Cervical Cancer Symptoms

Cervical cancer can have four main symptoms once the disease becomes more advanced. But in its early stages, the disease often has no symptoms.

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Cervical cancer is one of the most preventable forms of cancer. The World Health Organization estimates that 99% of cervical cancer cases are caused by certain types of human papillomavirus (HPV)—types that are largely vaccine-preventable. And early detection methods are highly effective at catching pre-cancerous changes to the cervix before they get more serious.

However, that doesn't mean that the risk of cervical cancer has vanished. The American Cancer Society (ACS) estimates that, in the US, about 14,100 people will be diagnosed with cervical cancer in 2022, and about 4,280 people will die from the disease.

The symptoms that those with cervical cancer experience depend on how advanced the disease is. Here are the cervical cancer symptoms experts say to be aware of.

First, what is cervical cancer?

Cervical cancer develops when cells on your cervix, which is the very bottom part of your uterus, mutate. Again, nearly all cases of cervical cancer are caused by an HPV infection. HPV is the most common sexually transmitted infection (STI); almost 42 million Americans have the virus. Most times the virus will go away on its own within two years without health problems. However, certain types of HPV can lead to cancer of the cervix (as well cancer of the mouth, throat, anus, and penis).

Cervical cancer is the fourth most common cancer in women globally. It used to be the leading cause of cancer death for women in the US, but routine screenings have dramatically decreased its numbers in the US over the last 40 years.

The ACS reports that cervical cancer's overall five-year survival rate is 66%. That figure jumps to 92% when the cancer is detected in the earliest, most treatable stages. Treatment becomes more complicated when cancer is more advanced. Depending on how advanced the illness is, you might need surgery, radiation, chemotherapy, immunotherapy, or a combination of treatments.

Cervical cancer symptoms

Cervical cancer is easy to detect through testing, even at the earliest stages. Your doctor can take a sample of cells from your cervix and send them to a lab for analysis, a process known as a Pap smear. The test can even identify precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately.

While doctors and lab technicians are adept at spotting cervical cancer, detecting it yourself is a lot more complicated. There is no self-exam to check for disease. Cancer in the cervix develops slowly and silently. Without routine testing, you might not have a clue what's going on with your body. Symptoms only show up when the disease is quite advanced.

Early warning signs

At its earliest stages, cervical cancer typically has no symptoms at all.

"It used to be a patient would come in with unusual bleeding, and that would be the first sign that something was wrong," Leah Torres, MD, ob-gyn and medical director at the West Alabama Women's Center, tells Health.

Dr. Torres says she seldom sees patients who have symptomatic cervical cancer. It's more likely that she will discover cancer when a patient comes in for a routine exam and a screening test shows cancerous or pre-cancerous cells.

While getting a surprise call to say there's cancer in your cervix is terrifying, Dr. Torres says that early-stage cervical cancer is treatable. "If you have a small area of cancer or pre-cancerous cells, we can remove those cells and get you back to zero abnormalities," she explains.

The fact that cervical cancer doesn't make its presence known until its later stages means that staying on top of your regular health care is essential. Just because your cervix isn't bothering you doesn't mean that there isn't a chance something is wrong.

"It is typical for patients to not experience any symptoms related to their cervical cancer until advanced disease is present," Kristen Kelley, MD, a hematology/oncology fellow at the Huntsman Cancer Institute in Utah, tells Health. "This underscores the importance of undergoing regular cervical cancer screening with human papillomavirus (HPV) testing and Papanicolaou smear ('Pap smear') exams for early detection and treatment of cervical cancer prior to the development of symptoms."

Symptoms of more-advanced cervical cancer

For cervical cancer to result in symptoms noticeable to the patient, the cancer must be large enough, according to Dr. Kelley. If cancer develops into sizable lesions or tumors, you may start to notice hallmark symptoms, including:

Vaginal bleeding

Unusual vaginal bleeding is a common symptom of advanced cervical cancer, according to Dr. Kelley. "Cancerous tissue is often friable, meaning it is fragile and bleeds easily," she explains. "The blood vessels that form are abnormal and are prone to bleeding. Invasion into surrounding normal tissue can also cause damage and bleeding."

Blood spots or light bleeding between or following periods; menstrual bleeding that is longer and heavier than usual; bleeding after intercourse, douching, or a pelvic examination; and bleeding after menopause are all possible symptoms of cervical cancer, according to the American Society of Clinical Oncology (ASCO).

While any bleeding other than normal menstrual bleeding should get your attention, it doesn't automatically mean that you have cancer. "A lot of times, bleeding is due to a cervical polyp, like a skin tag on your cervix," says Dr. Torres.

Other reasons for vaginal bleeding include STIs or endometriosis. Your doctor can help you get appropriate treatment for any type of unusual bleeding.

Unusual vaginal discharge

Most time, vaginal discharge is perfectly normal. But watery, bloody vaginal discharge that is heavy and has a foul odor might be a symptom of cervical cancer, according to the Mayo Clinic. The discharge might be pale, pink, or brown in color and may come between your periods or after menopause. An increase in vaginal discharge can be another symptom of cervical cancer, per ASCO.

Your cervix and vagina are lined with mucus membranes. Those membranes produce the typical vaginal discharge that keeps the delicate tissues protected, as well as providing lubrication during sexual activity. A disruption to the reproductive system can change the appearance, consistency, or odor of discharge. That includes cervical cancer, but any kind of infection, including yeast infections, can affect discharge as well.

Pelvic pain

"When cancer is advanced and has spread outside the uterus and into the pelvis or abdominal cavity, pain is often associated," Dr. Kelley says. The pain can be described as pelvic heaviness or abdominal bloating.

Keep in mind that there are many possible explanations for abdominal pain other than cervical cancer, including injury or infection. But you should speak to a doctor about new or worsening pain as soon as possible, per the Mayo Clinic.

Pain during sex

The pain might also come during sex. That's because cervical cancer can cause inflammation and damage to the cervix or surrounding vaginal tissue, according to Dr. Kelley.

Contact to the tumor or the surrounding affected area with a penis, finger, or sex toy might result in new or unusual discomfort. Of course, there are other causes for painful sex, including vaginal infections, endometriosis, and changes due to childbirth or menopause, but your doctor can figure out the cause and offer any necessary treatment.

Symptoms of even more advanced cervical cancer

It is possible for cervical cancer to spread to the vagina, lymph nodes, bladder, intestines, lungs, bones, and liver. When this happens, the symptoms may be more severe depending on the tissues and organs to which the disease has spread. According to MedlinePlus, these symptoms can include:

  • Back pain
  • Bone pain or fractures
  • Fatigue
  • Leaking of urine or feces from the vagina
  • Leg pain
  • Loss of appetite
  • Single swollen leg
  • Weight loss

Of course, these issues can be related to a number of other conditions; your doctor can diagnose the underlying cause of these symptoms.

Preventing cervical cancer

Every expert Health talked with emphasized that cervical cancer is preventable. Besides practicing safe sex, you can take these steps to dramatically reduce your risk of developing cervical cancer:

Get the HPV vaccine

The HPV vaccination is highly effective in protecting against the types of HPV that cause 90% of cervical cancers, according to the ACS. The US Food and Drug Administration has approved it for people of all sexes between the ages of 9 and 45, though it's most effective when administered in two doses around the age of 12. If you are older, you may need a three-dose series.

Since 2006, when HPV vaccines were first used in the US, researchers have seen notable changes in the incidence of cervical cancer. "While it is difficult to fully quantify the population-level benefit of HPV vaccination, studies suggest the greatest benefit in reduction of cervical cancer incidence in women," Kathleen "Katie" Kerrigan, DO, an oncologist at Utah's Huntsman Cancer Institute, tells Health. That includes a 2020 study of US cancer registry data that showed a decline in cervical cancer rates from 1999 to 2017. "The authors concluded that this reduction in cervical cancer was driven by HPV vaccination in women ages 15-20," Dr. Kerrigan says.

Get tested

Keeping up with your regular cervical cancer screenings is crucial in preventing precancers from developing into cancer. It's recommended that Pap smears be done every three years for those aged 21 to 29. Those who are aged 30 to 65 have three options when it comes to regular testing for cervical cancer prevention: They can have a Pap smear alone every three years, a Pap test and an HPV test together every five years, or HPV testing alone every five years.

Many experts recommend regular HPV testing because knowing HPV is present tells your doctor to be extra vigilant. "Routine HPV screening is very important in the gynecology clinic to identify high-risk, pre-cancerous changes on a woman's cervix," Dr. Kerrigan says. "Management of these pre-cancerous changes can help prevent the development of cervical cancer."

If you have any concerns about your own health or your risk of getting cervical cancer, give your doctor a call. They can help you assess your risks and advise you about what steps you can take to stay healthy.

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