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Last Updated: Feb 05, 2020
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Cervical Cancer: Treatment, Procedure, Cost and Side Effects

Overview Symptoms Causes Stages Diagnosis Treatment Side effects Post-treatment guidelines Recovery Cost Results Alternatives

What is Cervical Cancer?

Cervical cancer is a type of cancer that occurs in the cells of the cervix. Cervix is located in the lower part of the uterus that connects to the vagina. Cervical cancer is one major cause of cancer and cancer caused deaths in women.

What are the signs and symptoms of cervical cancer?

Early-stage cervical cancer generally do not produce any signs or symptoms. Signs and symptoms start to develop when the cells start affecting the surrounding cells of the cervix. Signs and symptoms of cervical cancer include abnormal pain, heavy abnormal discharge, pain during urination etc. Symptoms of more-advanced cervical cancer include vaginal bleeding after intercourse, between periods or after menopause, watery, bloody vaginal discharge that may be heavy and have a foul odor and severe pelvic pain or pain during intercourse.

What Causes Cervical Cancer?

What Causes Cervical Cancer?

Cervical cancer is caused when the cells in the cervix are infected by high-risk types of HPV or human papillomavirus

Stages of Cervical Cancer

Depending on extent of spread of cancer cells in the patient, they are staged under four stages - Stage I, stage II, stage III and stage IV.

How Cervical cancer is diagnosed?

Cervical cancer which is detected early can be cured faster and better and also alleviates the risk of other problems. Patients affected with cervical cancer are first screened and diagnosed properly before moving onto the treatment. Screening tests include a PAP test and HPV DNA test.

  • PAP test :

    During a Pap test, cells from the cervix are taken by the doctor using scrapes and brushes. These cells are then examined in a lab for abnormalities.A Pap test help to detect abnormal cells in the cervix, including cancer cells and cells that show changes that increase the risk of cervical cancer.

  • HPV DNA test :

    The HPV DNA test helps to diagnose cells collected from the cervix for infection with any of the types of HPV. These cells are most likely to lead to cervical cancer. This test is prescribed for women of age 30 and older, or for younger women with an abnormal Pap test.

  • Colposcope

    A special magnifying instrument (colposcope) is used to check for abnormal cells in the cervix which show signs and symptoms of being infected with cancer cells.

  • Other Test Include:

    Punch biopsy, Endocervical curettage, Electrical wire loop and cone biopsy are the several ways to detect the stage and extent of cancer in the body. For this purpose, imaging tests like X-rays, CT scans, magnetic resonance imaging (MRI) and positron emission tomography (PET) are used. These tests along with visual examination of the bladder and rectum help the doctor to determine whether the cancer has spread beyond the cervix region.

How cervical cancer treatment done?

Treatment for cervical cancer depends on several factors. These factors include the stage of the cancer, other health problems associated etc. Treatment methods include surgery, radiation, chemotherapy or a combination of the three.

  • Surgery:

    Surgery removes the cancer cells from the body, depending on the location and extent of cancer spread. Surgery also takes into consideration the choice of bearing babies. Surgery is done when the tumor cells can be removed overall. Surgical procedures include conization, hysterectomy, cryosurgery, laser surgery, pelvic exenteration. etc. These procedures include laser beams or freezing and destroying methods to kill the cancer cells developed and prevent further multiplication of the same.

  • Radiation:

    Radiation passes high-dose X-rays or implants in the vaginal cavity to kill the cancer cells. Radiotherapy can be of two types, external and internal. Radiotherapy may be given for larger tumours in the cervix and it is usually given if the cancer cells have spread beyond the cervix and is not curable with surgery alone. Radiotherapy may also be used after surgery when there is a high risk that the cancer may come back. It is often given in combination with chemotherapy (chemoradiation).

  • Chemotherapy:

    Chemotherapy is a method which uses medications which are usually injected into a vein, to kill cancer cells. These anti-cancer drugs aim to destroy all cancer cells with the least damage to normal cells. Chemotherapy is used in the advanced stage of cervical cancer. Chemoradiation is a combination of chemotherapy and radiation therapy.

Who is eligible for the treatment?

Women should always consult a doctor as soon as possible if they face symptoms that could indicate cervical cancer. They should visit the doctor if they experience unexpected bleeding between menstrual periods, irregular periods with severe vaginal bleeding, if the blood clots and causes pain, abnormal vaginal discharge containing mucus that may be tinged with blood and unexpected bleeding after douching or sex. If diagnosed with cervical cancer, they should consult the doctor immediately and get started with the treatment.

Are there any side effects?

There are several side effects of the methods used in the treatment of cervical cancer.

  • Side effects of Surgery:

    Surgery can also require removal of the ovaries which means one will not be able to bear children anymore. Surgeries can leave behind parts of the cancer cells, which may later develop into something severe.

  • Side effects of Radiation therapy:

    Radiation therapy for cervical cancer can cause side effects on the patient like fatigue (tiredness), upset stomach, diarrhea or loose stools (if radiation is given to the pelvis or abdomen), nausea and vomiting and skin changes.

  • Side effects of Brachytherapy radiation:

    Brachytherapy radiation only travels a short distance and causes irritation on the cervix and the walls of the vagina. Long term side effects of radiation therapy includes vaginal stenosis and vaginal dryness. They cause the cells and tissues to scar which make the vagina narrower and stretching limited.

  • Side effects of Radiation to the pelvis:

    Radiation to the pelvis can weaken the bones, leading to low bone density and bone fractures. Hip fractures are the most common. Legs can also become swelled because of the fluid drainage problems in the leg. This is called lymphoedema.

  • Women may also face side effects of menopause, which takes on after three months of the beginning of the treatment.

What are the post-treatment guidelines?

After cervical cancer surgery, patients are encouraged to start moving about as soon as possible. This is done to encourage faster recovery and it is an essential part of recovery. If movement is not possible, patients must do regular leg movements and deep breathing exercises. Taking further medicines as prescribed and maintaining a proper life style will aid recovery faster. People should also consult their doctors after treatment for check-ups.

How long does it take to recover?

For a laparoscopic or vaginal hysterectomy, people stay at the hospital for two or three days. They need about three to four weeks to recover. For an abdominal hysterectomy, patients stay at the hospital is for three to five days and complete recovery takes about four to six weeks.

Recovery from total pelvic exenteration takes a long time. They take around six months to recover completely. Some may even take a year or two. Radiation therapy and chemotherapy usually occur in sessions, thus, recovery takes a greater time.

What is the price of the treatment in India?

Treatment of cervical cancer is very expensive. Surgeries and session wise radiation and chemotherapies are highly out of pocket for most of the mass. The cost of the cervical cancer treatment in India is around Rs 3,00,000- Rs 10,00,000. Some people incur even greater costs due to extended treatment and other associated complications.

Are the results of the treatment permanent?

Treatment aims to permanently cure cancer or to bring about a complete remission of the disease. Usually, people with early detection of cervical cancer get treated permanently. But, the consequences of the procedures last life long for the majority of the people.

Also, treatment may fail to save the patient from the life threatening cancer cells if they are detected at a late stage when recovery is impossible. Later stages of cancer cannot be cured by treatment. Early detection may help the person live normal life expectancy but with some side effects.

What are the alternatives to the treatment?

There are several types of alternative treatments available for cervical cancer. Apart from the standardized surgeries and therapies, people may use other methods like acupuncture, massage therapy, herbal products, spiritual healing, visualization etc for curing cervical cancer. Meditation and a proper diet rich in vitamins can also be used to prevent cancer cells from growing and reproducing.

Many patients claim that these alternative treatments help them feel better. It is important to remember that these alternative treatments can only be done alongside the main treatment. These complementary treatments are done to provide relief from the symptoms and side effects of cancer treatments. Some types of alternative treatment may interfere with standard treatment. In some cases, the combination of alternative treatment and standard treatment may even be harmful. Hence, it is always better to consult a doctor at every step.

Popular Questions & Answers

I am a 21 female and I started the mini pill 3 months ago and for about a month now I have had a burning pain in both of my breasts and I have a family history of breast cancer so I am not sure if I should be worried. I have no lumps but it’s just the burning pain.

MD - Obstetrtics & Gynaecology, FCPS, DGO, Diploma of the Faculty of Family Planning (DFFP)
Gynaecologist, Mumbai
No need to worry from cancer point of view. Should do self breast examination every month and ideally yearly check up by doctor. For present complaints- meet gynecologist or surgeon.

My age is 27, height 5 ft 11 inch, weight 82 kg, unmarried. On 29 may ,i got 104f for 3 days. Urine report showed pus cell 18-25, rbc 10-12, bacteria 1+. I was having body ache all over. I took nitrofurantoin and levofloxacin for 15 days. On 1 july, my usg was normal and shown prostate size 21 cc. On 7 and 13 july, I got bleeding in semen. But after that there was no bleeding but I was having chillness in body and bone pain in hips and femur. On 14 aug 2020, my total psa was 2.06 ng/ml. Doctor did prostate ultrasound showing prostate volume 14. 8 cc. The prostate is normal in size, shape and shows ill defined parenchymal areas if increased echogenicity mainly limited to the anterior stromal zone and transitional zone of the prostate. The echogenic areas are seen extending and surrounding the opening of ejaculatory ducts on both side and there is preserved zonal differentiation noted in both lobes elsewhere. Possibility of chronic prostatitis needs to be ruled out. And my semen analysis showed 10-12 pus cell and also volume wqs very less around 1.5 ml.then he gave me ofloxacin 400 mg (bd, alfuzosin 10 mg (od) for 21 days. 8 days after taking that on 2 and 3 sep again I got bleeding in semen, I went to doc on 16 september after completing antibiotics course. On same day my total psa was done and it was 3.06 ng/ml (increase 1 ng/ml within one month but in 2016 ,it was 0.76 ng/ml ).i am having severe pain all over body specially hips site, femur connecting hip bone, feet arch pain on movement and rib cage pain, shoulder bone pain, joint pain and chillness all over body. My all these problem. Are increasing in daily basis. My body is becoming too painful day by day. I used to feel penis tip pain sometimes and I also have sore throat or something stuck in. Throat below layrnx (for which doc says might be due to acid reflux without checking. Can I have prostate cancer though rare at this age but my psa is increasing and having uncommon bone pain at uncommon bone sight?

DNB - urology
Urologist, Pune
No it's very very unlikely to have prostate cancer at your age. It seems to prostate infection which requires longer treatment. Don't worry.

My age is 27, weight 82 kg, unmarried.i was in uttar pradesh. I came to my home on 21st march and from 23rd I was feeling light increase of temp in head i.e was 99f. Then on 27 march you got sore throat (like something stuck in throat) and also my sternum sides are paining on body movement. U went to government hospital many times and they did xray and xray was normal and also took antibiotics for sore throat but still not resolved. On 29 may I got high fever 104f for 3 days and was having burning in penis after urination and also pain at tip of penis ,it was continued for 3 days and fever was not coming down with paracetamol. My urine report on 1 june was pus cell 18-25, rbc 10-12, bacteria 1+,albumin 1+ and blood report on 1st june was lymphocyte 10%, platelet 1.25thou/cumm (range 1.5 to 4, tlc was 4.then doctor gave me mefenamic acid and some antibiotics like nitrofurantoin and ofloxacin for 15 days. But after that I was feeling like shooting pain radiating from penis to rectum. On 1 july I visited urologist again, there junior resident ordered usg abdomen and it shows normal study and prostate size 21 cc. Then he sent to me general surgeon to check piles but it was normal as they checked with metal probe .on 7 july and 13 july I got bleeding in semen. Semen was fully mixed with blood. And I was also having hips pain, hips connecting to femur point pain, femur pain, thighs pain and legs pain, feet frontal part pain and hands frontal part pain, leg pain and also getting chills many times. On 14 aug, my vitamin d was 75 (range 74 to 215) but it is same since 2015. And blood report show lymphocyte 26%,platelet 2.34lakh and tlc 5 (range 5 to 10. On 14 aug 2020, my serum psa came 2.06 ng/ml but in 2016, it was 0.77 ng/ml. within 4 years it has increased 3 times. On 26august I went to urologist but my maine issues were to go to him to interrelated the cause of my bones pain as I saw blood in semen as first sign of problem. He did semen analysis showing 10-12 pus cell, and trus prostate showing "prostate volume 14. 8 cc. The prostate is normal in size, shape and shows ill defined parenchymal areas if increased echogenicity mainly limited to the anterior stromal zone and transitional zone of the prostate. The echogenic areas are seen extending and surrounding the opening of ejaculatory ducts on both side and there is preserved zonal differentiation noted in both lobes elsewhere" possibility of chronic prostatitis needs to be ruled out" I also had trus prostate in 2017, at that time prostate was normal having 13. 5 cc size (it was done in 2016 due to frequent urination problem. He gave me antibiotics for 21 days i.e oflox 400 mg (bd), alfuzosin 10 mg (od. 8 days after taking these antibiotics again I got blood in semen on 2 sep and 3 sep. My mai problem is that my whole body bones are paining i.e hips bone ,femur bone ,back of hips where it connect to femur near rectum, thighs pain, legs pain, feet pain (not able to walk properly, rib cage pain, chest frontal part pain ,teeth pain, having too much weakness in thighs and legs ,shoulder joints also started to pain since 6 days, hands pain above elbow, I get chills sometimes in these hot summer at back of lungs. My weakness intensity increasing on daily basis. Withing these two months pain acquired my whole body. My feet are paining too much and having weakness in hands too like somebody get tired after too much work. My sore throat (like something stuck in throat) not going even after showing to ent 2 or 3 times, they are saying it might be due to acid reflux without checking anything, they are not seeing properly. I do not feel they I have that much acid reflux to cause problem. With the intensity of increasing problem and sudden onset of whole body bone pain and burning sensation and specially too much weakness in femur and bone pain in hips bone connecting point, I assumed that I became prostate cancer patient though it is very rare at this age but I am not getting any solution to my problem even after showing to good urologist. Please guide me sir what to do?

MS - Obstetrics and Gynaecology, MBBS Bachelor of Medicine and Bachelor of Surgery
Gynaecologist, Shimla
I am sorry to hear about your concern but will be happy to assist you. A burning sensation is a type of pain that's distinct from dull, stabbing, or aching pain. A burning pain is often related to nerve problems. However, there are many other poss...

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