Don't Ignore These Cervical Cancer Warning Signs

The American Cancer Society estimates almost 13,000 new cases of cervical cancer were diagnosed in 2017, and just over 4,200 women died from cervical cancer. These numbers are staggering, especially when cervical cancer is one of the most preventable cancers in women. Fortunately, the death rate from cervical cancer has decreased by more than 50 percent over the last 40 years, due to increased use of the Pap test and HPV (Human papillomavirus) vaccination. Oncologist Aruna Turaka, MD, UnityPoint Health, lists the signs of cervical cancer and why knowing them can save your life.

Cervical Cancer Signs

Cervical cancer usually does not have any symptoms until the cancer becomes more advanced. In addition to HPV, causes of cervical cancer include:

• Smoking
• Multiple sexual partners
• Contraceptive use
• History of sexual transmitted infections (STI)
• Having multiple children
• HIV
• Organ transplant

“Cervical cancer isn’t as common in younger people,” Dr. Turaka says. “We usually see it toward middle age, 35 years old and above. However, it depends on different scenarios, including having routine screenings done.”

Once the cancer is more advanced, women may start to notice the following warning signs of cervical cancer:

Abnormal Vaginal Bleeding

Dr. Turaka says the most common cervical cancer symptom is abnormal vaginal bleeding, which typically occurs after the cancer has spread to nearby tissue. Although women often think bleeding is normal spotting, it's important to see your doctor if you experience:

• Bleeding between menstrual periods
• Heavier menstrual periods
• Longer menstrual periods
• Bleeding after sexual intercourse
• Bleeding after menopause
• Bleeding after a pelvic exam
• Bleeding resulting in anemia-causing fatigue, dizziness

Vaginal Discharge, Foul Smelling

If cervical cancer lacks oxygen, some cells may die off, infecting the tumor. The infection creates a foul smelling vaginal discharge, which serves as another sign of cervical cancer. This continuous discharge may be pale, watery, brown, or mixed with blood.

Pain During Sexual Intercourse

Women with advanced cervical cancer may experience pain during sexual intercourse because of tumor growth throughout tissues and reproductive organs.

Low Back, Pelvic or Appendix Pain

Low back pain or pelvic pain can be linked to problems with reproductive organs, such as the cervix. A sign of cervical cancer is pelvic pain, especially continuous pain. Pelvic pain near the appendix doesn't usually occur unless the cancer is in advanced stages. There will usually be other cervical cancer red flags before pelvic pain occurs.

Leg Pain

As the cancer grows and becomes more advanced, it may start to press against nerves in the pelvic wall, resulting in leg pain and sometimes swelling. While swelling could be a symptom of a number of medical problems, if accompanied by leg pain, this could be a warning sign of cervical cancer.

Loss of Appetite or Unexplained Weight Loss

As with many other cancers, a sign of cervical cancer is unexplained weight loss or loss of appetite. Sometimes, regardless of how much food is consumed, weight loss continues to be a problem for women with cervical cancer.

Prevention & Treatment

To protect yourself against cervical cancer, Dr. Turaka outlines the following prevention measures.

Pap Test

Pap tests (Pap smears) look for precancerous symptoms, like abnormal cells or changes in the cells of the cervix. Regular Pap smears are the best method of catching cervical cancer in the earliest stages and are strongly recommended.

“Because of effective screenings, cervical cancer is seen less in the United States,” says Dr. Turaka. “I came from India where cervical cancer is more prevalent because routine screening methods are not standard yet.”

Dr. Turaka says the American Cancer Society guidelines recommend:

• Women start regular Pap tests at age 21.
• From 21 to 29, women should get regular Pap smears every three years.
• Women between 30-65 years old should receive a Pap test every five years, along with HPV testing. If HPV testing is not done, then this same age group should continue receiving Pap smears every three years.

For women who’ve had a complete hysterectomy, where both the uterus and cervix are removed, then they don’t need to have a Pap test or HPV test. But, Dr. Turaka says for women who have partial hysterectomies, where the cervix is left intact, the screening guidelines would be the same as any other woman.

Pap Test Results

“If a woman is told her Pap test is abnormal, she would repeat the screening six months or a year later to ensure the results were accurate. Sometimes, Pap smears result in a false-positive or a false-negative, which is why we screen again so soon,” Dr. Turaka says.

If the Pap test is normal but the HPV testing is positive, the HPV will be tested again within one year as well. However, if it’s an especially dangerous type of HPV, then doctors will move forward with a colposcopy, a safe procedure that more closely examines the cervix, and/or biopsy. 

“In countries where screenings are done regularly, like the U.S., only five to 10 percent of Pap smears or HPV testing come back as abnormal. And, if immunization is done with the HPV vaccine, then the possibility of having a positive test will be less likely,” Dr. Turaka says.

HPV (Human papillomavirus) Vaccine

The most common cause of cervical cancer is the human papillomavirus (HPV), and Dr. Turaka says receiving the HPV vaccine is the best way to prevent cervical cancer. It’s important both males and females receive all doses of the HPV vaccine. The Centers for Disease Control and Prevention recommends:

• All kids ages 11-12 should get the HPV vaccine.
• Children are encouraged to get all doses of the vaccine at a young age, before being exposed to HPV.
• If teenagers and young adults do not get the vaccine when they are younger, women can get vaccinated through the age of 26 and men through the age of 21.

In addition to early screenings and the HPV vaccine, Dr. Turaka offers these steps to reduce your risk of cervical cancer:

• Practice safe sex, especially if you’ve had, or plan to have, multiple partners
• Avoid sexually transmitted infections (STI)
• Stop smoking

“Carcinogens associated with smoking can lead to early progression of cervical cancer and other cancers, too. That’s why it’s so important to break the habit as soon as possible,” Dr. Turaka says.

If cervical cancer is diagnosed, more tests, like blood work and scans of the abdomen, will allow your cancer team to form a plan. Treatment is very effective if caught in the early stages, with higher survival rates at five years (more than 80 percent) after the cancer is diagnosed.