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One of the most important things to know about cervical cancer is that women may not realise they have it until a later stage when the symptoms are more pronounced. Cervical cancer is usually asymptomatic in early stages.
“If cervical cancer is in its early stage, it doesn’t have any symptoms. To pick up cervical cancers early and in it’s precancerous condition, one needs to go for regular health checks and screening tests,” says Dr. Rama Joshi, gynae oncologist and director-gynaecology oncology, Fortis Memorial Research Institute, Gurugram.
Cervical cancer is found in the cervix, the opening between the vagina and the uterus. All cervical cancers are usually caused by an infection from certain types of human papillomavirus (HPV). According to the World Health Organisation (WHO), cervical cancer is the fourth most common cancer in women and the eighth most common cancer overall. An estimated 570,000 women around the world were diagnosed with cervical cancer in 2018. About 311,000 women died from the disease and most of these deaths were recorded in Low and Middle Income Countries, says the WHO. Research suggests cervical cancer contributes to about 6–29% of all cancers in women in India.
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Here are the most important signs and symptoms of cervical cancer that women should be aware of:
Abnormal vaginal bleeding
Bleeding in between periods
Bleeding or spotting in between periods is a common early symptom of cervical cancer. If women experience light bleeding or spotting between their periods, it shouldn’t be overlooked. It is not always a sign of cervical cancer but it does call for a visit to a doctor. Women may also experience menstrual periods that are longer or heavier than usual.
It is important to remember that “heavy” periods for every woman are different. For women whose period lasts about two to three days, a five or six day period may be unusual.
Postmenopausal bleeding is a symptom of endometrial cancer but it could also be caused by cervical and vulvar cancer. The likelihood of postmenopausal bleeding being cancer is not very high, but it calls for medical attention immediately, says gynaecologist Dr. Anuradha Sharma.
According to a study published in the Journal of the American Medical Association (JAMA) Internal Medicine, postmenopausal bleeding occurs in about 90% of women with endometrial cancer; but only only 9% of women with postmenopausal bleeding are diagnosed with endometrial cancer.
Dr Sharma says the incidence of postmenopausal bleeding is about 5-15%. “There are various reasons for it. There could be endometrial atrophy (thinning of the uterine lining), polyps (mostly non-cancerous growth on the inner wall of the uterus), tumour, or other kinds of growth inside the uterus,” she says. Postmenopausal bleeding should never be ignored; in case it is a sign of a malignancy, early diagnosis offers the best chance to beat endometrial or cervical cancer.
Unusual vaginal discharge
Vaginal discharge keeps the vagina moist, clean, and protected from infection. It is absolutely normal if it does not have an especially unpleasant smell, is clear, white or slightly yellowish, slippery, thick or sticky. Some of the possible causes of unusual vaginal discharge are sexually transmitted infections like gonorrhea, genital herpes, or chlamydia. Unusual vaginal discharge related to cervical cancer may be red-tinted due to small amounts of blood.
Bleeding or pain during/after intercourse, douching, or a pelvic examination
Post-coital bleeding could be caused by polyps, genitourinary syndrome of menopause (GSM) or vaginal atrophy (thinning, dryness of vaginal walls when the body produces less estrogen, especially post menopause), an infection, pelvic inflammatory disease (PID), or a sexually transmitted infection (STI). In rare cases, bleeding after sex is a symptoms of cervical or vaginal cancers.
Dyspareunia or pain during or after sex can be caused by various reasons like sexually transmitted infection (STI), menopause, vaginismus, endometriosis, fibroids etc. It can, however, be a sign of cervical cancer as well.
Persistent pelvic and/or back pain
Persistent pelvic pain can be a sign of various conditions like endometriosis, adenomyosis, irritable bowel syndrome, vulvodynia or unexplained pain that affects the vulva, or fibroids, amongst others. It can also be a sign of cervical cancer, and is usually accompanied by other symptoms like abnormal vaginal bleeding, unusual vaginal discharge, pain during intercourse, or unexplained weight loss. The pain or pressure is usually felt in the abdomen and can be sharp or dull, constant or transient.
Back pain as a symptom of cervical cancer may extend to the legs if the tumour is putting pressure on the nerves. Dr. Sunitha Daniel, advisor, cancer screening and early cancer detection, Karkinos Healthcare, says as the cancer spreads, it can affect the lymphatic system and nerves which causes severe pain. “Sometimes it can cause a fistula and ulcers, there can be a secondary infection which may cause pain. This usually happens in a later stage, some people experience a low back pain that is similar to a period pain just before the cancer is diagnosed,” she says.
Other signs of advanced cervical cancer may include swollen legs or the urge to pee often (if the tumour presses against the bladder). If these symptoms appear, women should speak to their doctor even if they appear to be mild. The earlier cervical cancer or precancerous cells are found and treated, the better the chances of prevention and cure.
Doctors and health agencies advise regular cervical cancer screening to find any infection or abnormal cells in the cervix that could lead to cancer. Periodic pap smears and HPV tests are the best way to diagnose precancers and prevent them from developing into cervical cancer. The HPV test finds high-risk types of HPV that can potentially lead to cancer, while a pap test looks for any early changes in cells that could lead to cervical cancer.
Read more about cervical cancer screening, diagnosis, and treatment
1. Health topic: Cervical Cancer, World Health Organisation (WHO)
2. Huntsman Cancer Institute, The University of Utah, 2021
3. Vulvovaginal Atrophy, National Library of Medicine
4. Cervical cancer, Centres for Disease Control and Prevention (CDC)
5. Cervical Cancer, American Cancer Society
6. National Health Service
7. American Society of Clinical Oncology (ASCO)
8. Planned Parenthood
Affiliate Disclaimer: We want to inform you that we have partnered with Karkinos Healthcare to bring you information and raise awareness about Cervical Cancer. Femoai Media will receive monetary compensation from Karkinos Healthcare if you decide to take the Karkinos CerviRaksha, Cobas HPV Test.