This topic talks about the testing, diagnosis, and treatment of cervical cancer. Cervical cancer occurs when abnormal cells on the cervix grow out of control. The cervix is the lower part of the uterus that opens into the vagina. Cervical cancer can often be successfully treated when it's found early. Cervical cancer is one of the most common cancers in women worldwide.




Most cervical cancer is caused by a virus called human papillomavirus, or HPV. You can get HPV by having sexual contact with someone who has it. There are many types of the HPV virus. Not all types of HPV cause cervical cancer. Some of them cause genital warts, but other types may not cause any symptoms.

Most adults have been infected with HPV at some time. An infection may go away on its own. But sometimes it can cause genital warts or lead to cervical cancer. That's why it's important for women to have regular Pap tests. A Pap test can find changes in cervical cells before they turn into cancer. If you treat these cell changes, you may prevent cervical cancer.

Abnormal cervical cell changes rarely cause symptoms. But you may have symptoms if those cell changes grow into cervical cancer. Symptoms of cervical cancer may include:

- Bleeding from the vagina that is not normal, such as bleeding between menstrual periods, after sex, or after menopause.
- Pain in the lower belly or pelvis.
- Pain during sex.
- Vaginal discharge that isn't normal.

As part of your regular pelvic exam, you should have a Pap test. During a Pap test, the doctor scrapes a small sample of cells from the surface of the cervix to look for cell changes. If a Pap test shows abnormal cell changes, your doctor may do other tests to look for precancerous or cancer cells on your cervix.




Cervical Cancer - Treatment Overview

Cervical cancer found in its early stages can be successfully treated. The choice of treatment and the long-term outcome (prognosis) of cervical cancer depend on the type and stage of cancer. Your age, overall health, quality of life, and desire to be able to have children must also be considered.


What are the risk factors for cervical cancer?

A risk factor is anything that changes your chance of getting a disease such as cancer. Different cancers have different risk factors

Human papilloma virus infection
Early sexual activity
Other sexually transmitted infections
Many sexual partners
A weak immune system


Colposcopy and Cervical Biopsy

Colposcopy is a way for your doctor to use a special magnifying device to look at your vulva, vagina and cervix. If a problem is seen during colposcopy, a small sample of tissue (biopsy) may be taken from the cervix or from inside the opening of the cervix (endocervical canal). The sample is looked at under a microscope.

Colposcopy is usually done to look at the vagina and cervix when the result of a Pap test is abnormal. Most abnormal Pap tests are caused by viral infections, such as human papillomavirus (HPV) infection, or other types of infection, such as those caused by bacteria, fungi (yeast), or protozoa (Trichomonas). Natural cervical cell changes (atrophic vaginitis) related to menopause can also cause an abnormal Pap test. In some cases, untreated cervical cell changes that cause abnormal Pap tests may progress to precancerous or cancerous changes.

During colposcopy, your doctor uses a lighted magnifying device that looks like a pair of binoculars (colposcope). The colposcope allows your doctor to see problems that would be missed by the naked eye. A camera can be attached to the colposcope to take pictures or videos of the vagina and cervix.





Cone Biopsy / Leep of the Cervix

A cone biopsy or LEEP is a minor surgical procedure. It involves the removal of a cylindrical or cone-shaped piece of the cervix in which the abnormal cells are located. Pathological examination will then confirm the diagnosis and ensure that all the abnormal cells have been removed.

Why Is It Performed?
A cone biopsy or leep is performed when:
There are precancerous changes of the cervix.
The entire abnormal area cannot be fully seen at colposcopy. This may occur when the abnormality extends into the cervical canal. This is the canal that leads from the vagina through the cervix and into the uterus. The PAP smear repeatedly shows abnormal cells although the colposcopy reveals normal results. This may mean that the abnormal cells are from the endocervical canal. The doctor is concerned that the abnormal cells show signs of a very early cancer.

How Is It Performed?
You will be positioned as for a gynaecological examination. For pain relief, a local anaesthetic (during which you will remain awake) or a general anaesthetic (during which you would be asleep for the entire procedure) will be administered.
In general, the procedure is performed via one of 3 methods:

- With a heated electrical loop wire - This is known as LLETZ (large loop excision of the transformation zone) or LEEP (loop electrosurgical excision)
- With a surgical knife
- With a laser

There is usually some mild discomfort after the procedure. A brown-coloured paste (Monsel's solution) may be applied to arrest the bleeding.
A vaginal pack may also be inserted temporarily to stop any bleeding and a tube (catheter) may be placed in the bladder to ensure that it remains empty until the gauze is removed. Painkillers and antibiotics may be prescribed after the procedure.