Cervical Cancer

What is the Cervix?

The cervix is located in the lower part of a women’s uterus. The cervix is typically about two inches long, it is shaped like a tube, and connects the uterus to the vagina. The cervix has two separate parts, each with its own type of cells. The endocervix is the opening of the cervix and it leads into the uterus. The walls of this part of the cervix are covered with glandular cells. These cells are involved in a woman’s menstrual cycle and they produce cervical mucus. The ectocervix is the outer part of the cervix and it is covered in non-keratinized squamous cells, which form the surface of hollow organs of the body such as the inside of your mouth or nose. All women can be at risk for cervical disease and cervical cancer, but through regular screening with a healthcare provider, cervical disease and cancer are preventable.

RESOURCES

Educational Materials: Cervical Diseases

Download

What is Cervical Cancer?

Cervical cancer is a malignant tumor that is located in the cervix. The transformation zone between the endocervix and the ectocervix changes as you get older and if you give birth. The transformation zone is where the two types of cells, glandular and squamous cells, meet. Most cervical cancers start in this area. The most common types of cervical cancers are squamous cell carcinoma (SCC) and Adenocarcinoma (ADC). Less common, but also possible, is a combination of SCC and ADC. SCC typically begins in the transformation zone and develops from cells in the exocervix. ADC typically develops in the endocervix from glandular cells.

Cervical Cancer and HPV

Human Papillomavirus (HPV) is the main cause of cervical cancer, in particular, specific types of HPV such as HPV16 and HPV18. HPV is the most common sexually transmitted disease (STD). A vaccine that prevents HPV types is available and is recommended for both girls and boys during routine vaccination starting at age 11 or 12 years old**. The HPV vaccination prevents new HPV infections but does not treat existing HPV infections or diseases.

*Mayo Clinic Laboratories
** CDC HPV Vaccine Recommendations

Under the Microscope

This is a pathology image of a cervical cancer Pap test. The long slender snake-like cells have abnormal DNA and are interspersed amongst tissue necrosis (dead tissue). These cellular elements are indicative of cervical cancer, also known as squamous cell carcinoma.

CORIE'S STORY

Before I was diagnosed with Chronic HPV, my life was normal. In 2002, I had gone in for a routine pap smear and was told that I had HPV. My pap results came back showing that I had both high-risk strains 16 and 18, which are the strains that are most likely to turn into cervical cancer. After doing some research and getting a few second opinions, I enrolled into a clinical trial which was monitoring women with high-risk HPV and their responses to certain treatments. This information was being used to better understand how aggressive some patients needed to be treated versus others in order to prevent cervical cancer from developing.

At my first visit with my clinical trial healthcare provider, I had a colposcopy, which is an internal exam to look at the cervix to see the specific areas of abnormality, followed by a LEEP procedure which removes abnormal tissue from the cervix to both diagnose and treat cervical disease. Unfortunately for me, the LEEP procedures did not work right away: initially it would look like everything was back to normal but months later I would again receive an abnormal Pap test. I would start feeling better, but then would experience bleeding again and it would be back to undergoing more biopsies and colposcopies

To help figure out what was going on and how I could manage my HPV effectively, I received multiple tests and treatments over the course of four years as part of the clinical trial. My biopsies from the laboratory would often come back with moderate abnormal development of cells (dysplasia) in my cervix. But over the years, lab tests showed that the abnormal cells became more and more invasive. This whole experience was very scary and it was an unnerving way to live because I was worried all the time about what was going to happen next.

My wife had previously been diagnosed with cervical cancer and I also have friends who had dealt with HPV issues, so I knew the risks of HPV. In 2010, I had another HPV flare up and this time my abnormal pap came back yet again as having high-risk strains 16 and 18, meaning that if this was not taken care of, it could again lead to cervical cancer. My clinical health care provider then recommended that I undergo a Dilation and Curettage procedure (D&C) to remove abnormal tissue. After undergoing that, I was finally in the clear and felt relieved and hopeful about moving forward in my health journey.

Since her diagnosis, Corie has become heavily involved in the patient advocacy community to help women understand the importance of screening for HPV and getting Pap tests. She encourages people to get involved with cervical cancer organizations and has written a book with information about pap smears and HPV testing and the importance of preventative testing. Her advice to other patients is to get as much information as you can about your condition so that you can talk in an educated way when you go to visit doctors. She also recommends to always seek out a second opinion as soon as you can in order to make the best decision for yourself.

DANIELLE'S STORY

At age 24, Danielle received a call from her gynecologist stating that she had an irregular Pap test result. She still remembers this call so clearly and gets chills down her spine. She went in for a repeat Pap test and when that came back irregular as well, a biopsy was ordered. The lab had found she had high-risk HPV and pre-cancerous cells in her cervix. When I found out, I felt terrified and very lonely, says Danielle, I only heard the word “cancer” not the “pre”in front of it. Danielle underwent two cryosurgeries, a procedure in which freezing gas is used to remove pre-cancerous cells on the cervix. However, her lab tests showed that the pre-cancer was still there. She then underwent a Loop Electrosurgical Excision Procedure (LEEP) which removes abnormal tissue from the cervix and vagina to both diagnose and treat cervical disease with the help of a wire loop heated by electric current. After two years, three procedures, and many lab tests she finally received the Pap results she had been hoping for: all normal. “Without laboratory testing I would not have known that I had pre-cancerous cells in my cervix. I'm afraid to think of what my life would be like without laboratory testing, because it's highly likely that I wouldn't even be here to ponder the question.”

Danielle Was Diagnosed With HPV and Shares Her Story in Preventing Cervical Cancer