Symptoms
Main symptoms of cervical cancer
Symptoms of cervical cancer include:
- vaginal bleeding that's unusual for you – including bleeding during or after sex, between your periods or after the menopause, or having heavier periods than usual
- changes to your vaginal discharge
- pain during sex
- pain in your lower back, between your hip bones (pelvis), or in your lower tummy
If you have another condition like fibroids or endometriosis, you may get symptoms like these regularly.
You might find you get used to them. But it's important to be checked by a GP if your symptoms change, get worse, or do not feel normal for you.
See a GP if:
- you have any symptoms of cervical cancer
Try not to be embarrassed – the doctor or nurse will be used to talking about these symptoms.
Important
These symptoms are very common and can be caused by many different conditions.
Having them does not definitely mean you have cervical cancer. But it's important to get them checked by a GP.
This is because if they're caused by cancer, finding it early means treatment is more likely to be successful.
What happens at the GP appointment
The GP may ask to examine you.
You can ask for a female doctor when you book your appointment.
You'll be asked to undress from the waist down, behind a screen. You'll be given a sheet to put over you.
Then the GP may:
- look at the outside of your vagina (vulva)
- feel inside your vagina with 2 fingers while pressing on your tummy (they will be wearing gloves)
- gently put a smooth, tube-shaped tool (a speculum) into your vagina so they can see your cervix
- take a small sample of cells from your cervix using a soft brush
It should not be painful, but you may find it uncomfortable. Talk to the GP if you're feeling uncomfortable.
You can have a friend, family member or other member of staff in the room with you during your exam if you want.
Important
You are in control you can ask the doctor to stop at any time.
Referral to a specialist
The GP or practice nurse may refer you for more tests or to see a specialist in hospital if they think you have a condition that needs to be investigated.
This may be an urgent referral, usually within 2 weeks, if you have certain symptoms. This does not definitely mean you have cancer.
Causes
Main causes of cervical cancer
Nearly all cervical cancers are caused by an infection with certain high-risk types of human papillomavirus (HPV).
You can get HPV from:
- any skin-to-skin contact of the genital area
- vaginal, anal or oral sex
- sharing sex toys
Who is more likely to get cervical cancer
Anyone with a cervix can get cervical cancer. This includes women, trans men, non-binary people, and intersex people with a cervix.
You cannot get cervical cancer if you've had surgery to remove your womb and cervix (total hysterectomy).
You might also be more likely to get cervical cancer if:
- you're under 45 – cervical cancer is more common in younger people
- you have a weakened immune system, like if you have HIV or AIDS
- you have given birth to multiple children or had children at an early age (under 17 years old)
- your mother took the hormonal medicine diethylstilbestrol (DES) while pregnant with you – your GP can discuss these risks with you
- you've had vaginal, vulval, kidney or bladder cancer in the past
How to lower your chance of getting cervical cancer
You cannot always prevent cervical cancer. But there are things you can do to lower your chances of getting cervical cancer.
Cervical screening and HPV vaccination are the best ways to protect yourself from cervical cancer.
- All women and people with a cervix between the ages of 25 and 64 are invited for regular cervical screening. It helps find and treat any changes in the cells of the cervix before they can turn into cancer.
- All children aged 12 to 13 are offered the HPV vaccine. It helps protect against all cancers caused by HPV, as well as genital warts.
You can also lower your chance of getting cervical cancer by:
- using condoms, which lower your chance of getting HPV – but they do not cover all the skin around your genitals so you're not fully protected
- quitting smoking – smoking can weaken your immune system and the chemicals in cigarettes can also cause cervical cancer
- eating a balanced diet to help support your immune system
Tests and next steps
Main test for cervical cancer (colposcopy)
If you have abnormal cells in your cervix, which could mean you have cervical cancer, you'll usually be referred for a test to have a closer look at your cervix. This is called a colposcopy.
You'll be asked to undress from the waist down, behind a screen. You'll be given a sheet to put over you.
During a colposcopy:
- The specialist nurse or doctor will ask you to lie back on a bed, usually with your legs bent, feet together and knees apart.
- They'll gently put a smooth, tube-shaped tool (a speculum) into your vagina so they can see your cervix. A small amount of lubricant may be used.
- A microscope with a light at the end is used to look at your cervix. The microscope stays outside your body.
- The nurse or doctor will usually put a liquid on your cervix to show any abnormal areas.
- A small sample of cells (biopsy) may be collected to send to a laboratory.
The test should take around 15 to 30 minutes.
It should not be painful, but you may find it uncomfortable. Talk to the nurse or doctor if you're feeling uncomfortable.
If you had a biopsy, you may have a small amount of bleeding or cramping afterwards.
Find out more
Getting your results
It can take several weeks to get the results of your colposcopy.
You may be asked to go to the hospital to get your results, or they may be sent to you in the post.
Try not to worry if your results are taking a long time to get to you. It does not definitely mean anything is wrong.
You can call the hospital or GP if you're worried. They should be able to update you.
A specialist will explain what the results mean and what will happen next. You may want to bring someone with you for support.
If you're told you have cervical cancer
Being told you have cervical cancer can feel overwhelming. You may be feeling anxious about what will happen next.
It can help to bring someone with you to any appointments you have.
A group of specialists will look after you throughout your diagnosis, treatment and beyond.
This will include a clinical nurse specialist, who will be your main point of contact during and after treatment.
You can ask them any questions you have.
Macmillan Cancer Support has a free helpline that's open every day from 8am to 8pm.
They're there to listen if you have anything you want to talk about.
Call 0808 808 00 00
Next steps
If you've been told you have cervical cancer, you'll usually need more tests.
These, along with the colposcopy, will help the specialists find out the size of the cancer and how far it's spread (called the stage).
Find out more about grading and staging cervical cancer on Jo's Cervical Cancer Trust website
You may need:
- blood tests
- scans, like a CT scan, MRI scan, PET scan or chest X-ray
- an internal examination of your vagina and cervix – you'll have a general anaesthetic, which means you'll be asleep during the examination
You may not have all these tests.
The specialists will use the results of these tests and work with you to decide on the best treatment plan for you.
Treatment
Treatment for cervical cancer
Cervical cancer is often treatable.
The treatment you have will depend on:
- the size and type of cervical cancer you have
- where the cancer is
- if it has spread
- your general health
It will usually include surgery, chemotherapy or radiotherapy. It may also include treatment with targeted medicines to treat the cancer.
The specialist care team looking after you will:
- explain the treatments, benefits and side effects
- work with you to create a treatment plan that's best for you
- talk to you about the impact that treatment may have on your fertility
You'll have regular check-ups during and after any treatments. You may also have tests and scans.
If you have any symptoms or side effects that you're worried about, talk to your specialists. You do not need to wait for your next check-up.
Surgery
Surgery is the often the main treatment for cervical cancer, especially if the cancer is found early.
There are several surgeries used to treat cervical cancer.
Different surgeries involve removing:
- part of the cervix – only possible if the cancer is very small
- the cervix and upper part of the vagina – the womb is not removed, so it's possible to get pregnant in the future
- the cervix and womb (hysterectomy) – can include removing the ovaries and fallopian tubes
- the cervix, womb, ovaries and fallopian tubes, and all or parts of the bladder, bowel, vagina or rectum – this is only offered if the cancer has come back and other treatment is not possible
You may need to have some lymph nodes, which are part of the body’s drainage system, removed.
Recovery from these surgeries can take a long time depending on the surgery. The specialist team looking after you will discuss all the benefits and side effects.
Find out more
Chemotherapy
Chemotherapy uses medicines to kill cancer cells.
You may have chemotherapy for cervical cancer:
- with radiotherapy (chemoradiotherapy) as the main treatment for your cervical cancer
- before surgery to help make the cancer smaller
- after surgery (usually with radiotherapy) to help stop the cancer coming back
- if the cancer is advanced, has come back or if it’s spread to other parts of your body
Find out more
Radiotherapy
Radiotherapy uses high-energy rays of radiation to kill cancer cells.
You may have radiotherapy for cervical cancer:
- as the main treatment if the cancer is large or has spread
- after surgery, usually with chemotherapy (chemoradiotherapy), to help stop the cancer coming back
- to help improve symptoms, like bleeding
Radiotherapy for cervical cancer can be given from outside or inside the body (brachytherapy).
Find out more
Treatment with targeted medicines
If you have advanced cervical cancer or the cancer has come back, you may have treatment with a targeted medicine called bevacizumab (Avastin).
The aim of this medicine is to help make the cancer smaller or stop it getting any larger, not to cure the cancer.
Find out more
What happens if you've been told your cancer cannot be cured
If you have advanced cervical cancer, it might be very hard to treat. It may not be possible to cure the cancer.
If this is the case, the aim of your treatment will be to limit the cancer and its symptoms, and help you live longer.
Finding out the cancer cannot be cured can be very hard news to take in.
You'll be referred to a special team of doctors and nurses called the palliative care team or symptom control team.
They'll work with you to help manage your symptoms and make you feel more comfortable.
The clinical nurse specialist or palliative care team can also help you and your loved ones get any support you need.
Find out more