Cervical cancer | Insight
Introduction
Cervical cancer is a type of cancer which develops in the cervix, part of the female reproductive system connecting the top of the vagina with the lower part of the womb.
Nearly all cases are caused by the human papilloma virus (HPV), which is transmitted by sexual contact. There are more than 100 variations of HPV, many of which cause no harm — but some can cause abnormal changes to the cervix, leading to cervical cancer.
Two types of HPV (16 and 18) are responsible for 70 per cent of all cases of cervical cancer. The HPV vaccine protects against these, but is not 100 per cent effective, so Pap smear tests are recommended to detect the disease.
Key takeaways
- Cervical cancer is the fourth-most common cancer in women and the seventh-most common overall
- It is usually slow-growing, but can spread and become serious
- In the UK, around 2,800 women are diagnosed with cervical cancer each year
- It usually affects women age over 20, with those aged 30-34 most-commonly affected
- Cervical cancer could be nearly 100% preventable in the UK with vaccinations and Pap smear testing
- Pap smear testing is available via the NHS to women aged 25-64 in England
- Cancer diagnoses are covered by the UK Equality Act 2010
- Most patients are able to continue working, but fatigue and pain can affect some peoples’ ability to do their jobs
- Employers should allow reasonable adjustments to work schedules and duties
Symptoms and signs
There may be no symptoms in the first stages of cervical cancer, but early symptoms can include:
- Abnormal vaginal bleeding with or after intercourse, between menstrual cycles or post-menopause
- Heavier periods
- Changes in vaginal discharge
- Pain during intercourse
- Pain to the lower back, pelvis or lower abdomen
Pap smear testing is used to detect precancerous or cancerous cells in the cervix. It involves taking a sample of cells from the cervix, with the aim of detecting cell changes before they turn into cancer.
If screening identifies abnormal cells, further tests will be conducted, with a biopsy (sample of cells) perhaps being taken.
If cancer cells are confirmed, then further investigations will be carried out. Invasive cancers will be staged and graded.
Treatment and recovery
Cervical cancer is treated with surgery, chemotherapy or radiotherapy, with targeted medicines also being used in some cases.
The choice of treatment will depend on the location, size and type of the cancer — and on whether it has spread. It will also depend on the patient’s overall health.
Surgery is usually the first line of treatment, particularly if the cancer is detected early. It will range from removing part of the cervix, if the cancer is small, to having a hysterectomy. Lymph nodes may also need to be removed.
Recovery time from surgery will vary depending on the operation, but may be lengthy. For example, a person may need to stay in hospital for three-to-five days for an abdominal hysterectomy, with a recovery period of four-to-six weeks depending on complications such as bleeding or infection.
Cervical cancer and work
A diagnosis of cancer is automatically covered by the UK Equality Act 2010, meaning employers must make reasonable adjustments to help staff continue to work.
Testing and diagnosis is likely to be a stressful time for an employee, and time off to attend
medical appointments will be needed. Regular welfare checks should be made to ensure they are coping. If available, referral to EAP for emotional support may be beneficial.
The majority of women who respond positively to treatment are able to either keep working or return to work and perform their roles well.
However, some will have ongoing symptoms which have a lasting impact on their ability to function. They are likely to require individually tailored adaptations to their work duties.
Fatigue is the most-frequent side effect of cancer treatment — and can be debilitating. This may be caused by anaemia, disturbed sleep, nausea and vomiting, side effects of medication or other factors.
Pain will also affect employees’ ability to work.
Those with significant fatigue and pain may benefit from:
- Being able to pace their usual activities
- Flexible working and / or rest breaks
- Changes to shift patterns
- Review of duties, e.g. in physical or safety-critical roles
- Help with travel, including an allocated parking space or support from Access to Work
- Working from home when symptoms are worse, or if recovering from treatment
- Phased return to work following surgery