Cervical Cancer

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Cervical cancer affects the cervix, which is between the uterus and vagina. Often it is caused by HPV.

Cervical cancer is very preventable and curable if diagnosed early. HPV vaccination and routine cervical cancer screening can prevent nearly all forms of cervical cancers.

Cervical cancer usually develops slowly, beginning with abnormal cells developing in cervical tissue. These abnormal cells, or precancerous cells, can be killed or removed surgically, preventing them from developing into cancer cells and spreading through the cervix and surrounding tissue.

About 91% of people live five years or more after getting a diagnosis of localized cervical cancer (before cancer cells have spread to nearby tissue and structures), according to the National Cancer Institute. If the cancer has spread to other organs, tissue or nearby lymph nodes, the five-year survival rate is about 60%.

While cervical cancer mortality has declined in recent decades, due to prevention and screening, the death rate in Black women and Native American women is about 65% higher than in white women, according to the American Cancer Society.

As many as 90% of cervical cancers start in the thin, flat, squamous cells that cover the outer part of the cervix, which can be seen during a pelvic exam. In these cases, the disease is called squamous cell carcinoma. Adenocarcinoma makes up the rest of cervical cancers. It develops in the mucous-producing glandular cells inside the cervical canal.

At the Forefront of Cervical Cancer Care

If you’ve been diagnosed with cervical cancer, you want to start getting better right away. That’s why we offer same-day appointments for newly diagnosed patients.

The board-certified and fellowship-trained specialists at Norton Cancer Institute are at the forefront of new cervical cancer treatments. Norton Cancer Institute physicians are also researchers leading clinical trials into experimental new treatments.

Patients benefit with easier access to gynecologic cancer clinical trials and expertise our physicians gain during the research studies. Once a treatment is approved for wider use, our providers often have unmatched experience with the new therapy.

You’ll have a one-on-one relationship with your gynecologic oncologist, surgeon, radiation oncologist or other specialist. The next cancer doctor you see will be either someone you know or someone you’ll be seeing again who knows your case.

Norton Cancer Institute has nine outpatient clinic locations and multiple chemotherapy infusion centers in the Louisville area, including Southern Indiana. We have four radiation centers located just off major interstates with free self-service parking and valet parking.

Cervical Cancer Prevention and Screening

Persistent HPV infection is the leading cause of cervical cancer. Just about anyone who’s sexually active will get an HPV infection at some point, and the infection goes away in a year or two. But other HPV infections can last for years and contribute to the formation of precancerous cells that can develop into cervical cancer.

The HPV vaccine offers the most protection when given before a person becomes sexually active. Those who are already sexually active may benefit less from the vaccine. This is because sexually active people may have been exposed to some of the HPV types the vaccine targets.

The Centers for Disease Control and Prevention recommends routine HPV vaccination for girls and boys at age 11 or 12. The vaccine can be given starting at age 9 and is recommended up to age 26. The vaccine might be right for adults over age 26 after a discussion with their medical provider.

There are some forms of cervical cancer that the vaccine can’t prevent. Regular cervical cancer screening is an important part of prevention. HPV tests and the Pap smear or Pap test are two important screenings that can detect high-risk HPV infection and precancerous cells.

Cervical cancer screening is typically done during a pelvic exam. Your medical provider collects a small sample of cells using a soft, narrow brush or tiny spatula. The sample is examined at a lab for HPV infection and abnormal cells.

Anyone with a cervix should get regular screening tests starting after they turn 20. Any abnormal test results require follow-up.

Cervical Cancer Symptoms

Screening is especially important, because those with early stage cervical cancer typically have no symptoms. By the time symptoms become evident or concerning, it’s because the cancer has spread. Cervical cancer symptoms can be the result of less dangerous conditions and easily dismissed. Discuss these or any other concerns with your gynecologist or primary care provider.

  • Vaginal bleeding after vaginal sex
  • Bleeding after menopause
  • Bleeding and spotting between periods
  • Menstrual periods longer or heavier than usual
  • Unusual vaginal discharge
  • Painful sex
  • Pelvic pain

Advanced cervical cancer symptoms can include swollen legs, difficulty urinating, difficulty moving bowels or blood in the urine.

Cervical Cancer Stages

Stage 1 cervical cancer describes cancer cells confined to the cervix. There are several subsets of Stage 1 cervical cancer to describe the size of the tumor and its depth. The size of Stage 1 cancer can range from cancerous cells that can only be seen under a microscope to a tumor about the size of a walnut (4 centimeters).

Stage 1 cervical cancer treatment can range from taking a small area of abnormal cells out of the cervix to hysterectomy for patients whose cancer is a high risk of recurrence. Stage 1 cancers that are larger than 2 centimeters or have invaded more than 5 millimeters into healthy tissue may be treated as Stage 2.

Stage 2 cervical cancer describes cancer that has spread to the upper two-thirds of the vagina or tissue surrounding the uterus.

Treatment for Stage 2 or some advanced instances of Stage 1 cervical cancer can include radiation therapy and chemotherapy, radical hysterectomy and removal of pelvic lymph nodes or various combinations. Stage 2 cervical cancer that has spread to the tissue around the uterus may be treated as Stage 3.

Stage 3 cervical cancer includes a spread to the lower third of the vagina or to the pelvic wall. At Stage 3, the cancer may be causing kidney issues or may include lymph node involvement.

Stage 3 cervical cancer treatment can include combined radiation therapy and chemotherapy, surgery to remove pelvic lymph nodes followed by radiation therapy and/or chemotherapy.

The most common treatment for late Stage 2, Stage 3 or early Stage 4 cervical cancer is a combination of external and internal radiation therapy. Chemotherapy at the same time as radiation therapy can make radiation therapy more effective.

Stage 4 means cancer has spread beyond the pelvis or to the lining of the bladder or rectum. It also can mean the cancer has spread to other parts of the body, such as the liver, lungs or bones.

Early Stage 4 cervical cancer — spread to the bladder or rectum — may be treated as Stage 3. Other Stage 4 cervical cancers and cervical cancer that recurred may be treated with immunotherapy alone or with chemotherapy and targeted therapy. Radiation therapy and chemotherapy may be given at the same time, depending on the spread.

Gynecologic Cancer Team

Why Choose Norton Cancer Institute

More patients in Louisville and Southern Indiana choose Norton Cancer Institute than any other provider in the area. We provide compassionate care for the whole person, not just the cancer.

Our Norton Cancer Institute oncologists are also researchers and principal investigators, offering patients sophisticated experience in the latest treatments and access to more than 200 clinical trials.

  • Access to more than 100 specialists, including board-certified and fellowship-trained oncologists
  • Multidisciplinary setting, meaning you get the benefit of opinions from multiple specialists across Norton Healthcare and often can schedule appointments for the same day in the same location
  • Immunotherapies such as CAR-T cell therapy, genetic therapies tailored to combat the unique genetic makeup of your cancer and the latest in surgical treatments, chemotherapy and radiotherapy
  • State-of-the-art Norton Cancer Institute Genomics Lab offering highly specialized testing that makes it possible to tailor advanced treatments based on a tumor’s specific genetic composition
  • Robotic-assisted bronchoscopy for minimally invasive lung biopsies that can reach more parts of the lung without major surgery
  • Medicare, Medicaid and most major commercial insurance accepted
  • At Norton Specialty Pharmacy, patients receive regular consultations on their medications and treatment plan, making sure they get their prescriptions quickly and accurately. Our specialty pharmacists collaborate closely with your oncology team.
  • Use your free Norton MyChart account to communicate with your provider, manage appointments, refill prescriptions, get on the wait list for an earlier appointment and more anytime from a mobile device or computer

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