Cervical cancer is a type of cancer that develops in the cells of the cervix, which is the lower part of the uterus that connects to the vagina. It is typically caused by the human papillomavirus (HPV), which is a common sexually transmitted infection. Cervical cancer often develops slowly over time and may not cause any symptoms in its early stages. However, as the cancer progresses, symptoms may include vaginal bleeding, pelvic pain, pain during sex, and abnormal vaginal discharge. Cervical cancer is often detected through regular screening tests, such as a Pap smear or HPV test. Treatment options for cervical cancer depend on the stage and severity of the cancer, as well as the individual's age, health status, and personal preferences. Treatment may include surgery to remove the cancer, radiation therapy, chemotherapy, or a combination of these approaches. It is important to work closely with a healthcare provider to develop a personalized treatment plan and receive appropriate follow-up care after treatment to monitor for recurrence and manage any side effects or complications. Prevention measures, such as vaccination against HPV and regular cervical cancer screening, can also help to reduce the risk of developing cervical cancer.

Cervical cancer begins when healthy cells in the cervix develop changes (mutations) in their DNA. A cell's DNA contains the instructions that tell a cell what to do.

Healthy cells grow and multiply at a set rate, eventually dying at a set time. The mutations tell the cells to grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can break off from a tumor to spread (metastasize) elsewhere in the body.

It isn't clear what causes cervical cancer, but it's certain that HPV plays a role. HPV is very common, and most people with the virus never develop cancer. This means other factors — such as your environment or your lifestyle choices — also determine whether you'll develop cervical cancer.

Types of cervical cancer

The type of cervical cancer that you have helps determine your prognosis and treatment. The main types of cervical cancer are:

• Squamous cell carcinoma. This type of cervical cancer begins in the thin, flat cells (squamous cells) lining the outer part of the cervix, which projects into the vagina. Most cervical cancers are squamous cell carcinomas.
• Adenocarcinoma. This type of cervical cancer begins in the column-shaped glandular cells that line the cervical canal.

Sometimes, both types of cells are involved in cervical cancer. Very rarely, cancer occurs in other cells in the cervix.

To reduce your risk of cervical cancer:

• Ask your doctor about the HPV vaccine. Receiving a vaccination to prevent HPV infection may reduce your risk of cervical cancer and other HPV-related cancers. Ask your doctor whether an HPV vaccine is appropriate for you.
• Have routine Pap tests. Pap tests can detect precancerous conditions of the cervix, so they can be monitored or treated in order to prevent cervical cancer. Most medical organizations suggest beginning routine Pap tests at age 21 and repeating them every few years.
• Practice safe sex. Reduce your risk of cervical cancer by taking measures to prevent sexually transmitted infections, such as using a condom every time you have sex and limiting the number of sexual partners you have.
• Don't smoke. If you don't smoke, don't start. If you do smoke, talk to your doctor about strategies to help you quit.

Treatment for cervical cancer depends on several factors, such as the stage of the cancer, other health problems you may have and your preferences. Surgery, radiation, chemotherapy or a combination of the three may be used.

Surgery

Early-stage cervical cancer is typically treated with surgery. Which operation is best for you will depend on the size of your cancer, its stage and whether you would like to consider becoming pregnant in the future.

Options might include:

• Surgery to cut away the cancer only. For a very small cervical cancer, it might be possible to remove the cancer entirely with a cone biopsy. This procedure involves cutting away a cone-shaped piece of cervical tissue, but leaving the rest of the cervix intact. This option may make it possible for you to consider becoming pregnant in the future.
• Surgery to remove the cervix (trachelectomy). Early-stage cervical cancer might be treated with a radical trachelectomy procedure, which removes the cervix and some surrounding tissue. The uterus remains after this procedure, so it may be possible to become pregnant, if you choose.
• Surgery to remove the cervix and uterus (hysterectomy). Most early-stage cervical cancers are treated with a radical hysterectomy operation, which involves removing the cervix, uterus, part of the vagina and nearby lymph nodes. A hysterectomy can cure early-stage cervical cancer and prevent recurrence. But removing the uterus makes it impossible to become pregnant.

Minimally invasive hysterectomy, which involves making several small incisions in the abdomen rather than one large incision, may be an option for early-stage cervical cancer. People who undergo minimally invasive surgery tend to recover more quickly and spend less time in the hospital. But some research has found minimally invasive hysterectomy may be less effective than traditional hysterectomy. If you're considering minimally invasive surgery, discuss the benefits and risks of this approach with your surgeon.

Radiation

Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer cells. Radiation therapy is often combined with chemotherapy as the primary treatment for locally advanced cervical cancers. It can also be used after surgery if there's an increased risk that the cancer will come back.

Radiation therapy can be given:

• Externally, by directing a radiation beam at the affected area of the body (external beam radiation therapy)
• Internally, by placing a device filled with radioactive material inside your vagina, usually for only a few minutes (brachytherapy)
• Both externally and internally

If you haven't started menopause yet, radiation therapy might cause menopause. If you might want to consider becoming pregnant after radiation treatment, ask your doctor about ways to preserve your eggs before treatment starts.

Chemotherapy

Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. It can be given through a vein or taken in pill form. Sometimes both methods are used.

For locally advanced cervical cancer, low doses of chemotherapy are often combined with radiation therapy, since chemotherapy may enhance the effects of the radiation. Higher doses of chemotherapy might be recommended to help control symptoms of very advanced cancer.

Targeted therapy

Targeted drug treatments focus on specific weaknesses present within cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die. Targeted drug therapy is usually combined with chemotherapy. It might be an option for advanced cervical cancer.

Immunotherapy

Immunotherapy is a drug treatment that helps your immune system to fight cancer. Your body's disease-fighting immune system might not attack cancer because the cancer cells produce proteins that make them undetectable by the immune system cells. Immunotherapy works by interfering with that process. For cervical cancer, immunotherapy might be considered when the cancer is advanced and other treatments aren't working.