Cervical Cancer Overview

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Early Detection, Diagnosis, and Staging TOPICS

How is cancer of the cervix found?

Cervical cancer can be found early as the result of screening (like an abnormal Pap test). If you have an abnormal Pap test, what other tests you need depends on the results. Some results can mean you need and HPV test or to have the Pap test repeated in 6 months or a year. Some Pap test results mean that you need colposcopy (discussed below) or other tests. For details about what work-up is needed for specific abnormal Pap test results, see our document Cervical Cancer Prevention and Early Detection.

Cervical cancer is also sometimes found in women who have symptoms of the disease. If you are having symptoms, you should see your doctor, who will examine you, and may do a Pap test and/or a colposcopy.

Colposcopy

If you have certain symptoms that suggest cervical cancer or if your Pap test shows abnormal cells, you will need to have a test called colposcopy. In this test, the doctor uses an instrument called a colposcope to look at your cervix. The colposcope is an instrument that stays outside the body. It has magnifying lenses (like binoculars). It lets the doctor see the surface of the cervix closely and clearly.

Colposcopy itself is no more painful than a regular pelvic exam, has no side effects, and can be done safely even if you are pregnant. Like the Pap test, it is rarely done during your period. If something not normal is seen on the cervix, a small piece of tissue will be removed from that area (a biopsy). The tissue is sent to be looked at under a microscope. A biopsy is the only way to tell for certain whether something is a pre-cancer, a true cancer, or neither. Although the colposcopy procedure is not painful, cervical biopsy can cause discomfort, cramping, or even pain in some women. You may also have some spotting after a biopsy.

Several different types of biopsies are used to diagnose cervical pre-cancers and cancers. Ask your doctor to explain what kind of biopsy you will have and what the results mean.

If a biopsy shows that cancer is present, your doctor may order certain tests to see how far the cancer has spread. Every patient will not need every test described below. Which tests are done is based on the results of the physical exam and biopsy.

Tests that look for cervical cancer spread

Imaging tests

If your doctor thinks that your cancer has spread, imaging tests may be used to create pictures of the inside of your body. These are not needed for early cancers

Chest x-rays: A plain x-ray of your chest may be done to see if your cancer has spread to your lungs. This is not likely unless your cancer is very advanced. If the results are normal, you most likely don’t have cancer in your lungs.

CT (computed tomography) scans: The CT scan is a special kind of x-ray. Instead of taking just one picture, a CT scanner takes many pictures as it moves around you. A computer then combines these pictures into an image of a slice of your body (think of a loaf of sliced bread).

CT scans can help tell if your cancer has spread to other places in the body. CT scans are also sometimes used to guide a biopsy needle into a place where the cancer might have spread. A biopsy (tiny sample or thin core of tissue) is removed and looked at under a microscope.

Before the first set of CT pictures is taken you may be asked to drink a liquid that helps outline structures in your body. You might also have an IV line through which you may be given a different kind of contrast dye.

The IV contrast can make you feel flushed (a feeling of warmth with some redness of the skin). A few people are allergic to the dye and can get hives. Rarely, more serious reactions, like trouble breathing and low blood pressure, can happen. Be sure to tell your doctor if you have ever had a reaction to contrast dye used for x-rays. It is also important to let your doctor know about any other allergies.

CT scans take longer than regular x-rays and you will need to lie still on a table while they are being done. Also, you might feel a bit confined by the ring-like equipment you're in when the pictures are being taken.

MRI (magnetic resonance imaging) scans: MRI scans use radio waves and strong magnets instead of x-rays to take pictures. MRI images are very useful in looking at pelvic tumors. They are also helpful in finding cancer that has spread to the brain or spinal cord.

An MRI scans take longer than CT scans − often up to an hour. Also, you have to be placed inside a narrow, tube-like machine, which can upset some people. Special, “open” MRI machines may be an option for some patients; the downside of these is that the images may not be as good. The machine makes a thumping noise that you might find annoying. Some places will give you headphones with music to block this out.

PET (positron emission tomography) scans: PET scans use glucose (a form of sugar) that contains a radioactive atom. Cancer cells in the body absorb large amounts of the treated sugar and a special camera can spot the cells. Some machines combine a CT scan and a PET scan to even better pinpoint the tumor. This test can help show if the cancer has spread to lymph nodes. PET scans can also be useful when your doctor thinks the cancer has spread but doesn't know where.

Cystoscopy, proctoscopy, and exams under anesthesia

These are most often done in women who have large tumors. They are not needed if the cancer is caught early.

In cystoscopy a thin tube with a lens and a light is put into the bladder through the urethra. This lets the doctor check to see if cancer is growing into these areas. Biopsy samples can also be removed. Cystoscopy can be done under a local anesthetic (the area is numbed with drugs), but some patients may need general anesthesia (drugs that put you in a deep sleep). Your doctor will let you know what to expect before and after the tests.

For proctoscopy a thin, lighted tube is used to check for spread of cervical cancer into your rectum.

Your doctor may also do a pelvic exam while you are under anesthesia to find out if the cancer has spread beyond the cervix.


Last Medical Review: 09/12/2014
Last Revised: 10/14/2014