Symptoms and screening
Early cervical cancer often has no symptoms — it is found on screening. When symptoms occur, the classic sign is bleeding after intercourse, between periods, or after menopause. Regular Pap smears and HPV testing catch precancerous changes years before cancer develops.
- Bleeding after intercourse
- Bleeding between periods or after menopause
- Persistent watery, blood-stained or foul-smelling discharge
- Pelvic pain in more advanced disease
Diagnosis and staging
Colposcopy with biopsy confirms the diagnosis. FIGO staging uses examination, pelvic MRI and PET-CT for larger tumours to decide between surgery and chemoradiation — the critical fork in the road for cervical cancer treatment.
Surgical treatment
For early-stage disease, a radical hysterectomy removes the cervix, uterus, upper vagina and surrounding tissue with pelvic lymph nodes. Nerve-sparing technique protects bladder function. In selected young women with small tumours, a radical trachelectomy removes the cervix while preserving the uterus, keeping pregnancy possible.
- Stage-specific planning on FIGO and MRI findings
- Nerve-sparing radical hysterectomy
- Fertility-sparing trachelectomy in selected patients
- Sentinel node mapping for small tumours
When surgery is not the first step
Tumours larger than 4 cm or with node involvement are treated better with chemoradiation than surgery. The treatment plan is made in a multidisciplinary tumour board — the value of a specialist opinion is choosing the right first treatment, because the wrong sequence is hard to undo.
Common questions
- Does HPV vaccination still help if I am already an adult?
- Vaccination is most effective before exposure to HPV, but adults up to 45 can still benefit. Vaccination does not replace screening — Pap smears and HPV testing remain essential.
- Can I have children after cervical cancer treatment?
- After chemoradiation, no. After a radical trachelectomy for early disease, pregnancy is possible and many successful pregnancies are reported — though delivery is by caesarean and the pregnancy is high-risk.
- Is robotic surgery safe for cervical cancer?
- Approach is individualised after the LACC trial raised questions about minimally invasive radical hysterectomy. The decision between open and robotic surgery is made honestly, based on tumour size and current evidence.
Related reading
This page is general education, reviewed by Dr. Ishaan Allahabadi, MCh Surgical Oncology (Edge Hill, UK) · MS Surgery · MBBS (Accredited by the Royal College of Surgeons of England). It is not a substitute for individual medical advice. Treatment decisions are made after reviewing your imaging and pathology, in a multidisciplinary tumour board.