Cervical cancer symptoms

Before the use of modern screening tools, cervical cancer was one of the most common causes of cancer death for women in the United States, according to the American Cancer Society. Development of the Pap test and, following that, the human papillomavirus (HPV) test have significantly decreased cervical cancer rates.

This article will cover:

• Early warning signs of cervical cancer
• Advanced cervical cancer symptoms
• A visual guide to signs and symptoms of advanced cervical cancer
• Cervical cancer screening

Early warning signs of cervical cancer

Although some patients don’t experience any symptoms until cervical cancer has advanced, it may be possible to notice signs at an early stage. These include:

Vaginal bleeding

• Sometimes cervical cancer mimics menstrual bleeding. Bleeding that seems different in any way should be reported to a doctor.
  • A longer or heavier menstrual cycle than usual
  • Spotting or bleeding between periods
  • Bleeding after menopause, especially if many months or years have passed since the last period

Pelvic pain

• Women may experience pain in their pelvic region, often for no apparent reason.
  • Some feel pain in their back, particularly in the lower back
  • It may feel like a sharp pain or pressure, located anywhere around the lower abdomen, below the belly button.

Vaginal discharge

• It's normal and healthy to have a vaginal discharge that’s clear, milky or slightly yellowish in color. But changes in color, consistency and/or odor should be investigated. Women should watch for these discharge changes, which may possibly be related to cervical cancer:
  • Discharge that looks red-tinged from small amounts of blood
  • An increase in the amount of discharge.

Pain during sex

• Some people experience pain during intercourse, or some bleeding afterward.

All of these cervical cancer symptoms should be discussed with a doctor.

According to the American College of Obstetricians and Gynecologists (ACOG), cervical cancer takes several years to develop. Early cell changes are known as dysplasia or cervical intraepithelial neoplasia. Early-stage cervical cancer may develop without any symptoms. Typically, symptoms don’t become obvious until the cancer has grown into nearby tissue. Cervical cancer symptoms are not likely to come on suddenly, but usually persist once they do appear.

Advanced cervical cancer symptoms

Cervical cancer may spread (metastasize) within the pelvis, to the lymph nodes, or form tumors elsewhere in the body. Signs of advanced cervical cancer include:

• Leg pain that feels like a persistent sharp or dull ache
• Swelling in the legs
• Weight loss
• Fatigue
• Back pain
• Leakage of urine or feces from the vagina
• Bone fractures
• Difficulty urinating and having a bowel movement
• Blood in the urine

Cervical cancer screening

Cervical cancer doesn’t typically cause noticeable symptoms in the early stages of cervical cancer. Routine cervical cancer screening is important to check for abnormal cells in the cervix and/or the presence of HPV, so it may be monitored and treated as early as possible.

For people at average risk, the American Cancer Society recommends these guidelines for screening for cervical cancer:

• Begin screening at age 25.

From ages 25 to 65, three options for testing include:

• A standalone HPV test every five years through age 65
• When standalone HPV test isn’t available, screening with co-testing (HPV testing in combination with a Pap test) every five years through age 65
• Pap test every three years

Then, for patients 65 and older:

• Women who reach age 65 and have no history of grade 2 early cervical cancer or more advanced cervical cancer within the last 25 years, and have had negative results over the past 10 years, don’t need to continue testing.

Other patient populations:

• Following a total hysterectomy, women may discontinue cervical cancer screening (HPV tests and Pap tests). If, however, the hysterectomy was performed to treat cervical cancer or pre-cancer, then screenings should continue.
• Women who've had a hysterectomy without having their cervix removed should continue getting cervical cancer screenings.

HPV vaccination does not preclude women from getting screened for cervical cancer.

The Pap test has been one of the most reliable and effective cancer screening methods available. However, the Pap test may not detect some cases of abnormal cells in the cervix. The HPV test screens women for the high-risk HPV strains that may lead to cervical tumors, and is now becoming a standard of care for cervical cancer screening.

Although screening methods aren’t 100 percent accurate, these tests are often an effective method for detecting cervical cancer in the early stages when it’s still highly treatable. Women should ask their doctor about which type of cervical cancer screening is right for them.