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Cervical Cancer

Cervical cancer is a gynecologic cancer that begins in the cervix, which is the opening of the uterus (womb) into the vagina (birth canal).

Michigan Medicine doctor Diane Harper talks about human papillomavirus or HPV. Dr. Harper is a family medicine physician scientist and the physician director of the Rogel Cancer Center’s community outreach program. She is internationally recognized as a clinical research expert in HPV associated diseases, their prevention, early detection and treatment for the prevention of cancer.

Most cervical cancer starts with normal cells that gradually develop into pre-cancerous changes that then develop into cancer. Several terms are used to describe these pre-cancerous changes including:

These changes can be detected with a Pap test. Most pre-cancerous go away without treatment and when treatment is needed it can prevent the development of cancer. Cervical pre-cancers and cancers are categorized by how they look under the microscope. The most common types of cervical cancer include:

Other less common types of cervical cancer include melanoma, sarcoma, and lymphoma.

Treatment of Cervical Cancer

  • Surgery:
    • hysterectomy: surgery that removes the cervix and uterus
    • cone biopsy: surgery that removes only the cancerous tissue and a small margin of surrounding healthy tissue
    • radical trachelectomy: a surgery which removes the cervix but not the uterus
  • Chemotherapy
  • Radiation Therapy

Treatment of cervical cancer depends on:

  • Stage of the cancer
  • Size and shape of the tumor
  • The woman's age and general health
  • Her desire to have children in the future

Treatment of early stage cervical cancer

Early cervical cancer is typically treated with a hysterectomy but that is not the only option. For woman who cannot or may not want surgery, radiation and chemotherapy can be used instead. Another option to avoiding a hysterectomy is a cone biopsy or a procedure called radical trachelectomy.

It should be noted that a woman does not necessarily lose the ability to bear children as a result of being treated for cervical cancer. If a woman has early stage cervical cancer, such as IA2 or stage IB, a radical trachelectomy may be an option which allows some of these young women to be treated without losing their ability to have children. After trachelectomy, some women are able to carry a pregnancy to term and deliver a healthy baby by cesarean section. The risk of the cancer coming back after this procedure is low.

Treatment of later / advanced cervical cancer

Radiation and chemotherapy are used to treat more advanced disease along with surgery; typically hysterectomy.

Women should ask their doctors about their various options. In addition, it's a good idea to consult with a gynecologic oncologist.