Cervical cancer

"Cervical cancer - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Cervical cancer Cervical cancer About cervical cancer Symptoms of cervical cancer Causes of cervical cancer Diagnosing cervical cancer Treating cervical cancer Complications of cervical cancer Living with cervical cancer Preventing cervical cancer About cervical cancer Cervical cancer is a type of cancer that develops in a womans cervix (the entrance to the womb from the vagina). Cancer of the cervix often has no symptoms in its early stages. If you do have symptoms,the most common is unusual vaginal bleeding, which can occur after sex, in between periods or after the menopause . Abnormal bleeding doesnt mean that you definitely have cervical cancer, but it should be investigated by your GP as soon as possible. If your GP thinks you might have cervical cancer, you should be referred to see a specialist within 2 weeks. Read more about the symptoms of cervical cancer and diagnosing cervical cancer Screening for cervical cancer Cervical screening (also known as a smear test) is routinely offered to anyone with a cervix in Scotland, between the ages of 25 and 64, every 5 years.You may be recalled more often depending on your test results. Those on non-routine screening (where screening results have shown changes that need further investigation or follow up) will be invited up to 70 years of age. If you have unusual discharge, or bleeding after sex, between periods or after the menopause, contact your GP practice. These symptoms are not usually caused by cancer but its important to have them checked. Youwill be sent a letter confirming when your screening appointment is due. Contact your GP if you think you may be overdue for a screening appointment. Read more about cervical screening What causes cervical cancer? Almost all cases of cervical cancer are caused by the human papilloma virus (HPV) . HPV is a very common virus that can be passed on through any type of sexual contact with a man or a woman. There are more than 100 different types of HPV, many of which are harmless. However, some types of HPV can cause abnormal changes to the cells of the cervix, which can eventually lead to cervical cancer. Two strains of the HPV virus (HPV 16 and HPV 18)are known to be responsible for 70% of all cases of cervical cancer.These types of HPV infection dont have any symptoms, so many women wont realise they have the infection. However, its important to be aware that these infections are relatively common and most women whohavethem dont develop cervical cancer. Using condoms during sex offers some protection against HPV, but it cant always prevent infection, because the virus is also spread through skin-to-skin contact of the wider genital area. Since 2008, a HPV vaccine has been routinely offered to girls aged 12 and 13. Read more about the causes of cervical cancer and preventing cervical cancer Treating cervical cancer If cervical cancer is diagnosed at an early stage, its usually possible to treat it using surgery. In some cases, its possible to leave the womb in place, but itmay need to be removed. The surgical procedure used to remove the womb iscalled a hysterectomy . Radiotherapy is an alternative to surgery for some women with early-stage cervical cancer. In some cases, its used alongside surgery. More advanced cases of cervical cancer are usually treated using a combination of chemotherapy and radiotherapy . Some of the treatments used can have significant and long-lasting side effects, including early menopause and infertility . Read more about treating cervical cancer Complications Many women with cervical cancer will have complications. These can arise as a direct result of the cancer or as a side effect of treatments such as radiotherapy, chemotherapy andsurgery. Complications associated with cervical cancer can range from the relatively minor, such as minor bleeding from the vagina orhaving to urinate frequently, to life-threatening, such as severe bleeding or kidney failure. Read more about the complications of cervical cancer Outlook The stage at which cervical cancer is diagnosed is an important factor in determining outlook. The staging, given as a number from 1 to 4, indicates how far the cancer has spread. The chances of living for at least 5 years after being diagnosed with cervical cancer are: stage 1  80-99% stage 2  60-90% stage 3  30-50% stage 4  20% Read more about the staging of cervical cancer Whos affected by cervical cancer? Following the success of the NHS Cervical Screening Programme and the early detection of cell changes, the number of cervical cancer cases in the UK has reduced. Around 3,000 cases of cervical cancer are diagnosed in the UK each year. Its possible for women of all ages to develop cervical cancer, but the condition mainly affects sexually active women aged between 30 and 45. Cervical cancer is very rare in women under 25. Symptoms of cervical cancer The symptoms of cervical cancer arent always obvious, and it may not cause any symptoms at all until its reached an advanced stage. This is why its very important that you attend all of your cervical screening appointments. Unusual bleeding In most cases, vaginal bleeding is the first noticeable symptom of cervical cancer. It usually occurs after having sex. Bleeding at any other time, other than your expected monthly period is also considered unusual. This includes bleeding after the menopause (when a womans monthly periods stop). Visit your GP for advice if you experience any type of unusual vaginal bleeding. Other symptoms Other symptoms of cervical cancer may include pain and discomfort during sex and an unpleasant smelling vaginal discharge. Advanced cervical cancer If the cancer spreads out of your cervix and into surrounding tissue and organs, it can trigger a range of other symptoms, including: constipation blood in your urine (haematuria) loss of bladder control ( urinary incontinence ) bone pain swelling of one of your legs severe pain in your side or back caused by swelling in your kidneys, related to acondition called hydronephrosis changes to your bladder and bowel habits loss of appetite weight loss tiredness and a lack of energy When to seek medical advice You should contact your GP if you experience: bleeding after sex (postcoital bleeding) bleeding outside of your normal periods new bleeding after the menopause Vaginal bleeding is very common and can have a wide range of causes, so it doesnt necessarily mean you have cervical cancer. However, unusual vaginal bleeding is a symptom that needs to be investigated by your GP. Causes of cervical cancer In almost all cases, cervical cancer is the result of a change in cell DNA caused by the human papilloma virus (HPV). Cancer begins with a change in the structure of the DNA thats present in all human cells. DNA provides the cells with a basic set of instructions, including when to grow and reproduce. A change in the DNAs structure is known as a mutation. It can alter the instructions that control cell growth, which means the cells continue growing instead of stopping when they should. If the cells reproduce uncontrollably, they produce a lump of tissue called a tumour. Human papilloma virus (HPV) More than99% of cervical cancercases occur in women who have been previously infected with HPV. HPV is a group of viruses, rather than a single virus. There are more than 100 different types. HPV is spread during sexual intercourse and other types of sexual activity (such as skin-to-skin contact of the genital areas, or using sex toys) and is thought to be very common.Its estimated that 1 in 3 women will develop an HPV infection within 2 years of starting to have regular sex, and about 4 in 5women will develop the infection at some point in their lives. Some types of HPV dont cause any noticeable symptoms and the infection will pass without treatment. Other types of HPV can cause genital warts , although these types arent linked to an increased risk of causing cervical cancer. About 15 types of HPV are considered high-risk for cervical cancer. The 2 types known to have the highest risk are HPV 16 and HPV 18, whichcause about 7 out of every 10 cervical cancers. High-risk types of HPV are thought to contain genetic material that can be passed into the cells of the cervix. This material begins to disrupt the normal workings of the cells, which can eventually cause them to reproduce uncontrollably, leading to the growth of a cancerous tumour. As most types of HPV dont cause any symptoms, you or your partner could have the virus for months or years without knowing it. See preventing cervical cancer for more information about reducing your chances of developing an HPV infection. Cervical intraepithelial neoplasia (CIN) Cancer of the cervix usually takes many years to develop. Before it does, the cells in the cervix often show changes known as cervical intraepithelial neoplasia (CIN) or, less commonly, cervical glandular intraepithelial neoplasia (CGIN). CIN and CGIN are pre-cancerous conditions. Pre-cancerous conditions dont pose an immediate threat to a persons health, but they can potentially develop into cancer in the future. However, even if you develop CIN or CGIN, the chances of it developing into cervical cancer are very small, and if the changes are discovered during cervical screening , treatment ishighly successful. The progression from becoming infected with HPV to developing CIN or CGINand then developing cervical cancer is very slow, oftentaking 10 to 20 years. Read more about cervical screening results Increased risk The fact that HPV infection is very common but cervical cancer is relatively uncommonsuggests that only a very small proportion of women are vulnerable to the effects of an HPV infection. There appear to be additionalrisk factors that affecta womans chance of developing cervical cancer. These include: smoking  women who smoke are twice as likely todevelop cervical cancer than women who dont; this may be caused by the harmful effects of chemicals found in tobacco on the cells of the cervix having a weakened immune system this can occur as a result of taking certain medications, such as immunosuppressants, which are used to stop the body rejecting donated organs, or as a result of a condition such as HIV or AIDS taking the oral contraceptive pill for more than 5 years  women who take the pill are thought to have twice the risk of developing cervical cancer than those who dont, although its not clear why having children (the more children you have, the greater your risk)  women who have 2 children have twice the risk of getting cervical cancer comparedwith women who dont have any children The reason for the link between cervical cancer and childbirth is unclear. One theory is that the hormonal changes that occur during pregnancy may make the cervix more vulnerable to the effects of HPV. The spread of cervical cancer If cervical cancer is undiagnosed and untreated, it will slowly spread out of the cervixand into the surrounding tissue and organs. The cancer can spread down to the vagina and the surrounding muscles that support the bones of the pelvis. Alternatively, it can spread upwards, blocking the tube that runs from your kidneys to your bladder (ureters). The cancercan then spread into your bladder, rectum (back passage) and eventually into your liver, bones and lungs. Cancerous cells can also spread through your lymphatic system. The lymphatic system is a series of nodes (glands) and channels spread throughout your body in a similar way to the blood circulation system. The lymph nodes produce many of the specialised cells needed by your immune system (the bodys natural defence against infection and illness). If you have an infection, the nodes in your neck or under your armpits can become swollen. In some cases of early cervical cancer, the lymph nodes close to the cervix contain cancerous cells. In some cases of advanced cervical cancer, lymph nodes in the chest and abdomen can be affected. Diagnosing cervical cancer If cervical cancer is suspected, youll be referred to a gynaecologist (a specialist in treating conditions of the female reproductive system). Referral will be recommended if the results of your cervical screening test suggest that there are abnormalities in the cells of your cervix. However, in most cases, the abnormalities dont mean you have cervical cancer. You may also be referred to a gynaecologist if you have abnormal vaginalbleeding, or if your GP has noticed a growth inside your cervix during an examination. The sexually transmitted infection (STI) chlamydia is one of the most common reasons why women experience unusual vaginal bleeding. Your GP may recommend that youre tested for it first before being referred. Testing for chlamydia involves taking a small tissue sample from your cervix, or carrying out a urine test. Colposcopy If youve had an abnormal cervical screening test result, or your symptoms suggest that you may have cervical cancer, your gynaecologist will usually carry out a colposcopy . This is an examination to look for abnormalities in your cervix. During a colposcopy, a small microscope with a light source at the end (colposcope) is used. As well as examining your cervix, your gynaecologist may remove a small tissue sample ( biopsy ) so that it can be checked under a microscope for cancerous cells. Cone biopsy In some cases, a minor operation called a cone biopsy may also be carried out. The operation is carried out in hospital, usually under a local anaesthetic . During a cone biopsy, a small, cone-shaped section of your cervix will be removed so that it can be examined under a microscope for cancerous cells. You may experience vaginal bleeding for up to four weeks after the procedure. You may also have period-like pains. Further testing If the results of the biopsy suggest you have cervical cancer and theres a risk that the cancer may have spread, youll probably need to have some further tests to assess how widespread the cancer is. These tests may include: a pelvic examination carried out under general anaesthetic  your womb, vagina, rectum and bladder will be checked for cancer blood tests these can be used to help assess the state of your liver, kidneys and bone marrow computerised tomography (CT) scan  scans are taken of the inside of your body and a computer is used to assemble them into a detailed three-dimensional image; the CT scan can help to identify cancerous tumours and show whether cancerous cells have spread magnetic resonance imaging (MRI) scan  this type of scan uses strong magnetic fields and radio waves to produce detailed pictures of the inside of your body; it can also be used to check whether cancer has spread chest X-ray  this will indicate whether cancer has spread to your lungs positive emission tomography (PET) scan a specialised scan, where a mildly radioactive substance is injected into your veins so the cancerous tissue shows up more clearly; its often combined with a CT scanand is used to see if the cancer has spread, or to check how well a person is responding to treatment Staging After all of the tests have been completed and your test results are known, it should be possible to tell you what stage cancer you have. Staging is a measurement of how far the cancer has spread. The higher the stage, the further the cancer has spread. The staging for cervical cancer is as follows: stage 0 (pre-cancer)  there are no cancerous cells in the cervix, but there are biological changes that could trigger cancer in the future; this is called cervical intraepithelial neoplasia (CIN) or carcinoma in situ (CIS) stage 1  the cancer is still contained inside the cervix stage 2  the cancer has spread outside of the cervix into the surrounding tissue, but hasnt reached the tissues lining the pelvis (pelvic wall) or the lower part of the vagina stage 3  the cancer has spread into the lower section of the vagina and/or into the pelvic wall stage 4  the cancer has spread into the bowel, bladder or other organs, such asthe lungs Treating cervical cancer Treatment for cervical cancer depends on how far the cancer has spread. As cancer treatments are often complex, hospitals use multidisciplinary teams (MDTs) to treat cervical cancer and tailor the treatment programme to the individual. MDTs are made up of a number of different specialists who work together to make decisions about the best way to proceed with your treatment. Your cancer team will recommend what they thinkthe best treatment options are, but the final decision will be yours. In most cases, the recommendations will be: early cervical cancer  surgery to remove some or all of the womb, radiotherapy ,or a combination advanced cervical cancer  radiotherapy and/or chemotherapy , althoughsurgery is also sometimes used The prospect of a complete cure is good for cervical cancer diagnosed at an early stage, although the chances of a complete cure decrease the further the cancer has spread. In cases where cervical cancer isnt curable, its often possible to slow its progression, prolong lifespan and relieve any associated symptoms, such as pain and vaginal bleeding. This is known as palliative care . Removing abnormal cells If your screening results show that you dont have cervical cancer, but there are biological changes that could turn cancerous in the future, a number of treatment options are available. These include: large loop excision of the transformation zone (LLETZ)  the abnormal cells are cut away using a fine wire and an electrical current cone biopsy  the area of abnormal tissue is removed during surgery laser therapy  a laser is used to burn away the abnormal cells Read more about treating abnormal cells in the cervix Surgery There are 3 main types of surgery for cervical cancer. They are: radical trachelectomy  the cervix, surrounding tissue and the upper part of the vagina are removed, but the womb is left in place hysterectomy  the cervix and womb are removed; depending on the stage of the cancer, it may also be necessary to remove the ovaries and fallopian tubes pelvic exenteration  a major operation in which the cervix, vagina, womb, bladder, ovaries, fallopian tubes and rectum are removed Radical trachelectomy A radical trachelectomy is usually only suitable if cervical cancer is diagnosed at avery early stage. Its usually offered to women who want to preserve their child-bearing potential. During the procedure, the surgeon will make a number of small incisions (cuts)in your abdomen. Specially designed instruments will be passed through the incisions and used to remove your cervix and the upper section of your vagina. Lymph nodes from your pelvis may also be removed. Your womb will then be reattached to the lower section of your vagina. Comparedwith a hysterectomy or pelvic exenteration,the advantage of this type of surgeryis that your womb remains intact, which means that you maystill be able to have children. However, its important to be aware that the surgeons carrying out this operation cant guarantee youll still be able to have children. If you do have children after the operation, your child would have to be delivered bycaesarean section. Its also usually recommended that you wait 6 to 12 months after having surgery before trying for a baby, so that your womb and vagina have time to heal. Radical trachelectomy is a highly skilled procedure. Its only available at a number of specialist centres in the UK, so it may not be available in your area and you may have to travel to another city to be treated. Hysterectomy A hysterectomy is usually recommended for early cervical cancer. This may be followed by a course of radiotherapy to help prevent the cancer coming back. There are 2 types of hysterectomies used to treat cervical cancer: simple hysterectomy  where the cervix and womb are removed and, in some cases, the ovaries and fallopian tubes are also removed; this is only appropriate for very early stage cervical cancers radical hysterectomy  where the cervix, womb, surrounding tissue and lymph nodes, ovaries and fallopian tubes are all removed; this is the preferred option in advanced stage 1 and some early stage 2 cervical cancers Short-term complications of a hysterectomy include infection, bleeding, blood clots and accidental injury to your ureter, bladderor rectum. The risk of long-term complications issmall, but they can be troublesome. They include: the risk that your vagina canbecome shortened and drier, which can make sex painful urinary incontinence swelling of your arms and legs, caused by a build-up of fluid ( lymphoedema ) your bowel becomes obstructedbecause ofa build-up of scar tissue this may require further surgery to correct As your womb is removed during a hysterectomy, youll no longer be able to have children. If your ovaries are removed, it will also trigger the menopause if you havent already experienced it. See complications of cervical cancer for more information about the menopause. Pelvic exenteration A pelvic exenteration is a major operation thats usually only recommended when cervical cancer returns after what was thought to be a previously successful course of treatment. Its offered if the cancer returns to the pelvis, but hasnt spread beyond this area. A pelvic exenteration involves two phases of treatment: the cancer is removed, plus your bladder, rectum, vagina and the lower section of your bowel 2 holes called stomas are created in your abdomen the holes are used to pass urine and faeces out of your body into collection pouches called colostomy bags Following a pelvic exenteration, your vagina can be reconstructed using skin and tissue taken from other parts of your body. This means youll be able to have sex after the procedure, although it may be several months until you feel well enough to do so. Radiotherapy Radiotherapy may beused on its own or combined with surgeryfor early-stagecervical cancer. It may be combined with chemotherapy for advanced cervical cancer, where it can be used to control bleeding and pain. There are 2 ways that radiotherapy can be delivered. These are: externally  a machine beams high-energy waves into your pelvis to destroy cancerous cells internally  a radioactive implant is placed inside your vagina and cervix In most cases, a combination of internal and external radiotherapy will be used. A course of radiotherapy usually lasts for around 5 to 8 weeks. As well as destroying cancerous cells, radiotherapy can sometimes also harm healthy tissue.This means it can cause significant side effects many months, and even years, after treatment. However,the benefits of radiotherapy often tend to outweigh the risks. For some people, radiotherapy offers the only hope of getting rid of the cancer. Side effects of radiotherapy are common and can include: diarrhoea pain when urinating bleeding from your vagina or rectum feeling very tired (fatigue) feeling sick (nausea) sore skin in your pelvis regionsimilar to sunburn narrowing of your vagina, which can make having sex painful infertility damage to the ovaries, which will usually trigger an early menopause (if you havent already experienced it) bladder and bowel damage, which could lead to incontinence Most of these side effects will resolve within about eight weeks of finishing treatment, although in some cases they can be permanent. Its also possible to develop side effects several months, or even years after treatment has finished. If infertility is a concern for you, it may be possible to surgically remove eggs from your ovaries before you have radiotherapy, so that they can be implanted in your womb at a later date. However, you may have to pay for this. It may also be possible to prevent early menopause by surgically removing your ovaries and replanting them outsidethe area of your pelvis that will be affected by radiation. This is known as an ovarian transposition. Your MDT can provide more information about the possible options for treating infertility and whether youre suitable for an ovarian transposition. Chemotherapy Chemotherapy can be combined with radiotherapy to tryto cure cervical cancer, or it can be used as a sole treatment for advanced cancer to slowits progression and relieve symptoms (palliative chemotherapy). Chemotherapy involves using either a single chemotherapy medication called cisplatin or a combination of different chemotherapy medications to kill thecancerous cells. Chemotherapy is usually given using an intravenous drip on an outpatient basis, so youll be able to go home once youve received your dose. As with radiotherapy, these medications can also damage healthy tissue. Side effects are thereforecommon and caninclude: nausea and vomiting diarrhoea feeling tired all the time reduced production of blood cells, which can make you feel tired and breathless (anaemia) and vulnerable to infection because of a lack of white blood cells mouth ulcers loss of appetite hair loss  your hair should grow back within three to six months of your course of chemotherapy being completed, although not all chemotherapy medications cause hair loss Some types of chemotherapy medication can damage your kidneys, so you may need to have regular blood tests to assess the health of your kidneys. Follow-up After your treatment has been completed and the cancer has been removed, youll need to attend regular appointments for testing. This will usually involve a physical examination of your vagina and cervix (if it hasnt been removed). As theres a risk of cervical cancer returning, these examinations will be used to look for signs of this. If anything suspicious is found,a further biopsy can be carried out. If cervical cancer does return, it usually returns around 18 months after a course of treatment has been completed. Follow-up appointments are usually recommended every four months after treatment has been completed for the first 2 years, and then every 6 to 12 months for a further 3 years. Complications of cervical cancer Complications of cervical cancer can occur as a side effect of treatment or as the result of advanced cervical cancer. Side effects Early menopause If your ovaries are surgically removed or theyre damaged during treatment with radiotherapy , it will trigger an early menopause (if you havent already had it). Most women experience the menopause in their early fifties. The menopause is caused when your ovaries stop producing the hormones oestrogen and progesterone. This leads to the following symptoms: you no longer have monthly periodsor your periods become much more irregular hot flushes vaginal dryness loss of sex drive mood changes stress incontinence (leaking urine when you cough or sneeze) night sweats thinning of the bones, which can lead to brittle bones ( osteoporosis ) These symptoms can be relieved by taking a number of medications that stimulate the production of oestrogen and progesterone. This treatment is known as hormone replacement therapy (HRT) . Narrowing of the vagina Radiotherapy to treat cervical cancer can often cause your vagina to become narrower, which can make having sex painful or difficult. There are 2 main treatment options if you have a narrowed vagina. The first is to apply hormonal cream to your vagina. This should increase moisture within your vagina and make having sex easier. The second is to use a vaginal dilator, which is a tampon-shaped device made of plastic. You insert it into your vagina and is designed to help make it more supple. Its usually recommended that you insert the dilator for 5 to 10 minutes at a time on a regular basis during the day over the course of 6 to 12 months. Many women find discussing the use of a vaginal dilator embarrassing, but its a standard and well-recognised treatment for narrowing of the vagina. Your specialist cancer nurse or radiographers in the radiotherapy department should be able to give you more information and advice. You may find that the more times you have sex, the less painful it becomes. However, it may be several months before you feel emotionally ready to be intimate with a sexual partner. The Macmillan Cancer Support website has more information about sexuality and cancer Lymphoedema If the lymph nodes in your pelvis areremoved, it can sometimes disrupt the normal workings of your lymphatic system. One of the functions of the lymphatic system is to drain away excess fluid from the bodys tissue. A disruption to this process can lead to a build-up of fluid in the tissue known as lymphoedema . This can cause certain body parts to become swollen  usually the legs, in cases of cervical cancer. There are exercises and massage techniques that can reduce the swelling. Wearing specially designed bandages and compression garments can also help. Read more about treating lymphoedema Emotional impact The emotional impact of living with cervical cancer can be significant. Many people report experiencing a rollercoaster effect. For example, you may feel down when you receive a diagnosis, but feel better when removal of the cancer has been confirmed. You may then feel down again as you try to come to terms with the after-effects of your treatment. This type of emotional disruption can sometimes trigger depression . Typical signs of depression include feeling sad, hopeless and losing interest in things you used to enjoy. Contact your GP if you think you may be depressed. There is a range of effective treatments available, including antidepressant medication and talking therapies, such as cognitive behavioural therapy (CBT). You may also find Jos Cervical Cancer Trust a useful resource. Its the UKs only charity dedicated to women affected by cervical cancer. Local cancer support groups may also be availablein your area for women affected by cancer. Your specialist cancer nurse should be able to provide contact details. Read more aboutfeelings andcancer Advanced cervical cancer Some of the complications that can occur in advanced cervical cancer are discussed below. Pain If the cancer spreads into your nerve endings, bones or muscles, it can often cause severe pain. A number of effective painkilling medications can usually be used to control the pain. Depending on the levels of pain, they can range from paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen , to more powerful opiate-based painkillers, such as codeine and morphine. Tell your care team if the painkillers youre prescribed arent effective in reducing your pain. You may need to be prescribed a stronger medication. A short course of radiotherapy may also be effective in controlling the pain. Macmillan nurses , who work both in hospitals and in the community, can also provide expert advice about pain relief. Kidney failure Your kidneys remove waste material from your blood. The waste is passed out of your body in urinethrough tubes called the ureters. Kidney function can be monitored by a simple blood test called serum creatinine level. In some cases of advanced cervical cancer, the cancerous tumour can press against the ureters, blocking the flow of urine out of the kidneys. The build-up of urine inside the kidneys is known ashydronephrosis and can cause the kidneys to become swollen and stretched. Severe cases of hydronephrosis can cause the kidneys to become scarred, which can lead to the loss of most or all of the kidneys functions. This is known as kidney failure. Kidney failure can cause a wide range of symptoms, including: tiredness swollen ankles, feet or hands, caused bywater retention shortness of breath feeling sick blood in your urine (haematuria) Treatment options for kidney failure associated with cervical cancer include draining urine out of the kidneys using a tube inserted through the skin and into each kidney (percutaneous nephrostomy). Another option is to widen the ureters by placing a small metal tube called a stent inside them. Blood clots As with other types of cancer, cervical cancer can make the blood stickier andmore prone to forming clots. Bed rest after surgery and chemotherapy can also increase the risk of developing a clot. Large tumours can press on the veins in the pelvis, which slows the flow of blood and can lead to a blood clot developing in the legs. Symptoms of a blood clot in your legs include: pain, swelling and tenderness in one of your legs (usually your calf) a heavy ache in the affected area warm skin in the area of the clot redness ofthe skin, particularly at the back of your leg, be