Diagnosis of Cervical Cancer

Symptoms

Early cervical cancers usually don’t cause symptoms. When the cancer grows larger, women may notice one or more of these symptoms:
  • Abnormal vaginal bleeding
    • Bleeding that occurs between regular menstrual periods
    • Bleeding after sexual intercourse, douching, or a pelvic exam
    • Menstrual periods that last longer and are heavier than before
    • Bleeding after going through menopause
  • Increased vaginal discharge
  • Pelvic pain
  • Pain during sex

Diagnosis of Cervical Cancer

If you have abnormal Pap or HPV test results, your doctor will suggest other tests to make a diagnosis:
  • Colposcopy: The doctor uses a colposcope to look at the cervix. The colposcope combines a bright light with a magnifying lens to make tissue easier to see. It is not inserted into the vagina. A colposcopy is usually done in the doctor’s office or clinic.
  • Biopsy: Most women have tissue removed in the doctor’s office with local anesthesia. A pathologist checks the tissue under a microscope for abnormal cells.
    • Punch biopsy: The doctor uses a sharp tool to pinch off small samples of cervical tissue.
    • LEEP: The doctor uses an electric wire loop to slice off a thin, round piece of cervical tissue.
    • Endocervical curettage: The doctor uses a curette (a small, spoon-shaped instrument) to scrape a small sample of tissue from the cervix. Some doctors may use a thin, soft brush instead of a curette.
    • Conization: The doctor removes a cone-shaped sample of tissue. A conization, or cone biopsy, lets the pathologist see if abnormal cells are in the tissue beneath the surface of the cervix. The doctor may do this test in the hospital under general anesthesia.

Staging

If the biopsy shows that you have cancer, it is important to learn the extent (stage) of the disease to help you choose the best treatment. Some of the following tests may be done:
  • Chest x-rays: X-rays often can show whether cancer has spread to the lungs.
  • CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your organs. A tumor in the liver, lungs, or elsewhere in the body can show up on the CT scan. You may receive contrast material by injection in your arm or hand, by mouth, or by enema. The contrast material makes abnormal areas easier to see.
  • MRI: A powerful magnet linked to a computer is used to make detailed pictures of your pelvis and abdomen. The doctor can view these pictures on a monitor and can print them on film. An MRI can show whether cancer has spread. Sometimes contrast material makes abnormal areas show up more clearly on the picture.
  • PET scan: You receive an injection of a small amount of radioactive sugar. A machine makes computerized pictures of the sugar being used by cells in your body. Cancer cells use sugar faster than normal cells, and areas with cancer look brighter on the pictures.
The stage is based on where the cervical cancer is found. These are the stages of invasive cervical cancer:
  • Stage I: The tumor has invaded the cervix beneath the top layer of cells. Cancer cells are found only in the cervix.
  • Stage II: The tumor extends to the upper part of the vagina. It may extend beyond the cervix into nearby tissues toward the pelvic wall (the lining of the part of the body between the hips). The tumor does not invade the lower third of the vagina or the pelvic wall.
  • Stage III: The tumor extends to the lower part of the vagina. It may also have invaded the pelvic wall. If the tumor blocks the flow of urine, one or both kidneys may not be working well.
  • Stage IV: The tumor invades the bladder or rectum. Or the cancer has spread to other parts of the body.
  • Recurrent cancer: The cancer was treated, but has returned after a period of time during which it could not be detected. The cancer may show up again in the cervix or in other parts of the body.
The stages of the cervical cancer may determine the treatment options. If you have symptoms associated with cervical cancer, contact us to request an appointment with our oncology specialists to to begin diagnostic testing.