Cervical cancer thrives in silence. It hides behind signs that feel “normal,” which is why so many women overlook or dismiss them. However, did you know this fourth most common malignancy in women is highly treatable and even preventable?
What everyone should know is that the body often whispers before it screams to hint subtly that something is wrong. For women, recognizing the signs of cervical cancer and taking action can be life-saving.
Quick Facts You Should Know About Cervical Cancer: An Overview
What It Is
The cervix is a donut-shaped fibromuscular organ that connects the uterine cavity to the vagina. Cervical cancer is a form of gynecologic cancer that develops when abnormal cells grow uncontrollably and eventually form a tumor in said organ. These changes begin with precancerous cells, which can progress to cancer if left unaddressed.
Leading Cause
The number-one cause of cervical cancer is infection with high-risk strains of human papillomavirus (HPV). This virus spreads through sexual contact and is one of the most common, easily sexually transmitted infections worldwide. According to the World Health Organization (WHO), it affects about 620,000 women and 70,000 men each year.
Although most HPV infections resolve without causing harm, infections with high-risk types can lead to cellular changes in the cervix.
Risk Factors
Other factors can increase the likelihood of cervical cancer. Smoking exposes cervical cells to harmful chemicals and raises the risk of abnormal growth. A weakened immune system because of an autoimmune disease or other chronic condition reduces the body’s ability to fight off infections, including HPV. Family history and having multiple sexual partners also contribute to higher risks.
Cervical cancer doesn’t appear suddenly. Doctors consider cervical cancer a silent killer since it typically develops over several years, progressing from precancerous lesions to invasive cancer. Regular screening and vaccination can help interrupt this process.
Signs and Symptoms of Cervical Cancer
Early stages produce little to no symptoms. When signs do appear, they may resemble common conditions, leading to delays in diagnosis. Recognizing these signs and consulting a medical professional can save lives, as early-stage cervical cancer has a five-year survival rate of over 90%. Below are the most common symptoms and the reasons why they occur.
1. Abnormal Vaginal Bleeding or Spotting
Unusual vaginal bleeding is one of the most prominent early warning signs of cervical cancer. This symptom includes bleeding between menstrual periods, after penetrative sex, or following menopause.
According to a population-based study from the United Kingdom, irregular bleeding occurs in roughly 62% of women with cervical cancer. While it can happen because of non-cancerous causes like hormonal changes or fibroids, any instance of unexpected bleeding requires prompt medical evaluation. Heavy and prolonged menstrual flow, bleeding after vaginal douching, and bleeding after a pelvic exam are additional warning signs.
For women in menopause, any amount of vaginal bleeding is abnormal. Postcoital bleeding, or bleeding after sex, can indicate irritation from precancerous or cancerous lesions on the cervix. These lesions make the cervical tissue more fragile and prone to bleeding.
2. Unusual Vaginal Discharge
Discharging fluid or mucus is the female body’s way of cleaning and protecting the vagina. However, changes in vaginal discharge, particularly if it appears watery, thick, or blood-tinged, may signal cervical cancer. The discharge can have a foul and sometimes fishy odor, especially in advanced stages, due to tissue breakdown.
A study published in Health Expectations supports the findings that women with cervical cancer experience offensive vaginal discharge (83%), as well as intermenstrual vaginal bleeding (84.5%), post‐menopausal bleeding (84.1%), and post‐coital vaginal bleeding (76.1%).
Some discharge is normal during the menstrual cycle, while the much lower levels of estrogen and progesterone during menopause means less vaginal discharge, not more. Any persistent or unusual discharge, with or without an abnormal color or odor, requires attention.
3. Pelvic or Lower Abdominal Pain
Pain in the pelvis or lower abdomen, unrelated to menstrual cramps, may signal cervical cancer. The pain is dull, persistent, and can occur at random times. As the tumor grows, it may press on nearby tissues or organs, causing further discomfort.
Chronic pelvic pain requires medical attention, especially if it disrupts daily life or intensifies over time. While ovarian cysts or endometriosis can cause similar symptoms, cervical cancer is on the list of possibilities until a doctor rules it out.
4. Pain During Sex
Pain during sexual intercourse, also called dyspareunia, occurs when cancerous lesions form on the cervix. As these lesions grow, they can cause irritation or tearing during penetration, leading to sharp or persistent pain. The same study above found that 71.1% of cervical cancer patients experience said symptom.
Unlike temporary discomfort due to lack of lubrication or other minor issues, pain linked to cervical cancer worsens over time. Women may notice accompanying symptoms, such as bleeding during or after intercourse. These warning signs suggest changes in cervical tissue that require medical evaluation.
Ignoring this symptom delays the opportunity to address potential issues early. A healthcare provider can examine the cervix for abnormalities and recommend appropriate tests. Pain during intercourse is never “normal,” and addressing it promptly is critical for overall health and well-being. Pain or bleeding from penetrative sex can suggest non-serious health issues, too. “Inflammation of the cervix, a vaginal infection, or cervical polyp—all of these are non-serious causes, which is why the general mantra is that if anything doesn’t seem right and is consistent, get it checked out,” explains Dr. Lauren Streicher, gynecologist and founding medical director of the Northwestern Center for Sexual Medicine and Menopause.
5. Painful or Difficult Urination
Pain, burning, or discomfort during urination can be a sign of advanced-stage cervical cancer. These symptoms occur when cancer spreads to nearby tissues, irritating the upper and lower urinary system. Patients may also experience frequent urination, urinary incontinence, or difficulty emptying the bladder.
These urinary symptoms may overlap with urinary tract infections (UTIs), which are common and easily treated. However, recurring or persistent symptoms warrant further investigation, as they could indicate more serious conditions.
6. Changes in Bowel Habits
Aside from affecting bladder functions, cervical cancer can disrupt bowel movements. When a tumor is large enough to press against the intestines, it may interfere with the smooth passage of stool, leading to symptoms like constipation or diarrhea. Some women also report changes in stool consistency, such as appearing thinner or irregularly shaped. Unfortunately, these changes could be a sign that cancer cells have reached the colon.
7. Weight Loss
Unexplained weight loss is a hallmark of many cancers, including of the cervix. As cancer cells multiply and the disease progresses, they trigger an inflammatory response that interferes with the normal use and breakdown of nutrients. This process speeds up the body’s energy consumption and reduces appetite, which can manifest through weight loss regardless of how much food a patient consumes. These changes often develop alongside other symptoms, such as persistent fatigue or chronic pain.
“If you are losing weight and you aren’t trying to lose weight by making changes in your exercise routine or diet, people should see their doctor to consider possible causes,” says Brian Wolpin, MD, MPH, the lead investigator of a 2024 study published in the Journal of the American Medical Association. “There are many conditions that can result in unexpected weight loss. Your doctor can determine if there is something that needs evaluation.”
8. Leg Pain and Swelling
Leg pain and swelling may develop if cervical cancer spreads to lymph nodes in the pelvis or blocks blood vessels in the lower body. This blockage, known as deep vein thrombosis, causes swelling, tenderness, and a persistent sharp or dull ache in one or both legs. The swelling often coincides with a feeling of heaviness or limited mobility.
“Cervical cancer can spread (metastasize) to lymph nodes in the area between the hip bones. Cancer cells can also stop lymph fluid from draining away. This might lead to swelling in your legs due to fluid build-up,” explains Dr. Christine Horner, a surgeon, author, and natural health expert.
Although leg pain and swelling are more common in advanced stages, these symptoms may appear earlier in some cases. Ignoring them increases the risk of complications such as blood clots or reduced circulation.
9. Lower Back Pain
Back pain can occur when cervical cancer grows and presses on surrounding nerves or tissues. The cervix is close to the lower spine and pelvic nerves, so tumors in this area can cause pain. As cancer advances, it may spread to nearby lymph nodes or the pelvic wall, intensifying discomfort. The pain often manifests as a persistent ache in the lower back, which can worsen over time or with physical activity.
Back pain alone is not a definitive indicator of cervical cancer. It usually coexists with symptoms like abnormal bleeding or pelvic discomfort. Seeking medical advice for chronic back pain helps identify or rule out potential causes.
10. Fatigue
Cancer-related fatigue differs from typical tiredness, as it persists even after adequate rest and can disrupt daily activities. This symptom occurs because the body uses extra energy to combat the disease, while the cancer itself depletes vital resources needed for normal function.
Chronic blood loss from abnormal vaginal bleeding can cause anemia or low red blood cell levels. Anemia reduces oxygen delivery to the body’s tissues, which further contributes to fatigue, weakness, and shortness of breath.
This symptom often overlaps with other conditions, but fatigue combined with additional signs such as weight loss or pelvic pain warrants medical attention. Addressing the root cause early can improve energy levels and overall wellness.
Signs and Symptoms Based on the Stage of Cervical Cancer
Cervical cancer develops in stages. Understanding the different stages helps women recognize warning signs and seek medical evaluation.
Stage 0: Carcinoma in Situ
Stage 0 is the earliest stage of cervical cancer, where abnormal cells remain confined to the surface layer of the cervix. These cells have not invaded deeper tissues or spread to other areas. Symptoms rarely appear at this stage.
Stage I: Localized Cancer
At Stage I, cancer affects only the cervix. The tumor has started invading deeper tissues but remains confined to the cervix. Women may experience light spotting, postcoital bleeding, or mild pelvic discomfort. Many women overlook these early signs, mistaking them for hormonal changes or minor gynecological issues. The survival rate at this stage exceeds 90% with proper treatment.
Stage II: Cancer Spreading Beyond the Cervix
Stage II cancer extends beyond the cervix but has not reached the pelvic wall or lower third of the vagina. Symptoms become more noticeable, including heavier bleeding, irregular discharge, and pelvic pain. Pain during sex and increased urinary frequency may also appear due to tumor growth pressing on nearby organs.
Stage III: Advanced Local Spread
Stage III occurs when cancer spreads to the pelvic wall, the lower third of the vagina, or blocks the ureters, the tubes connecting the kidneys to the bladder. This blockage can lead to kidney swelling and reduced kidney function. Symptoms intensify, with chronic pelvic pain, back pain, and swelling in the legs becoming prominent. Digestive issues may also occur.
Stage IV: Advanced Cancer
At Stage IV, cancer has spread beyond the pelvic region to nearby organs like the bladder or rectum or distant areas such as the lungs or liver. Symptoms include chronic abdominal pain, difficulty breathing, significant weight loss, and fatigue. Women may experience blood in their urine or stool due to organ involvement. Survival rates drop significantly at this stage.
Recognizing the symptoms linked to each stage of cervical cancer can help women take action before the disease advances. Routine health screenings, such as Pap tests and HPV testing, remain the most effective tools for catching cervical cancer early.
Diagnostic Tools and Procedures
Various tools and procedures help identify abnormal changes in the cervix, allowing doctors to recommend timely and appropriate treatment.
Pap Smear Test
A Pap smear is one of the most reliable methods for detecting cervical abnormalities. During this test, a healthcare provider collects cells from the cervix and inspects them for signs of precancerous or cancerous changes. Women should begin Pap testing at 21 and follow screening guidelines based on age and medical history.
HPV Testing
HPV tests identify high-risk strains of the human papillomavirus (HPV) linked to cervical cancer. This test often accompanies a Pap smear for women aged 30 and older. HPV testing confirms the presence of the virus that causes cellular changes. A negative result eliminates the most common cause of cervical cancer. Related: DIY Cervical Cancer Screening via HPV Self-Collection
Colposcopy
A colposcopy closely examines the cervix using a specialized magnifying device. Doctors perform this procedure when a Pap smear or HPV test shows abnormal results. The colposcope illuminates and magnifies the cervix to allow the doctor to identify suspicious areas requiring further evaluation. A colposcopy often includes a biopsy to analyze cervical tissue.
Biopsy
A biopsy confirms cervical cancer by removing and examining a sample of cervical tissue under a microscope. Medical providers may use several types of biopsies based on the abnormality’s location and severity. These include punch biopsies, which remove small tissue samples, and endocervical curettage, which collects cells from the cervical canal. Doctors may also require a cone biopsy (conization), which removes a cone-shaped section of the cervix for analysis. It is both a diagnostic and treatment procedure.
Imaging Tests
Imaging tests assess whether cervical cancer has spread to other areas of the body. Tests like CT scans, MRI, or PET scans provide detailed images of internal structures. A CT scan evaluates lymph node involvement and tumor size, while an MRI offers a clearer view of soft tissues. PET scans detect cancer activity throughout the body by highlighting areas with increased metabolic activity.
Pelvic Examination
A thorough pelvic exam helps doctors identify physical abnormalities in the cervix or bordering structures. During the exam, a physician checks for changes, irregularities, or growths that may insinuate cancer. While a pelvic exam alone cannot confirm cervical cancer, it is the first step in distinguishing abnormalities that necessitate further investigation.
How to Reduce Cervical Cancer Risk
Preventing cervical cancer starts with addressing its causes and adopting habits that minimize risk.
HPV Vaccination
The HPV vaccine protects against high-risk strains of human papillomavirus, which cause most cases of cervical cancer. Vaccines like Gardasil and Cervarix target the viruses linked to cervical abnormalities. The Centers for Disease Control and Prevention (CDC) recommends vaccination for girls and boys starting at age 11 or 12. Still, individuals up to age 45 can benefit if they have not already received the vaccine.
Routine Screenings
Regular Pap smears and HPV tests detect abnormal cervical cells before they turn cancerous. Guidelines suggest women start Pap testing at age 21 and continue every three years. Women aged 30 to 65 benefit from co-testing with Pap smears and HPV tests every five years. These screenings find early warning signs and give doctors a chance to treat precancerous changes before they progress.
Safe Sexual Practices
Safe sex reduces HPV transmission and lowers the risk of cervical cancer. Using condoms or dental dams while engaging in sexual activity protects against HPV and similar transmissible infections. Limiting one’s number of sexual partners and maintaining open communication about sexual health with partners also reduces exposure to high-risk HPV strains.
In addition, include these articles in your reading list for more information on cervical cancer prevention:
When the Doctor Says “You Have Cervical Cancer”
Know your options. There are various treatments for cervical cancer that do not include surgery, radiation, or high-dose chemotherapy. If you’re interested in non-invasive, alternative cervical cancer treatment options, please visit our contact us to schedule your consultation. New Hope Unlimited is a leader in patient care, treatment innovation, and cancer education.
