Cervical Cancer – Diagnosis and Treatment of abnormal cells

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Diagnosing Cervical Cancer

When diagnosed, cervical cancer is one of the most successfully treatable forms of cancer, as long as it is detected early and managed effectively. Cancers diagnosed in late stages can also be controlled with appropriate treatment and palliative care.

Contact your doctor if you notice a change that isn't normal for you or if you have any of the possible signs and symptoms as outlined here. Your doctor will take a history of your symptoms and may enquire about your general health and your family history.

Your doctor may want to examine you. You can ask for someone to be present in the room with you if you want, to act as a chaperone. This chaperone can be a friend or relative, or a trained health professional such as a practice nurse. The doctor will use a speculum to gently open your vagina. They can look at your cervix and vagina to see if there is anything abnormal. They might take a swab (sample) to check for infections.

For some symptoms, your doctor may ask you to wait to see if the symptoms get better or respond to treatment, such as antibiotics.

If your GP or doctor thinks you need further investigations, he/she will refer you directly to a specialist called a Gynaecologist.

A gynaecologist is a specialist who treats conditions to do with a woman's reproductive system. The Gynaecologist may refer you for a colposcopy to have a closer look at your cervix.

You will usually be referred for a colposcopy if:

  • you have persistent HPV infections
  • your cervical screening test result found abnormal (pre-cancerous) cell changes

Don’t panic as your symptom may not be due to cancer. But if it is, the earlier it's picked up the greater the chance of successful treatment.


Treatments for abnormal cells

There are different treatments that can remove the area of abnormal cervical cells. The advantage of these treatments is that the piece of cervical tissue that has been removed can be sent to the laboratory for examination under a microscope.

In the laboratory, the pathologist rechecks the level of cell changes in the piece of tissue to make sure your screening result was accurate. They also closely examine the whole piece of tissue to make sure that the area containing the abnormal cells has been completely removed.



Treatments may include:

LLETZ Treatment:

LLETZ stands for large loop excision of the transformation zone. It’s also known as loop electrosurgical excision (LEEP) or loop diathermy. A LLETZ may be carried out at the same time as a colposcopy or you may be given an appointment to come at another date. This is the most common treatment for abnormal cervical cells.

Your colposcopist uses a thin wire loop to remove the transformation zone of the cervix. The wire has an electrical current running through it, which cuts the tissue and seals the wound at the same time.

The transformation zone is the area around the opening of the cervix.

LLETZ is an outpatient treatment and takes up to 15 minutes. You usually have it under local anaesthetic.

You may notice a burning smell during this procedure. This is normal. The tissue sample is sent to the lab for assessment.

If you become pregnant, it is important to tell your GP or doctor that you have had a LLETZ. This is because there may be a small risk to future pregnancies.


Cold coagulation

Despite what the name suggests, this treatment uses a hot probe to burn away abnormal cells in the cervix.

It is usually done while you're awake. Local anaesthetic is injected into your cervix to numb it during the treatment. This means that you won't feel pain.

You may feel period-like pain during this treatment. The pain may last for a short time afterwards. A tissue sample is not taken.

You may notice a burning smell during this procedure. This is normal.


Cone biopsy

A cone biopsy is a minor operation to cut out a cone-shaped piece of tissue containing the abnormal cells. Your doctor removes the whole area where cells can become abnormal (the transformation zone). It is usually only used if a large area of tissue needs to be removed.

It cannot be done at the same time as a colposcopy. It is done under general anaesthetic (where you're asleep). You may need an overnight stay in hospital.

If you become pregnant, it is important to tell your GP or doctor that you have had a cone biopsy. This is because there may be a small risk to future pregnancies.


After your treatment for abnormal cervical cells

Most women feel fine after having treatment for abnormal cervical cells but some may feel unwell and need to go home and rest.

It takes 4 to 6 weeks for your cervix to heal after treatment.

To reduce the risk of infection do not:

  • Use tampons for 4 to 6 weeks - use sanitary pads instead
  • Have sex for 4 to 6 weeks
  • Swim or use a Jacuzzi for 4 to 6 weeks
  • Exercise for at least a few days, or while there's still any bleeding or discharge. This includes light exercise, such as golf
  • Do heavy work or heavy house work such as vacuuming
  • Take a bath for 6 weeks - have a shower instead

9 out of 10 women who have had a treatment at colposcopy will not need further treatment.


Results of your treatment

You will get a letter with the results of your treatment in about 6 weeks.

Your results letter will include detail about:

  • The grade of abnormal cells that was diagnosed in the lab
  • Your next recommended step

In most cases, the next step is a follow-up appointment at the clinic in 6 months.


HPV Cervical screening post treatment for abnormal cells in the cervix

You may need another cervical screening test within a year of treatment. This is to check that treatment was successful and to check for HPV infection and abnormal cells.

Once your follow-up cervical screen is clear of HPV and abnormal cells, you will be scheduled to have a cervical screen every 3 years, regardless of your age.