If you learn from your doctor that the cells collected in your Pap test might suggest you have cancer, it's natural to feel scared. But the good news is that when detected early, many types of Cervical Cancer can respond extremely well to treatment.

Depending on the type of cancer you're dealing with, your doctor may use various terms to describe your condition, including precancers, invasive cancer, adenocarcinoma or squamous cell cancer.

Although Cervical Cancer can cause abnormal vaginal bleeding, increased or abnormal vaginal discharge and pain during intercourse, early Cervical Cancer usually does not cause symptoms, so the first suggestion of the disease may be found from your Pap test results.

Understanding more about Cervical Cancer
To understand more about what Cervical Cancer is, you should first know that most cancers of the cervix are squamous cell carcinomas—in fact, about 80 to 90% of Cervical Cancers are squamous cell carcinomas. 10 to 20% of Cervical Cancers are adenocarcinomas.

Additionally, a necessary cause of Cervical Cancer is human papillomaviruses (HPVs). HPVs are a group of over 100 viruses, and over 30 of these different types of HPV can be passed from one person to another through sexual contact. Most HPV infections go away on their own, but some can persist for many years, with or without causing any kind of cell abnormality. Infection with high-risk HPV types increases the chance that abnormalities may require treatment, and may progress to Cervical Cancer.

An aggressive type of Cervical Cancer
Adenocarcinoma is a relatively aggressive type of Cervical Cancer that's difficult to detect. That's because instead of occurring on the outer surface of the cervix, like other Cervical Cancers do, adenocarcinomas usually occur on the inside of the cervix. Pap tests evaluate cell samples from the outer surface of the cervix, so by the time an adenocarcinoma is discovered, the cancer is usually at a more advanced stage. Caused by cancer-causing HPV types, including types 16, 18, 45 and 31 adenocarcinomas are becoming more common, particularly in young women. The cancers do not respond well to conservative treatment and usually require a hysterectomy to treat.

Testing for Cervical Cancer
A biopsy can give your doctor more information about your condition. First, your doctor may want to do a colposcopy, an exam that allows him or her to see changes in the cells of the cervix up close. Just as with a Pap test, you lie on the exam table and your doctor inserts an instrument called a speculum into the vaginal opening to get a look at the cervix. During a colposcopy exam, however, your doctor will also use a lighted microscope called a colposcope to magnify the cervical tissue and look for abnormal cells. The exam is somewhat uncomfortable and usually lasts only about ten minutes.

At the same time, your doctor may do a biopsy, usually numbing the cervix and then taking very small tissue samples. This may cause some cramping or pain and light bleeding after the procedure.

During the biopsy, your doctor may also use a special speculum and take a scraping of cells from the inside of your cervix to see if it shows anything abnormal, especially if your Pap test results indicated atypical glandular cells of undetermined significance (AGUS). That's because glandular cell changes do not occur on the outer surface of the cervix, like other cervical cell changes do. Instead, they usually occur on the inside of the cervix.

If Cervical Cancer is confirmed by your biopsy, your doctor may have you undergo further tests, such as X-rays, a cystoscopy (a procedure that uses a lighted tube to see into the bladder) or a proctoscopy or colonoscopy (a procedure that uses a lighted tube to see into the rectum or colon). These tests can help determine whether the cancer has spread and what stage the cancer is.

Treatment options

If the cancer has not spread to other organs and is still in its early stages, it may be possible to remove all the cancerous tissue from the cervix using conization.

Conization, also known as a cone biopsy, is another biopsy method. Using a surgical scalpel, a doctor removes a cone-shaped piece of tissue from the cervix. This procedure can serve as treatment if all the cancerous tissue is removed.

If the cancer is in more advanced stages or has spread, your doctor may recommend one or more ways to treat it, including:

	Surgery: This may include removing the uterus (called a hysterectomy) and in some cases the ovaries and/or internal lymph nodes. In advanced stages, other organs may also need to be removed.
	Radiation therapy: If the cancer has spread into other tissues (called invasive cancer) or has come back after already being treated (called recurrent cancer), radiation therapy, where high-energy X-rays are focused on cancerous areas, may be recommended.
	Chemotherapy: Another way to treat invasive or recurrent cancer, chemotherapy involves using drugs to destroy the cancer cells.

Treatment for Cervical Cancer can include a hysterectomy, especially in cases of adenocarcinoma. Whatever approach your doctor recommends, be sure you understand your options and the risks involved with each. It never hurts to get a second opinion, which many health insurance companies will pay for.

Facing the future
If left untreated, Cervical Cancer may lead to death; however, if invasive Cervical Cancer is caught early, the five-year survival rate is very high. Many Cervical Cancer survivors live much longer. But even with this in mind, it's important for you to do all you can to educate yourself now about Cervical Cancer—so ideally you can prevent it rather than have to treat it.