Understanding Cervical Cancer
- Vikki Ellis was 23 years old when she began experiencing lower back pain, irregular discharge and pain during intercourse—but she couldn’t get checked for cervical cancer until two years later, a test which revealed she had cancer.
- Now that she’s beaten the disease, had a child, and undergone a preventative hysterectomy (a surgical procedure that removes your uterus) at age 35 in October 2021, to reduce her risk of cancer recurrence, she’d urging others to push for answers when it comes to your health.
- Cervical cancer begins in the cells lining the cervix, the lower part of the womb (uterus). It usually develops slowly, however, before cancer presents itself. Vaginal bleeding or pelvic pains are common symptoms.
- Pap smears are one way to detect cervical cancer early. During the test, a doctor will collect a sample of cells from your cervix (using a small brush or spatula). The cells are then examined under a microscope for abnormalities, including cancer and changes that could indicate pre-cancer.
- Although it’s unclear what led to Ellis’ cancer diagnosis, it’s important to note that more than 70% of cases of cervical cancer are caused by the human papillomavirus (HPV). More than 90% of HPV-related cancers, including cervical cancer, are preventable in people who get the HPV vaccine that is recommended for all preteens (both girls and boys) 11 to 12 years old.
She was ultimately diagnosed with cervical cancer two years later, when she was eligible to get screened for cervical cancer. Now she’s sharing her story to help spread awareness for the disease and encourage others to push for answers when it comes to their health.
Read More“It was caught early enough and I was very lucky, but it was probably there for 18 months or so before my actual diagnosis.”
After explaining how she had an “instinct” to fight the disease, she underwent surgery in June 2015 to get the cancer removed at the Royal Marsden Hospital.
She explained further, “At 25, I was told that doctors were removing most of my cervix and I might have difficulty carrying a child. I was so worried. Though thankfully, a few years later in 2017, I had my daughter, who is now seven.”
In addition to having her cervix removed, and a successful surgery which took out all of the cancer, she also had lymph nodes removed from her stomach.
Years later, in 2020, a questionable mass was discovered at her five-year followup. She then underwent more testing and had non-cancerous growths removed.
Ellis later decided to undergo a preventative hysterectomy (a surgical procedure that removes your uterus) at age 35 in October 2021, to reduce her risk of cancer recurrence.
She then warned, “Catching it early and starting treatment quickly provides the best chances of survival. That’s why it’s absolutely vital to recognize the early symptoms, which include unusual vaginal bleeding, pain or discomfort during sex, vaginal discharge, and pain in the pelvis, and raise money for research.”
Ellis concluded, in an effort to urge others to get checked sooner than later, “My biggest regret is not backing myself when I knew something was wrong. It’s so important to have your routine smear tests – particularly after childbirth, when you might forget – and we need to encourage open conversation to normalize discussions about cervical health.
“I lacked guidance on gynecological health during my own upbringing and I want to make sure my daughter has a better foundation. We have begun to have age-appropriate conversations to provide her with a basic understanding. I would never want my daughter to miss a smear test. If you are concerned about your symptoms and you are continuing to be dismissed, don’t be afraid to speak up.”
Understanding Cervical Cancer
According to the National Cancer Institute (NCI), cervical cancer forms in the cells of the cervix, the lower, narrow end of the uterus (womb) which connected the uterus to the vagina.
“Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes known as dysplasia, in which abnormal cells begin to appear in the cervical tissue,” the NCI explains.
“Over time, if not destroyed or removed, the abnormal cells may become cancer cells and start to grow and spread more deeply into the cervix and to surrounding areas.”
Expert Cervical Cancer Information
- New Cervical Cancer Test Detects Disease Significantly Better Than HPV Test and Pap Smear
- HPV Vaccination Dramatically Reduces Cervical Cancer Rates; Everything You Should Know About The Vaccine
- New Cervical Cancer Screening Guidelines Recommend HPV & Pap Testing Now Start at Age 25
- New Hope for Patients With Cervical Cancer: Adding Immunotherapy Drug to Standard Chemo Treatment Could Improve Survival Time
- Why Is Late-Stage Cervical Cancer On The Rise? The Importance of Pap Smears and Testing For HPV
- 10 Meaningful Cervical Cancer Tattoos That are Full of Hope and Resilience
- 5 Well-Known Women Who Have Battled Cervical Cancer — Survivors Like Erin Andrews & Judy Blume Inspire
It’s important to know there are two main types of the disease, squamous cell carcinoma (up to 90% of cervical cancers) and adenocarcinoma.
Squamous cell carcinoma forms in the cells of the ectocervix (outer part of the cervix) and adenocarcinoma develops in the glandular cells of the endocervix (inner part of the cervix).
Cervical cancer is often difficult to detect as it doesn’t normally have symptoms until the disease has spread.
The NCI explains that symptoms of early-stage cervical cancer may include:
- vaginal bleeding after sex
- vaginal bleeding after menopause
- vaginal bleeding between periods or periods that are heavier or longer than normal
- vaginal discharge that is watery and has a strong odor or that contains blood
- pelvic pain or pain during sex
Symptoms of a advanced cervical cancer may include:
- difficult or painful bowel movements or bleeding from the rectum during bowel movements
- painful urination or blood in the urine
- dull backache
- swelling of the legs
- abdominal pain
- fatigue
“These symptoms may be caused by many conditions other than cervical cancer. The only way to know is to see a health professional. If it is cervical cancer, ignoring symptoms can delay treatment and make it less effective,” the NCI explains.
The Importance of Pap Smears
Pap smears are one way to detect cervical cancer early. During the test, a doctor will collect a sample of cells from your cervix (using a small brush or spatula). The cells are then examined under a microscope for abnormalities, including cancer and changes that could indicate pre-cancer.
This is an important procedure because symptoms of cervical cancer might show up until the disease is at stage 3 or 4. By helping doctors catch signs of the disease early, Pap smears can lead to broader and more effective treatment options.
One of the leading causes of cervical cancer is the human papillomavirus (HPV), one of the most common viruses which can be transmitted through sexual contact. HPV is the biggest risk factor for cervical cancer, and there are usually no early signs or symptoms of the disease. However, cervical cancer can be detected through regular check-ups, such as pap smears.
According to the Centers for Disease Control and Prevention, it’s recommended that women start getting Pap tests at age 21. “If your Pap test result is normal, your doctor may tell you that you can wait three years until your next Pap test,” the CDC explains.
Meanwhile, anyone between 20 and 65 years old is urged to speak with their doctor on which testing option is best for them. The CDC explains, “An HPV test only. This is called primary HPV testing. If your result is normal, your doctor may tell you that you can wait five years until your next screening test.
“An HPV test along with the Pap test. This is called co-testing. If both of your results are normal, your doctor may tell you that you can wait five years until your next screening test. A Pap test only. If your result is normal, your doctor may tell you that you can wait three years until your next Pap test.”
For women older than age 65, the CDC says your doctor may suggest you don’t need further screenings if: “You have had at least three Pap tests or two HPV tests in the past 10 years, and the test results were normal or negative, and you have not had a cervical precancer in the past, or you have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.”
Understanding Fertility Preservation
“When a woman is diagnosed with cancer in her childbearing years, fertility preservation should be a part of the conversation, like it’s part of the treatment plan,” Jaime Knopman, MD, a reproductive endocrinologist at CCRM Fertility in New York City, previously told SurvivorNet.
“Everyone in their reproductive years should be advised of their options.”
Freezing Eggs Or Embryos: What Should I Do?
Some types of chemotherapy can destroy eggs in your ovaries. This can make it impossible or difficult to get pregnant later. Whether or not chemotherapy makes you infertile depends on the type of drug and your age since your egg supply decreases with age.
“The risk is greater the older you are,” Knopman explained. “If you’re 39 and you get chemo that’s toxic to the ovaries, it’s most likely to make you menopausal. But, if you’re 29, your ovaries may recover because they have a higher baseline supply.”
If your cancer treatment includes surgery in which both ovaries are completely removed, then IVF will likely be needed to help get pregnant.
Radiation to the pelvis can also destroy eggs. It can damage the uterus, too. Surgery to your ovaries or uterus can hurt fertility as well.
Meanwhile, endocrine or hormone therapy may block or suppress key fertility hormones and may prevent a woman from getting pregnant. This infertility may be temporary or permanent, depending on the type and length of treatment.
If you are having a treatment that includes infertility as a possible side effect, your doctor won’t be able to tell you for sure whether you will have this side effect. That’s why you should discuss your options for fertility preservation before starting treatment.
Dr. Terri Woodard Discusses Options For Preserving Fertility After Cancer
Research shows that women who have fertility preservation prior to breast cancer treatment, in particular, are more than twice as likely to give birth after treatment than those who don’t take fertility-preserving measures.
The Importance of Advocating for Yourself
Standing up for yourself is important. If you feel that you’re being dismissed or mistreated by a doctor. Getting a second opinion is crucial if something doesn’t feel right. Experts tell SurvivorNet that no one knows your body better than you, so if you feel like something is wrong, keep pushing for answers.
Dr. Zuri Murrell, a colorectal surgeon at Cedars-Sinai Medical Center, previously told SurvivorNet that sometimes, patients need to be pushy.
Be Pushy, Be Your Own Advocate… Don’t Settle
“From a doctor’s perspective, every problem should have a diagnosis, a treatment, a plan for follow-up, and a plan for what happens next if the treatment doesn’t work,” Dr. Murrell said.
And as a patient, “If you don’t feel like each of these four things has been accomplished, just ask! Even if it requires multiple visits or seeing additional providers for a second opinion, always be your own advocate.”
Ultimately, patients advocating for their health can lead to better patient outcomes. This is especially important when you find your doctor has misdiagnosed your symptoms.
A component of advocating for yourself in healthcare includes going back to the doctor multiple times and even getting multiple opinions.
Dr. Steven Rosenberg is the National Cancer Institute Chief of Surgery, and he previously told SurvivorNet about the advantages of getting input from multiple doctors.
Cancer research legend urges patients to get multiple opinions.
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care. Because finding a doctor who is up to the latest of information is important,” Dr. Rosenberg said.
Contributing: SurvivorNet Staff
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