• Persistent HPV (Human Papilloma Virus) Infection

• Smoking
• AIDS (Acquired immunodeficiency syndrome)
• Low Immunity (because of organ transplantation, immunosupressive drugs, HIV (Human immunodeficiency virus) infections
• Many live births (vaginal deliveries)

Cervical cancer might not cause any symptoms at first. Any of the following could be symptoms of cervical cancer

• Bleeding after menopause
• Bleeding between periods and sexual intercourse
• Foul smelling white discharge
• Pelvic pain
• Longer and heavier menstrual bleeding

These symptoms can also be caused by conditions that are not cancer. But if you have vaginal bleeding at these times, tell your doctor or nurse.

Yes.

• Pap test (also called a “Pap smear”) is used to screen women for cervical cancer.
• Test for virus called “human papillomavirus” (HPV). Because person with HPV virus infection has more risk for cervical cancer development.

For these tests, your doctor or nurse looks inside your vagina using a device (called a speculum). He or she will then collect fluid from cervix by applying small brush over it. In Pap smear test, a doctor will examine the collected fluid under a microscope to see whether cells are normal or abnormal. For an HPV test, the fluid is processed in a laboratory to check for the presence of virus in it.

If the test results are abnormal, then doctor will advise you either for further follow up or additional cervical biopsy. During a biopsy procedure, the doctor will remove a tiny piece of tissue from the suspicious area of cervix. In most cases, doctor may use magnifying lens called a “colposcope” during cervical biopsy procedure.

Doctors sometimes find abnormal cells in the cervix that are not cancer, but it has high chance of turning into cancer. These cells are called “precancer” cells. He or she can treat them in different ways (e..g. cutting or ablating that cervical area). Doctor might watch them closely over time.

Cancer staging is a way in which doctors assess how far a cancer has been spread.

The right treatment for you will depend a lot on the stage of your cancer, your healh problems, and age. Your treatment will also depend on whether you wish to get pregnant in the future.

Cervical cancer can be treated in different ways according to stage of disease at the time of diagnosis. These include:

• Surgery – There are different types of surgery which involve:
• Removing the cervix, uterus, and upper part of the vagina – This surgery is called a “radical hysterectomy” (figure 2).
• Removing all or part of the cervix but leaving the uterus in place – This type of surgery is done when you wish to conceive in the future or in case of very early stage.
• Radiation therapy–Radiation is basically X-ray/Photon rays that kill cancer cells. Radiation can be given through a machine that is outside the body or with a radiation source directly into the vagina.
• Chemotherapy–Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.

After treatment, you will be checked every 3-month interval for the first 2 years after treatment. This close follow-up visit intended to see if the cancer comes back. Follow-up visits usually include PAP tests, examination or imaging tests. If you have symptoms similar to the time of diagnosis, then tell your doctor.

If the cancer comes back or spreads, you might require more surgery, chemotherapy or radiation therapy. Your doctor will give you more information and suitable options for treatment in this situation.

Some women can still get pregnant even after cervical cancer treatment. If you have not yet gone through menopause and want to have a baby in future, talk with your doctor. A woman cannot get pregnant after a hysterectomy or radiation. Your doctor can discuss different options with you.

It is important to follow all your doctors’ instructions about visits and tests. It’s also important to talk to your doctor about any side effects or problems you have during treatment. It is important to inform your doctor about any symptoms or side effects to follow his/her instructions carefully. Always express your expectations and feelings about treatment to your doctor. Anytime you are offered treatment plan, it is better to ask:

• What are the benefits of this cancer treatment? Will it reduce or relieve my symptoms?
• What are the side effects to this treatment?
• What other treatment is there beside this plan?
• What happens if I do not wish to have this treatment?