How aggressive is cervical cancer?
While the majority of cervical cancers are slow growing, others can be aggressive which means that they may grow or spread more quickly into other adjacent organs, lymph nodes or recur quicker.
There are two main types of cervical cancer named after where they originate from:
Squamous cell carcinoma
This is the most common type (it accounts for about 70% of cases), which begins at the bottom of the cervix in the squamous cells. These usually develop slowly over time, and when detected early through Cervical Screening Tests they have high survival rates. Survival is lower when tumours spread into pelvic or aortic lymph nodes.
This is the second most common type of cervical cancer and develops in the glandular (mucus-producing) cells higher up in the cervix. It accounts for about 25% of all cases.
Many organs have glandular cells and adenocarcinoma can develop in any of these organs.
Adenocarcinoma and squamous cell carcinoma are both treated in the same way, which you can read about on the Cervical Cancer Page. They are both caused by HPV infection. The time from HPV infection to cervical cancer is usually 10-15 years. Regular cervical cancer tests every 5 years will screen for these cervical cancers.
Other rare types of cervical cancer
Adenosquamous cancers or mixed carcinomas are tumours that have both squamous and glandular cancer cells. They are considered high grade, fast-growing tumours and believed to be more aggressive than squamous cell carcinoma or adenocarcinomas. Their treatment follows the same principles as squamous cell carcinoma and adenocarcinoma.
Small cell cancer
Small cell cancer of the cervix is rare and starts in the upper part of the cervix. Small cell cancers tend to grow very fast and are the most aggressive type of cervical cancer. They account for less than 1% of all cervical cancers. It may also be referred to as small cell neuroendocrine carcinoma, as it originates in the neuroendocrine cells.
There are other types of neuroendocrine carcinomas, including large cell neuroendocrine carcinomas, which are treated in a similar way to small cell cervical cancers; even less people have these large cell cancers.
Small cell cancers are sometimes found alongside other more common types of cervical cancers, such as squamous cell carcinoma and adenocarcinoma. Due to their aggressive nature, they tend to be diagnosed at advanced stages, when they have spread to the lymph nodes or other areas of the body.
Unfortunately, neither the Pap test nor the Cervical Screening Test effectively detects neuroendocrine cancers. They are also treated in a different way to the more common types of cervical cancer, and will depend on the stage of the cancer. Treatment usually involves a combination of radiation treatment with chemotherapy. The average 5-year overall survival rate for women with this subgroup of cervical cancer is unfortunately as low as 34%.
Rare Cancers Australia report women diagnosed with small cell cervical cancer tend to be younger than those diagnosed with other cervical cancers.
Other (even more) rare types of cervical cancer
Very rarely, other types of cancer can occur in the cervix such as melanomas, lymphomas and sarcomas. They are treated in a different way to cervical cancer, and are more often found in other parts of the body.
Cervical cancer symptoms
The symptoms of all cervical cancers are the same:
- Abnormal vaginal bleeding during or after sexual intercourse, or between periods.
- Postmenopausal vaginal bleeding, if you are not on hormone replacement therapy or have stopped it for six weeks.
- Unusual vaginal discharge.
- Discomfort or pain during sex.
- Continuous lower back pain.
Being diagnosed with an aggressive cancer can be a distressing process—speaking to a gynaecological oncologist will help you to be informed on how to effectively treat the disease.