Cervical cancer is the most common cause of cancer under the age of 35. Every year around 3,000 women are diagnosed with cervical cancer.
How is cervical cancer caused?
Cervical cancer is overwhelmingly caused by a virus known as HPV (human papilloma virus) that is transmitted through sexual contact. However, it’s important to point out that HPV is so common that most sexually-active men and women will become infected with a form of this virus. In other words, not everyone who is infected with HPV will develop cervical cancer.
What are the symptoms of cervical cancer?
There are usually no signs in the earlier stages of cervical cancer, which is why it’s so vital to have regular smear tests. One sign to watch for is spotting or bleeding in between your usual period or after having sex. If you bleed after the menopause has occurred you should also see a doctor or gynaecologist.
Other things to look out for include an unpleasant-smelling vaginal discharge, feeling pain during sexual intercourse and an ache in the lower back or pelvis.
Screening for cervical cancer
The NHS recommends women have smear tests every two years from the age of 25. Cervical cancer is very rare in women under 25. However, it is not unheard of. According to data from Cancer Research UK, two out of every 100 women diagnosed with cervical cancer are under 25. Anyone who has concerns should speak to their doctor about the possibility of getting a smear before this age. Women will continue to be tested, usually every three years, but more frequently if there are abnormal smears, until the age of 49. After that, women are invited every 5 years until the age of 64.
What happens during a smear test?
You will need to remove your undergarments and may have to partially undress, as the gynaecologist or medical practitioner will need to insert a speculum to perform the smear test. In the appointment, you will be asked to lie down on a couch. You will be asked to bend your knees and separate your legs and relax. A speculum will be slid into the vagina, and the smear will be taken from the cervix. The sample is then sent to the lab for testing to check to see whether there is any human papilloma virus present.
What do the smear test results mean?
Don’t panic if you are told there is a problem with the result. There may be an issue with the test its self. There are a variety of reasons for this, including an inadequate sample, menstrual period or infection. The test will simply be repeated a few months later.
Less than one in ten women will have an abnormal result after a smear. It means that there are some changes to the cells on the cervix. The cells around the cervix can alter – it’s an immune response called dyskaryosis; infection with HPV can trigger it. If you’ve had a smear test, you may see dyskaryosis on your medical notes. This will be referred to as either low grade dyskaryosis, which means there have been mild cell changes, or moderate or high grade dyskaryosis. This means the cell changes have been more pronounced.
What is dyskaryosis?
It’s important to remember that dyskaryosis isn’t cancer its self – it’s simply cell changes. Around 90 % of dyskaryotic cells become healthy again. However, as 10 % can progress to become more abnormal and potentially cancerous, it’s vital that these are investigated. The good news is, our bodies are usually quite efficient at fighting off HPV infections. However, in some cases the HPV overrides the immune system causing cell changes that may lead to cervical cancer. This why cervical cancer screening is vital – it allows the gynaecologists to remove abnormal cervical cells at an early enough stage, before they become cancerous.
Regular screening means it is highly unusual to be told you have cervical cancer. Getting smear tests regularly can stop cancer from developing.
How are abnormal cervical cells are treated?
You will usually be referred for a colposcopy if your doctor has concerns about your smear. This enables clinicians to discover far more about whether dyskaryosis is of concern. A specialist microscope is used to check for any signs of cell changes with a high-powered microscope. At Twenty-five Harley Street, we use DYSIS technology for colposcopy - Dynamic Spectral Imaging – has been shown to provide the most accurate and sensitive measurement when it comes to discovering cervical cell changes. A series of images are taken. These are then stored in a database which allows doctors to compare the results with other cervical cells and track any changes which may be cause for concern. The clinician may be able to treat the abnormal cells during the colposcopy using a system called LLETZ.
How is LLETZ?
At Twenty-five Harley Street, LLETZ is used to treat abnormal cells. LLETZ stands for large loop excision of the transformation zone. This is the most common treatment for abnormal cervical cells. The procedure cuts the tissue and seals the wound at the same time. Around 40% of women won’t require further treatment, such as laser treatment.
What if the tests turn out to be cervical cancer?
The treatment strategy will depend on the stage of the cancer.
Radiotherapy may be necessary; surgery may be required to remove the neck of the womb. If the cancer is more advanced, it may be necessary to have a hysterectomy. A combination of chemotherapy and radiotherapy may be required.
What are the survival rates for cervical cancer?
Making sure you get regular smear tests to ensure any cell changes can be caught early, as well as informing your doctor of any unusual symptoms, such as vaginal bleeding outside of your menstrual periods. However, if it does develop in to cervical cancer, the survival rate is 80-99% for stage 1. If it’s caught at stage 2, the survival rate is 60-90% , for stage 3 it is 30-50% and for stage 4 it is 20%.
In the UK, just under 1,000 women die from cervical cancer every year.
25 Harley Street's Consultant Gynaecologists
Mr Gardner is Clinical Director for Gynaecology at the Queen Alexandra Hospital. A specialist in endometrial cancer screening and colposcopy. >Read more
A consultant obstetrician and gynaecologist based in London. Within the NHS he practises at Epsom and St Helier University Hospitals NHS Trust. Mr Athanasias has developed special skills in minimally invasive surgery. >Read more
You can phone to discuss a consultation on 020 3883 9525, or email [email protected]