Why is my cervix bleeding
Cervical Cancer Signs & Symptoms (& Why They Occur)
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hi everyone this lesson is on the signs
and symptoms of cervical cancer if you
want more information on cervical cancer
please check out my full lesson on that
topic before we get into the signs and
symptoms let's talk about what cervical
cancer is cervical cancer is cancer of
the cervix and the cervix is actually
the lower end of the uterus at the
junction of the vagina so here is the
cervix and you can see that there is a
cancer growing here and it can spread
into surrounding structures leading to
particular signs and symptoms and other
findings we're going to talk about later
on in this lesson cervical cancer is
caused by human papillomavirus or hpv
and there are specific types of hpv that
increase the risk of getting cervical
cancer if you want more information
again please check out my full lesson on
that topic and the risk factors for
getting cervical cancer are related to
risk factors for getting hpv again
please check out my full lesson for more
information now cervical cancer is a
very common type of cancer it's actually
the third to fourth most common
gynecological cancer worldwide although
it is more prevalent in developing
countries compared to developed
countries
the average age of onset of this cancer
is 52 years old and there has been
declining rates of this type of cancer
over the past few decades due to
increased screening programs with pap
smears so again for more information
please check out my full lesson on this
topic but the topic of this lesson is
the signs and symptoms and in fact
cervical cancer can cause a variety of
signs and symptoms and we're going to
talk about those signs and symptoms and
why they occur in the next upcoming
slides now let's talk about the signs
and symptoms of cervical cancer before
we actually get into the signs and
symptoms it's important to note that
many cases of cervical cancer are going
to be detected with screening methods
like pap smear and colposcopy so a lot
of times patients may have a very early
stage of cervical cancer but they may
have no symptoms at all which means that
they would be asymptomatic so some cases
of cervical cancer can be asymptomatic
meaning that they have no symptoms at
all but if they do have signs and
symptoms the most important finding or
the most important sign of cervical
cancer and oftentimes the first sign of
cervical cancer is abnormal vaginal
bleeding so abnormal vaginal bleeding is
again one of the most common and early
signs of cervical cancer if not the
first sign
it often starts with postcoital bleeding
meaning that after intercourse the
patient will experience vaginal bleeding
so this is oftentimes going to be the
first time patients will notice this
abnormal vaginal bleeding over time
though this abnormal vaginal bleeding
will become more frequent and
spontaneous
as the disease progresses this will show
up as heavy menstrual bleeding so
menstrual bleeding or patients period
will become heavier they may also have
intermenstral bleeding meaning that
there is bleeding spotting or heavier
bleeding between periods or if a woman
is postmenopausal if they have post
menopausal bleeding that is going to be
abnormal vaginal bleeding as well so you
can imagine the reason why this occurs
is that if there is a growing cancer on
the cervix the cervix can become eroded
ulcerated from the cancer and cause
bleeding to be found
another important finding in cervical
cancer is vaginal discharge
so vaginal discharge is again one of the
first signs of cervical cancer it's
often again going to be found early on
in the disease course
what will be noted is that the vaginal
discharge will often start out as a
watery discharge and then will
later on become more red to brown in
coloration it can also become malodorous
meaning that it can smell or have a
funny smell to it and it's due to the
inflammatory process that is going on
within the cervix due to the growing
cancer
so this is also an important finding
with cervical cancer as well
other important symptoms of cervical
cancer include vaginal discomfort
so vaginal discomfort is going to be
either pain discomfort or irritation
this can be found with pain during
intercourse as well so this would be
known as dysperunia so this can be a
fining of cervical cancer so if there's
dyspernia and then post coral bleeding
this can be
findings in cervical cancer and you can
imagine the reason why this occurs is
because the cancer starts to spread it
starts to extend past the cervix into
the vagina and this can lead to
pain irritation and discomfort
pelvic pain can also be another finding
in cervical cancer this is going to be
an unexplained pelvic pain so if there's
another explanation that doesn't mean
that the pelvic pain is due to cervical
cancer so this is oftentimes going to be
an unexplained pelvic pain and this is
going to be due to the cancer spreading
into the surrounding areas impinging on
local nerves
so again that cancer starts to extend
out past the cervix
and enter into the pelvic wall and
impinge on some of the surrounding
structures in the pelvis
cervical cancer patients can also have
back pain so as the cancer
spreads and it increases in size it
starts to extend
into other areas there can be
unexplained back pain so
again it's going to be unexplained so
it's not going to be due to some
musculoskeletal injury it's going to be
an unexplained back pain and again this
is going to be due to
the cancer extending into or past the
true pelvis this urea is also another
finding in cervical cancer in some
patients so a lot of these findings
we're going to talk about are going to
be in later stages of the disease when
the cancer has spread so this urea is a
burning sensation while urinating
so this burning sensation while
urinating is going to be or could be due
to the cancer impinging on the bladder
itself or on the urethra so if there's
something pushing on the bladder or the
urethra and
when an individual urinates there can be
some burning from that from that
impingement so again these findings
including back pain and dysuria are
going to be findings that occur later on
in the disease so in later stages of the
disease so most commonly a patient will
experience abnormal vaginal bleeding and
vaginal discharge before they have some
of these other findings including back
pain and dysuria and the other findings
we're going to talk about here in a
moment and some of those include urinary
retention so urinary retention is a
difficulty initiating urination
disrupted urine stream or a complete
inability to urinate so patient feels
that they have to urinate they try but
there's some difficulty initiating
urination or when they get started
there's some disruption of the urine
strain it's not a steady stream or
there's a complete inability to urinate
at all so a patient may be completely
obstructed in their ability to urinate
so that would be complete urinary
retention and this is
due to the cancer compressing
surrounding structures including the
urethra so we talked about dysuria being
a case where the cancer may be
compressing the urethra but in the case
of urinary retention this may be a
complete compression of the urethra so
the patient may not be able to urinate
at all
constipation can also occur in patients
with cervical cancer in later stages of
the disease so constipation is going to
be reduced frequency of defecation or
increased consistency of stool and
patients may also have obstetrician
meaning that they don't pass any flatus
at all and this would be due to a bowel
obstruction so as the cervical cancer
grows and extends and starts to compress
on the large intestine this can cause
constipation and in some cases may even
lead to a bowel obstruction so lead to
the patient having obstruction now there
are some other complications of
metastasis of the cervical cancer a lot
of the previous findings we talked about
are going to be due to increased
extension of the cervical cancer into
surrounding areas but there can be even
more extension into particular areas
that lead to particular findings and
these include the following
leg edema so leg edema is a swelling of
the legs due to accumulation of
interstitial fluid so there's increased
fluid in the interstitial area so what's
supposed to happen is that the fluid in
the interstitial area is supposed to be
drained by the lymphatics
but if there is a growing cancer in the
pelvis
this can lead to compression on
lymphatic drainage in the pelvis meaning
that the
flow of limb for drainage of the fluid
is impeded so this can lead to a buildup
of fluid in the legs so this can lead to
leg edema you can also see pain and this
is going to again be back pain we talked
about before and we can also see
hydronephrosis hydronephrosis is going
to be
a condition where there is fluid buildup
around the kidney and this condition of
hydronephrosis is going to be due to
compression on urinary outflow or
urinary retention
so if the cancer from the cervix begins
to compress on one of the readers this
can lead to compression of the ureter
and
lead to a hydro ureater so the kidney
will continue to make urine but if
there's a compression on one of the
ureters that urine cannot pass that
obstruction leading to a backup of the
urine in the ureter leading to
hydroureter and eventually that urine
will back up into the kidney itself
leading to hydronephrosis
in the case where the cervical cancer
actually impinges or completely
compresses
the urethra leading to urinary retention
this can lead to a patient having a full
bladder they're not able to urinate if
they're not able to actually clear that
obstruction their kidneys again continue
to make urine so both kidneys will
continue to make urine but if they have
nowhere to go if that urine has nowhere
to go
the urine starts to back up into the
readers again causing hydro ureators on
both sides and bilaterally
and lead to fluid accumulation or that
urine being accumulated in the kidney
leading to hydronephrosis bilaterally so
those are two ways that hydronephrosis
can occur in cervical cancer
all three of these findings are a triad
indicating pelvic wall involvement so
this is something that can be helpful in
determining pelvic level involvement if
you see leg edema back pain and
hydronephrosis these are a triad
indicating pelvic wall involvement and
the next signs are going to be signs
that are noted when a clinician actually
visibly looks at or examines the cervix
so there are visible abnormalities on
the cervix that can be found in patients
with cervical cancer because there is a
cancer that is going to be growing on
the cervix
so oftentimes
what can be noted is that the cervix
itself can be friable can have redness
and there can be some ulcerations so
these are some key
words or findings or descriptions of a
cervix that has a
cancerous growth or cancer tissue
developing on it so
this would be something that a physician
or clinician may see when they are
examining the cervix but again not all
cases of cervical cancer will have these
visible abnormalities there may be a
very early case that is detected by pap
smear so there would be a case of
cervical cancer that shows no
abnormality so
again that can also be important because
a lot of times there may be no symptoms
so asymptomatic but there may also be no
signs on the cervix as well especially
if detected early on
with pap smear if you want to learn more
about cervical cancer please check my
full lesson on this topic and if you
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thanks so much for watching and hope to
see you next time