Cervical Cancer

There are a number of symptoms or changes you should look out for, including:

• bleeding from the vagina between periods
• bleeding from the vagina after menopause (the time when women stop having their periods)
• pain or bleeding during or after having sex
• having an unusual discharge or blood coming from your vagina
• having heavier or longer periods than normal
• feeling very tired
• unusual swelling in your legs
• leg or back pain.

Having these symptoms may not mean you have cancer, but it is important to check. 

If you have unusual bleeding, discharge or pain, see your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker. If you have bleeding that is unusual, you may be referred to a gynaecologist, who is a doctor that specialises in women’s health.

Sometimes when women find out they have cervical cancer, they may not have had any symptoms and never knew they had a problem.

If you have any concerns or are worried about something else, yarn with your doctor, nurse or Aboriginal and Torres Strait Islander health worker.

Cervical cancer is one of the most preventable cancers. Regular cervical screening of women aged 25-74 years old is done to find cervical cancer when it is very early and is an important part of being healthy for yourself, your family and your mob. Most women don’t know they have cervical cancer until it is detected on a cervical screening test.

The old Pap Test has been replaced with a new Cervical Screening Test, which you only have to do every five years. Just one Cervical Screening Test every five years can help you avoid cervical cancer.

What happens at a Cervical Screening Test?

The test looks for human papillomavirus (HPV) and it is quick and simple. If you have ever had a Pap test before, the way this test is done will feel the same. Read more about what happens at a Cervical Screening Test. 

How do I arrange a Cervical Screening Test?

You can arrange your test through your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker, at an Aboriginal Medical Service, community or women’s health centre, or family planning and sexual health clinic. Remember, you can always ask for a female doctors, nurses and health workers to do your test if that makes you feel more comfortable and able to stay within Women’s Business protocols.

Watch Your guide to cervical screening for Aboriginal and Torres Strait Islander women

Find out more at Cervical screening for Aboriginal women | Cancer Institute NSW.

Almost all cases of cervical cancer are caused by the human papillomavirus (HPV). You can prevent HPV-related cancers and diseases by making sure  all the kids in your family and mob get the free and safe HPV immunisation.

HPV is a very common virus that can cause cancer of the cervix, vulva, vagina, penis and anus as well as some cancers of the mouth and throat. The HPV immunisation protects against HPV-related cancers. These cancers are considered by our mob as Women’s Business and Men’s Business. Use these links for more information.

HPV immunisations have been offered in Australia since 2007 and are proven to be very safe. The HPV immunisation is provided free in schools for kids aged approximately 12–13 years. It’s two shots six months apart. Your child’s best protection against HPV-related cancers such as cervical cancer is making sure they are vaccinated before they are exposed to an infection.

Read more about HPV immunisation.

You may have done a Cervical Screening Test and heard from the cervical screening program that you might need more tests. Cervical cancer is one of the most treatable cancers if it is found early through the cervical screening program. 

You won’t know if you have cervical cancer until your doctor or nurse has yarned with you, done a physical examination and completed some tests.

The tests might include:

• a colposcopy, where a special microscope is used to look at your cervix
• a biopsy, where a tiny bit of your cervix is removed, and they look at it under a microscope.  

Most women who have these tests find out they don’t have cervical cancer, but it’s important to check.  

The two main types of cervical cancer are named after the type of cells they come from:

• Squamous cell carcinoma: the most common type of cervical cancer (about 80 per cent of all cases), squamous cell carcinoma starts in the squamous cells of the cervix.
• Adenocarcinoma: a less common type of cervical cancer that starts higher in the cervix, and is more difficult to reach with the brush or spatula used in a Cervical Screening Test.

If you have cervical cancer, you might be told it’s at a certain stage. This describes whether or not it has spread to other part of your body, and how far. Knowing the stage of the cancer helps you and your doctors to decide on the best treatment for you.

• Stage 0: the cancer is confined to the surface layers of the cervix
• Stage 1: the cancer has grown deeper into the cervix but has not spread beyond it
• Stage 2: the cancer has spread beyond the womb to the upper vagina, but not to the pelvis
• Stage 3: the cancer has spread to the pelvic wall or the lower part of the vagina. It may also have spread to lymph nodes in the pelvis.
• Stage 4: the cancer has spread beyond the pelvis to other organs.

With all stages of cervical cancer, there is plenty of treatment and support that can help you, including traditional medicine and practices like ceremony and being on Country.

There are a number of different ways to treat cervical cancer, depending on the stage of your cancer.

Your doctors will yarn with you about what treatments they recommend and what options are best for you.

Very early cancer cells in the cervix are called precancerous cells. Not all precancerous cells need treatment.

If you do need treatment, then part of your cervix will be removed to get rid of the cancer cells. This treatment is quite simple and usually very successful. Treatments include a cone biopsy, which removes a cone-shaped piece of tissue with abnormal cells from the cervix, or a loop excision, which cuts out a larger piece of the cervix.

Sometimes laser surgery is used to destroy the cells with a laser.

If you have cervical cancer, you might need surgery, radiotherapy or chemotherapy, or a combination of them.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about which treatment you might have and any traditional healing, bush medicines and cultural practices you may want to include in your treatment plan.

Surgery

Surgery is a procedure done in hospital to remove the cancer and help to stop it from spreading to other parts of your body. Surgery involves staying in hospital and having an anaesthetic and an operation to remove the cancer.

Some women just have a small piece of their cervix removed. Some have all the cervix removed.

Your doctor will yarn with you about what they plan before surgery.

Yarn with your doctor, nurse or Aboriginal and Torres Strait Islander health worker if you have any concerns about surgery and assistance available for travel and accommodation for you and your family if you need to travel away from home for surgery.

Read more about surgery.

Radiotherapy

Radiation therapy, also called radiotherapy, uses X-rays to destroy cancer cells in one part of your body.

External radiotherapy

Most women who have radiotherapy have it every day 5 days per week for 4-6 weeks, and each session can take 15 minutes. But it might be different for you.

To have your radiotherapy, you might need to travel to your nearest big town or city – see this list. If your doctor thinks radiotherapy would help, and you don’t live near a radiotherapy site, assistance is available for travel and accommodation for you and your family.

Internal radiotherapy

Radiation therapy can also be given internally. This is called brachytherapy. This involves giving radiation via a needle or another device into the vagina. The device stays in place from a few minutes to a few days. Depending on the treatment and the dose of radiation you receive, you might need to stay in hospital or make a daily visit for treatment.

Your doctor, nurse or Aboriginal and Torres Strait Islander health worker will be able to yarn with you about radiotherapy that is right for you.

Read more about radiotherapy.

Chemotherapy

Chemotherapy or ‘chemo’ involves you taking strong drugs to kill the cancer cells.

Many people have chemo in cycles – such as one day every three weeks, or sometimes once a week. You may also be recommended to have chemo at the same time as your radiotherapy, and this is usually given once a week for the duration of the radiotherapy. Some women have chemotherapy tablets at home, but most need to go to a hospital or clinic.. But you usually don’t need to stay in hospital for chemo.

Most chemo comes as injections into your arm or hand that drip in over a few hours and some need you to take home a small bottle of chemo for two days then come back to take it off again. Some chemo comes as tablets. If you’re having chemo, your doctor will tell you exactly how it will work for you.

Chemo can make some people feel sick for a while. There are things that can help, so it is important to talk to your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about them. Mob who have had chemo say that being on Country, traditional healing, bush medicines, cultural practices, Men’s Business and Women’s Business also help during treatment.

Read more about chemotherapy and side effects.

It’s important for you to understand why you are getting the treatment your doctor recommends and how it is supposed to help you. Different treatments try to do different things. It depends on what cancer you have, and whether it has spread, and what you want. Ask your doctor or specialist if the treatment they suggest:

• is meant to cure you, by getting rid of the cancer and stopping it spreading, or
• won’t cure you, but is meant to prolong your life, or make your feel better.

Your doctors will yarn with you and explain this. You can yarn with them, ask questions, and tell them what you think, and what you want. Some people will want to try everything possible to stay alive. Others want simpler treatments, or don’t want to leave Country for treatment, or don’t want any treatment. It’s your choice. You can also talk to another doctor to help you decide.

It can take time to decide about treatment. There are usually some options to hear about and choices to make.

It can be helpful to write things down, and have someone else come to appointments to help remember information

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Read more about treatment.

Always ask about the cost of treatment. Many treatments are free through public hospitals, but some are not. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Learn more about financial support.

It all depends on the type of treatment you’re having. People will have treatment for different durations of time. After treatment is over, your doctor might keep in touch with you to check how you’re going and monitor your health.

During your cancer journey you will have the opportunity to build trust and safe relationships with your doctors, nurses and Aboriginal and/or Torres Strait Islander health workers that may last beyond your treatment.

Nearly all cervical cancers are caused by a human papillomavirus (HPV) infection. 

As well as infection with the Human Papilloma Virus (HPV), there are other features that are more common in women who develop cervical cancer. These features are called ”risk factors”.

Cervical cancer is not infectious. And unlike some other cancers, cervical cancer is not caused by an inherited faulty gene, so other members of your family are not likely to be at risk of developing it.

Other risk factors for cervical cancer include:^:

• smoking tobacco
• Age - cervical cancer mainly occurs in women over 35 years old and is less common in women under 25. Around 7 out of 10 of cervical cancers are diagnosed in women under 60 years old.
• weakened immune system
• lack of regular Cervical Screening Tests
• taking contraceptive pills for a long time
• previous abnormality or cancer of the cervix
• having many children
• being exposed to diethylstilboestrol (DES).

 If you have any of these risk factors or you’re worried about your risk for cervical cancer, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Clinical trials might be an option for you. Yarn with your doctor to help you decide if taking part is a good option. Read more about clinical trials.

Read more detail on cervical cancer here.