What every woman needs to know about HPV and cervical cancer

With the largest gynecologic oncology program in the Midwest, Siteman provides exceptional cervical cancer patient care through a multidisciplinary team and personalized treatment plans. We offer general information about the human papillomavirus (HPV) and its connection to cervical cancer, HPV screening tests and HPV vaccinations.

How are HPV and cervical cancer linked?

HPV is a group of more than 200 related viruses, some of which are spread through sexual contact. Infection with HPV is so common that nearly every person who is sexually active will get HPV at some point in his or her life. HPV usually goes away on its own, but in some cases, it lingers and can develop into a number of cancers, including cervical cancer. About 9 out of 10 cases of cervical cancer are caused by HPV, which can be largely prevented by HPV vaccination.

Cervical cancer is the only HPV-related cancer that can be detected early by a recommended screening test. To determine your cervical cancer risk, click here.

Preventing HPV and cervical cancer

While HPV is linked to several cancers, there is a key step that can be taken even before beginning routine screening: the HPV vaccine. According to the Centers for Disease Control and Prevention (CDC), HPV is estimated to cause nearly 36,000 cases of cancer in men and women in the U.S. every year; HPV vaccination can prevent more than 32,000 of those cancers from ever developing by preventing HPV infection in the first place. The HPV vaccine is safe, effective, long-lasting and recommended for all children aged 11 to 12 years to protect against HPV-related cancers. It is available for anyone between the ages of 9 and 45 years old.

Afraid of HPV and cervical cancer? You’re not alone

Common fears and concerns about HPV and cervical cancer include:

• Stigma about sexually-transmitted infections
• Anxiety about disclosure to family, friends, and sexual partners
• Concerns about transmitting the infection
• Infertility
• Serious health complications or death due to cervical cancer

HPV: What are the symptoms?

Certain types of HPV cause genital warts, common warts, plantar warts, or flat warts. But the types of HPV that cause cervical cancer – which may take 20 years or longer to develop after initial HPV infection – typically don’t cause noticeable symptoms.

HPV: Screening and diagnosis

During an HPV screening, a sample of cells is taken from the cervix with a swab and sent to a lab for testing. The screening may be done at the same time as a Pap test for cervical cancer screening in women aged 30 to 65 years. It may also be done after a Pap test yields abnormal results.

If you are diagnosed with HPV, it is important to remember that most HPV infections will go away on their own: more than 90% of women who receive a positive diagnosis will fully clear the infection within two years. For the remaining 10%, however, the body’s immune system will be unable to get rid of the infection. The infection lingers over time and turns normal cells into abnormal cells, which can eventually turn into cancer.

Cervical cancer: What are the symptoms?

During the early stages of cervical cancer, there are often no warning signs or symptoms. Pre-cancerous cells (called dysplasia) are usually found when the cervix is swabbed during a Pap smear or an HPV test. In the later stages, symptoms may include:

• Vaginal bleeding or bleeding after intercourse
• Pelvic pain
• Abnormal vaginal discharge
• Pain with intercourse

Cervical cancer: Screening and diagnosis

If abnormal cells are found during a Pap smear or an HPV test, your provider will perform a cervical biopsy for lab testing. If the results of the biopsy are cause for concern, your provider may perform a loop excision or a cone biopsy, which will allow your provider to reach deeper layers of cervical tissue.

If it is determined that you have cervical cancer, further testing will be carried out to determine the stage of your cancer.

The Siteman approach

As a leader in cancer treatment, research, prevention, education and community outreach, Siteman has the expertise, experience and compassion to carry you through your cancer journey. We have a multidisciplinary team of specialists who meet each week to discuss all cases, reviewing each one and determining the best treatment plan for each patient.

Surgery and radiation therapy for cervical cancer can make it difficult or even impossible to conceive. However, there are certain treatments that may preserve fertility. Specialists at Washington University’s Fertility and Reproductive Medicine Center provide comprehensive infertility services that combine the latest medical advancements, clinical expertise and attentive care. If you have cervical cancer and are worried about your fertility, our specialists are here to help.

Cervical cancer treatment options

Washington University Physicians at Siteman are committed to creating personalized treatment plans for each patient. Cancer treatment is not one-size-fits-all; each patient requires a treatment plan that is unique to his or her own cancer. You can take comfort in knowing that if you have been diagnosed with cervical cancer, your treatment will be specifically tailored to your cancer and your treatment plan will be managed by a team of specialists who are familiar with your unique case.

There are a variety of treatment options for cervical cancer:

Chemotherapy: uses drug(s) to stop the growth of cancer cells, either by killing them or by stopping them from dividing. When chemotherapy is infused into a vein or taken by mouth, the drugs enter the bloodstream and can reach cancer cells in almost all areas of the body. The type of chemotherapy given depends on the stage and location of your cancer.

Radiation therapy: uses high energy X-rays to kill cancer cells. The types of radiation therapy most commonly used to treat cervical cancer are:

• MR-guided adaptive radiation: an MRI is used to guide radiation therapy, which can be readapted to the patient every day. Siteman is currently the only cancer center in the world performing this type of therapy.
• Stereotactic body radiation: special equipment is used to position a patient and deliver radiation directly to the cancer. The total dose of radiation is divided into smaller doses given over several days in order to help prevent damage to normal tissue.
• Brachytherapy (internal radiation): a device is placed in the vagina or cervix to emit a high-dose concentration of radiation in or near the cancer. The radiation source is applied with an intrauterine applicator or a vaginal ring. Siteman has the largest Brachytherapy Center in the United States.
• Intensity–modulated radiation (IMRT): advanced technology is used to deliver precise radiation directly to cancer cells from different angles. The goal is to conform the radiation dose to the target and reduce damage to surrounding healthy tissue.

Vaccines and immunotherapy: vaccines are currently being tested in trials to allow your immune system to fight cervical cancer without the harsh side effects of traditional chemotherapy.

Targeted therapy: uses drugs to target and attack specific cancer cells without harming normal cells. Vascular endothelial growth factor (VEGF) is a protein that helps tumors form new blood vessels to get nutrients they need to grow. Bevacizumab, a monoclonal antibody, binds to this protein and may prevent the growth of new blood vessels in the tumors. Bevacizumab is used to treat cervical cancer that has metastasized as well as recurrent cervical cancer.

Surgery: performed to remove any abnormal tissue. These surgeries include:

• Conization: a procedure in which a cone-shaped piece of tissue is removed from the cervix and cervical canal.
• Loop electrosurgical excision procedure (LEEP): a procedure in which an electrical current passes through a thin wire loop to cut out abnormal tissue.
• Total or radical hysterectomy: the surgeon removes the cervix and uterus and one or more reproductive organs such as the tubes and/or ovaries.
• Radical trachelectomy: the surgeon removes the cervix, nearby tissue and lymph nodes, as well as the upper part of the vagina. This procedure may be used to treat women with early-stage cervical cancer who want to have children.

For more information on cervical cancer surgery and other treatment options, click here.

Our care team

The cervical cancer treatment program at Siteman is comprised of a wide range of specialists, including gynecologic oncologists, radiation oncologists, pathologists, nurses, a psychologist and a social worker. The diverse expertise of our collaborative team is what allows our specialists to create personalized and compassionate treatment plans for each and every patient.

The importance of getting screened

Cervical cancer is one of the most preventable cancers when screening is performed routinely. The American Cancer Society (ACS) recommends cervical cancer screening with an HPV test alone every 5 years for all women with a cervix from age 25 to 65. If HPV testing alone is not available, women can get screened with an HPV/Pap cotest every 5 years or a Pap test every 3 years.

You’ve been diagnosed with cervical cancer. Now what?

If you’ve been diagnosed with cervical cancer, you may be experiencing a wave of emotions including fear, anger and sadness. Siteman providers are here to support you every step of the way throughout your cancer journey. With our exceptional physicians, psychological services and survivorship care, we are committed to caring for your body, mind and wellness, even after treatment ends.