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Cancer of the cervix, a common kind of cancer in women, is a disease in which cancer cells are found in the tissues of the cervix. The cervix is the opening of the uterus (womb). The uterus is the hollow, pear-shaped organ where a baby develops. The cervix connects the uterus to the vagina (birth canal).

Cancer of the cervix usually grows slowly over a period of time. Before cancer cells are found on the cervix, the tissues of the cervix go through changes in which cells that are not normal begin to appear (known as dysplasia). A Pap Smear will usually find these cells. Later, cancer cells start to grow and spread more deeply into the cervix and to surrounding areas.

Since there are usually no symptoms associated with cancer of the cervix, you must be sure you doctor does a series of tests to look for it. The first of these is a Pap Smear, using a piece of cotton, a brush or a small wooden stick to gently scrape the outside of the cervix in order to pick up cells. You may feel some pressure, but you usually do not feel pain.

If cells that are not normal are found, your doctor will need to cut a sample of tissue (called a biopsy) from the cervix and look at it under a microscope to see if there are any cancer cells. A biopsy that needs only a small amount of tissue may be done in your doctor's office. If your doctor needs to take a larger, cone-shaped piece of tissue (conization), you may need to go to the hospital.

Your prognosis (chance of recovery) and choice of treatment depend on the stage of your cancer (whether it is just in the cervix or has spread to other places) and your general state of health.

Stages of Cancer of the Cervix

Once cancer of the cervix is found, more tests will be done to find out if cancer cells have spread to other parts of the body (staging). Your doctor needs to know the stage of your disease to plan treatment.

The following stages are used for cancer of the cervix:

The Carcinoma stage in cervical cancer is very early cancer. The cancer is found only in the first layer of cells of the lining of the cervix.

Stage one of the cancer is found throughout the cervix, but has not spread nearby. In Stage I, a very small amount of cancer is found deeper in the tissues of the cervix.

In Stage two, a larger amount of cancer is in the tissues of the cervix and the cancer has spread to nearby areas, but is still inside the pelvic area.

In Stage three, the cancer has spread beyond the cervix to the upper two-thirds of the vagina.

In Stage four, the cancer has spread to the tissue around the cervix and throughout the pelvic area. Cancer cells may have spread to the bones of the pelvis and/or gone into the lower part of the vagina. The cells also may have spread to block the tubes that connect the kidneys to the bladder (the ureters).

In Stage five, the cancer may have spread to other parts of the body.

In Stage six, the cancer has spread to the bladder or rectum (organs close to the cervix)

In Stage seven, the cancer has spread to faraway organs such as the lungs.

What does recurrent mean?

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the cervix or in another place.

Your Treatment Options

There are treatments for all patients with cancer of the cervix. Three kinds of treatment are used:

1. Surgery (taking out the cancer in an operation)
2. Radiation therapy (using high-dose x-rays or other high- energy rays to kill cancer cells)
3. Chemotherapy (using drugs to kill cancer cells).

Your doctor may use one of several types of surgery for very early cancer of the cervix:

1. Cryosurgery kills the cancer by freezing it.
2. Diatherrny kills the cancer by heat from electrical or magnetic currents.
3. Laser surgery uses a narrow beam of intense light to kill cancer cells

Your doctor may also take out the cancer using one of these operations:

1. Conization means taking out a cone-shaped piece of tissue where the cancer is found.

Conization may be used to take out a piece of tissue for biopsy, but it can also be used to treat early cancers of the cervix.

2. Hysterectomy is an operation in which the uterus and cervix are taken out along with the cancer. If the uterus is taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus is taken out through a cut (incision) in your abdomen, the operation is called a total abdominal hysterectomy. Sometimes the ovaries and fallopian tubes are also removed, which is called a bilateral salpingo-oophorectomy.

A radical hysterectomy is an operation in which the cervix, uterus, and part of the vagina are removed. Lymph nodes in the area may also be removed (this is called lymph node dissection). (Lymph nodes are small bean-shaped structures that are found throughout the body. They produce and store cells that fight infection).

If the cancer has spread outside the cervix or the female organs, your doctor may take out the lower colon, rectum, or bladder (depending on where the cancer has spread) along with the cervix, uterus, and vagina. This is called an exenteration.

You may need plastic surgery to make an artificial vagina after this operation.
Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation). Radiation may be used alone or in addition to surgery.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells outside the cervix.