Early cervical pre-cancers or cancers often have no signs or symptoms. That's why it's important for women to have regular Pap tests. Symptoms often do not start until the cancer is further along and has spread to nearby areas. You should report any of the following to your doctor right away:

• abnormal vaginal bleeding, such as bleeding after sex, bleeding after menopause, bleeding and spotting between periods, and having periods that are longer or heavier than usual. Bleeding after douching, or after a pelvic exam is a common symptom of cervical cancer but not pre-cancer.

• an unusual discharge from the vagina (not your normal period)

• pain during sex

Of course, these symptoms do not mean that you have cancer. They can also be caused by something else. But you must check with a doctor to find out.

It is best to not wait for symptoms to appear. Get regular Pap tests and pelvic exams.

Tests for cervical cancer

Medical history and physical exam

The doctor will ask you abut your health, your risk factors, and about the health of your family members. A complete physical exam will be done with special attention to your lymph nodes to look for any signs that cancer has spread.

Cystoscopy, proctoscopy, and exam 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 whether the cancer has spread beyond the cervix.

Methods used to get pictures of the inside of the body (imaging studies)

If your doctor finds that you have cervical cancer, imaging studies may be used to show the inside of your body. They can show whether the cancer has spread beyond the cervix.

Chest x-ray: A plain x-ray of your chest will be done to see if your cancer has spread to your lungs. This is not likely unless your cancer is very advanced.

CT scan (computed tomography): 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 some 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 cause your body to 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. But CT scans are getting faster and your stay might be short.

MRI scans (magnetic resonance imaging): 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. The machine makes a thumping noise that you may find annoying. Some places will give you headphones with music to block this out.

PET scan (positron emission tomography): 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. Newer machines combine a CT scan and a PET scan to even better pinpoint the tumor. This test can help see whether the cancer has spread to lymph nodes. PET scans are also useful when your doctor thinks the cancer has spread but doesn't know where.

Last Medical Review: 09/24/2009
Last Revised: 09/24/2009