Early-stage cervical cancer is challenging to identify in patients because symptoms are not usually obvious. In fact, by the time a woman realises that there is something wrong, she may already have advanced stage disease; and, as is the case with all cancers, the more advanced the cancer, the more difficult it is to treat.
The ideal scenario is to identify precancerous changes in the cells of the cervix. Precancerous cells can be removed and the cervix monitored closely, reducing the risk of cervical carcinoma. This is why it is so important for women to undergo regular pap smears; it is estimated that 83% of deaths from cervical cancer could be prevented, if everyone who was eligible attended regular screening.
However, not all women do attend screening and, even amongst those that do, there is the risk of abnormal cells developing in the time between smear tests. This highlights the need for women to be aware of their own bodies, able to identify subtle changes and seek medical advice if anything seems untoward.
The main symptom of cervical cancer is abnormal vaginal bleeding. However, this is a symptom with a range of possible aetiologies, many of which are harmless; and it can take time for a doctor to identify the cause, or causes, of any abnormal bleeding. Bleeding after intercourse, between periods and after the menopause should all be investigated by a specialist.
Other symptoms include, pain or discomfort during intercourse, unusual or unpleasant vaginal discharge and pain in the lower back or pelvic region. The vagueness of these symptoms is immediately apparent; as is the difficulty in identifying a particular gynaecological issue, when so many of them manifest in a very similar way.
Once the cervical cancer spreads to other parts of the body it is termed advanced. Advanced cancer is more challenging to treat and has a worse prognosis. The symptoms of advanced cervical cancer depend on where in the body the cancer has spread to. Initially, the spread is likely to be localized, with metastatic cancer cells found most often in the kidneys, bladder and bowel. After this, the cancer can spread to other locations within the body.
Some of the symptoms of advanced cervical cancer are:
- Pain in the region of the kidneys
- Increased frequency of urination and/or defecation
- Bowel or bladder incontinence
- Blood in the urine
- Swelling of the legs
- Severe vaginal bleeding.
With the development of vaccinations against HPV, which is the trigger for most cases of cervical cancer, it is hoped that global incidence rates of this type of cancer will continue to fall.
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- “Cervical Cancer.” Symptoms | Cervical Cancer | Cancer Research UK, 25 May 2017, https://www.cancerresearchuk.org/about-cancer/cervical-cancer/symptoms.
- “Cervical Cancer – Symptoms and Signs.” Cancer.Net, 10 June 2019, https://www.cancer.net/cancer-types/cervical-cancer/symptoms-and-signs.
- “Cervical Cancer | Symptoms.” NHS Choices, NHS, https://www.nhs.uk/conditions/cervical-cancer/symptoms/.
- Landy, Rebecca, et al. “Impact of Cervical Screening on Cervical Cancer Mortality: Estimation Using Stage-Specific Results from a Nested Case–Control Study.” British Journal of Cancer, vol. 115, no. 9, 25 Oct. 2016, pp. 1140–1146., doi:10.1038/bjc.2016.290.