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Cervical Cancer Prevention Week: How to prevent cervical cancer and how it affects fertility

In the UK, around nine people are diagnosed with cervical cancer every day, but it is actually one of the most avoidable cancers, with 99.8% of cases being completely preventable. As part of Cervical Cancer Prevention Week, we want to raise awareness of how cervical cancer affects fertility, but also how to protect yourself against it.

What is cervical cancer?

Cervical cancer is when abnormal cells grow in the lining of the cervix (the opening from the vagina to the womb). These abnormal cells are not cancerous but, if undetected and left over time to grow in an uncontrolled way, they can develop into cancer.

There are different types of cervical cancer, and these types are also described in ‘stages’, telling you the size of the cancer and whether it has spread. You can read more about the different types of cervical cancer here: https://www.cancerresearchuk.org/about-cancer/cervical-cancer/stages-types-grades

What causes cervical cancer?

Nearly all cases of cervical cancer (99.7%) are caused by an infection called human papillomavirus (HPV). There are over 100 different types of HPV, and the infection is so common that four out of five sexually-active adults will come into contact with it in their lives. However, only around 13 types of HPV have been linked to cervical cancer (known as ‘high-risk’ types), and just two types cause over 70% of cervical cancers in the UK. 

Some other factors, such as smoking tobacco, increases the risk of getting cervical cancer. You can find out more about contributing factors to cervical cancer here: https://www.cancerresearchuk.org/about-cancer/cervical-cancer/risks-causes

How does cervical cancer affect your fertility?

Like all cancers, cervical cancer needs to be treated to prevent the cancer spreading. Unfortunately, many of the treatments for cervical cancer can affect fertility, with some treatments leaving patients unable to become pregnant in the future.

A common treatment for cervical cancer is the removal of cancerous, or even pre-cancerous, cells from the cervix. Depending on the type and stage of the cancer, this can mean removing just a few cells, or surgery to remove the whole womb (a radical hysterectomy).

Another treatment for cervical cancer is radiotherapy, possibly combined with chemotherapy. Radiotherapy and some chemotherapy drugs can affect the womb and the ovaries, causing them to stop working and prompting early menopause.

How can you preserve your fertility if you have cervical cancer?

Even with a cervical cancer diagnosis, there are many steps you can take to preserve your fertility and help you get pregnant in the future.

Before treatment

Before undertaking radiotherapy, chemotherapy or removing cancerous cells, it may be possible to remove some eggs to then freeze and preserve. This is possible through your ovaries being stimulated using fertility drugs to produce more eggs, just like in IVF, which are then collected and frozen. You could even choose for the collected eggs to be fertilised with sperm and develop into embryos before freezing

This can be a worthwhile way to protect your fertility and, at CARE, around 95% of good quality embryos survive the entire process of freezing and thawing.

During treatment

Though a patient’s recommended cervical cancer treatment will always depend on their circumstances, there are a few ways doctors can try to ensure you can get pregnant in the future, even after treatment. Babies have been born safely even after procedures like a radical trachelectomy, where most of the cervix and upper part of the vagina is removed. The most important thing to remember is that your doctors will always take your wishes into account, and try their best to preserve your fertility, if that’s what you wish.

How can you prevent cervical cancer?

Of course, the best way to preserve your fertility is to protect yourself against cervical cancer. The three best ways to prevent cervical cancer are attending cervical screenings, having the HPV vaccination, and knowing the symptoms of cervical cancer.

Cervical screenings (the smear test)

The best way to prevent cervical cancer is to regularly have a cervical screening (sometimes known as a smear test). This quick and easy procedure prevents about 75% of cervical cancers through detecting abnormal cells early on, before they develop into cancer. That means you can receive the right care before there is even a problem.

Every woman between the ages of 25 and 64 is automatically invited for cervical screening every few years by their GP, with a few exceptions. You can read more about cervical screening and how often you should get one here: https://www.jostrust.org.uk/information/cervical-screening/what-is-cervical-screening

From Dr David Polson FRCOG, Consultant Gynaecologist:

“The most important thing is to have your smear test: that is absolutely fundamental. At CARE, we always check patients are up to date with their cervical screening before we begin treatment, because our top priority is a healthy mother and a healthy baby. Even if your smear shows signs of some abnormal cells, it doesn’t stop you from having fertility treatment; you have your smear, have any abnormal cells dealt with, and then come back and have your treatment. It may be delayed by a month or two, but so much better to solve any issues than have problems down the line, especially if you’ve just started a family.

Remember: stage one cervical cancer is completely curable, it’s not the case that you can’t have children any more, and there’s many ways that women can now give birth after a cervical cancer diagnosis. Having your smear test regularly is the best way to protect your fertility.”

HPV vaccination

Another way to prevent cervical cancer is the HPV vaccination, which protects against high-risk HPV strains, including the ones linked to cervical cancer. This vaccination injection is offered free in schools, and is also available on the NHS in certain situations. You can also pay to have the vaccination privately. Find out how you can get the HPV vaccination here: https://www.jostrust.org.uk/information/hpv-vaccine/who-can-have-the-hpv-vaccine 

Knowing the symptoms of cervical cancer

Finally, knowing the symptoms of cervical cancer will ensure you act quickly if something doesn’t seem right. The main symptoms of cervical cancer are:

  • Abnormal bleeding during or after sexual intercourse, or between periods
  • Post-menopausal bleeding, if you are not on hormone replacement therapy or have stopped it for six weeks or more
  • Unusual vaginal discharge
  • Discomfort or pain during sexual intercourse
  • Lower back pain

Of course, many of these symptoms could be caused by something else, so don’t panic if you notice anything change. Just make an appointment to see your GP as soon as possible, and tell them about your concerns.

Having a baby after an abnormal cervical smear test

One of our wonderful patients, Rebecca Brown, was shocked attending a routine smear test and finding out she had pre-cancerous cells. Here’s how things turned out, with a little help from CARE:

Rebecca’s story

“I went for a routine smear in February 2018 and got the result in April that I would be sent a hospital appointment as abnormal cells had been detected. My hospital appointment came the following day and it was set for the following week. At the hospital the consultant told me I had high grade pre-cancerous cells on the internal cells of the cervix. I had a Lletz procedure done the same day. The results showed no clear cells detected when I went back for my follow up hysterectomy was discussed. This prompted me to say how much I wanted to become a mum. So, in agreement with the consultant, more cells where taken. During the 6 weeks wait, I had discussed with my parents and sister my desire to be a mother and go down the IVF route as a single lady using a sperm donor. I got my clear result from my second Lletz in mid-July and August/September time I went for a free 1-1 consultation at CARE Nottingham. I felt so comfortable and at ease that’s where my journey began.

5 minutes of feeling uncomfortable can save your life and give you piece of mind and the rest of your life to enjoy.”

There’s lots of resources and support available if you want to find out more about cervical cancer, such as Cancer Research UK  and Jo’s Cervical Cancer Trust.

Cervical cancer can seem scary, but it may not be the end of your fertility journey. Talk to a fertility expert, and know we’re here to help you every step of the way.

With love from CARE xxx 

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