Everything you need to know about cervical cancer

Written by: Dr Natalia Povolotskaya
Published:
Edited by: Aoife Maguire

Cervical cancer is a disease which affects thousands of women in the UK each year. Renowned consultant gynaecologist and cancer surgeon Dr Natalia Povolotskaya provides answers to your frequently asked questions about the disease and explains its relationship with HPV.

 

What is cervical cancer?

Cervical cancer is cancer of the neck of the womb. It is the fourth most frequently diagnosed cancer and the fourth leading cause of cancer mortality in women. Persistent infection with oncogenic human papillomavirus (HPV) is prerequisite in most cervical cancers. However, in recent years HPV‐independent cervical cancers, adenocarcinoma in particular, have been recognised.

 

Are all cervical cancers related to HPV?

90 - 99% of cervical cancers are HPV related.  Fortunately, 90% of HPV infections resolve spontaneously within 2 years, while only about 10% of all HPV infections become persistent. Persistent HPV infections can put the woman at risk of developing precancerous cervical lesions.

 

The time interval between HPV infection and development of precancerous lesions is 1-10 years, while progression to invasive carcinoma is usually 7 -10 years

 

What risk factors are linked to cervical cancer?

The main risk factors for developing cervical cancer are:

 

•       Persistent Human papillomavirus (HPV) infection

•       Not taking part in cervical screening programme

•       Having untreated high-grade cervical intraepithelial neoplasia (CIN)

•       Tobacco usage/smoking

•       Being Immunodeficient/immunocompromised

 

If you have an abnormal smear you will need to have a colposcopic assessment of your cervix. A colposcope is a microscope that stays outside your body, but allows a clinician to undertake an assessment and take a biopsy.

 

What are the most common symptoms of cervical cancer?

Symptoms of cervical cancer are as follows:

 

•       Unscheduled vaginal bleeding

•       Heavy menstrual bleeding

•       Contact vaginal bleeding ( e.g after sexual intercourse)

•       Vaginal discharge which is watery or malodorous

•       Pain during sexual intercourse

•       Bleeding after menopause

•       Unexplained, persistent pelvic and/or back pain

•       Urinary symptoms

 

In some cases, cervical cancer does not show any signs.

 

What is the best treatment for cervical cancer?

Treatment given depends on the stage of cervical cancer. In very early stages, when cancer can be seen only under microscope, an LLETZ procedure may be sufficient. This is a procedure which permits the patient to preserve their fertility.

 

If fertility preservation is no longer required, a minimal access hysterectomy can be performed. For treatment of organ confined tumours which are relatively small but visible to the human eye, radical hysterectomy is an option.

 

With regards to tumours that are of higher stage, chemoradiotherapy is the treatment of choice. MRI scans, CT scans and PET-CT scans can all be used to determine the stage of cervical cancer, prior to making a decision regarding the appropriate treatment.

 

 

If you are concerned about cervical cancer and would like to book a consultation with Dr Povolotskaya, simply visit her Top Doctors profile today.

By Dr Natalia Povolotskaya
Obstetrics & gynaecology

Dr Natalia Povolotskaya is a consultant gynaecologist and cancer surgeon with over 20 years of experience, based in Portsmouth. Dr Natalia Povolotskaya is an expert in gynaecological cancers, cancer prevention, colposcopy and complex gynaecological problems.  She offers rapid cancer diagnosis and treatment for ovarian cancer, cervical cancer, endometrial cancer and vulval cancer.
She has expertise in minimal access (keyhole surgery) laparoscopic and robotic, complex open surgery. She offers hysterectomy for cancer, fibroids, ovarian cysts, heavy periods. She offers risk reduction hysterectomy and removal of tubes and ovaries. She offers surgery for vulval cancer and sentinel lymph node biopsy. She offers all range of diagnostic procedures.

She currently practises at the Spire Portsmouth Hospital and Queen Alexandra Hospital/ Portsmouth University Hospitals NHS Trust.

Dr Povolotskaya completed her medical studies in St Petersburg, achieving a degree in pharmacology (diploma with distinction), before being awarded her medical degree from Pavlov State Medical University in Saint-Petersburg (Diploma with Distinction). She undertook complete UK based postgraduate training in obstetrics and gynaecology. She worked in the best UK hospitals under mentorship of renowned clinicians and surgeons. In addition to completion of general training in obstetrics and gynaecology, she completed extra 3 years of rigorous training in the Subspeciality in Gynaecological Oncology.

She has worked as a consultant in gynaecological oncology since 2015 and has performed hundreds of complex surgeries. Some of her work was featured on the Channel 4 programme 'Shut-Ins'.

Dr Povolotskaya was elevated to fellow status of the Royal College of Obstetricians and Gynaecologists for significant contribution to the obstetrics and gynaecology specialty, furthering the standards of practice, teaching and research.

She is clinical lead for gynaecological oncology at Queen Alexandra Hospital, as well as a surgical lead for the Regional Genetics Multidisciplinary Meeting for Familial Gynaecological Cancers. Previously Dr Natalia Povolotskaya held the position of gynaecological oncology network chair for Wessex Cancer Alliance for three years.

As a Royal College of Obstetricians and Gynaecologists (RCOG) recognised supervisor of sub-speciality training in gynaecological oncology, she is responsible for training the next generation of subspecialty trainees in gynaecological oncology. She is also a colposcopy trainer.

She led a team of clinicians who won a Pride of Portsmouth Award in 2019 for implementing a new approach to follow up in patients with endometrial cancer.

Dr Povolotskaya has multiple publications in scientific journals. She takes active part in Clinical Research. She was a PI for the FORECEE and SUCCOR studies. She is currently a PI for the PROTECTOR study.
 

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