Cervical Cancer - Diagnosis & Treatment

How is cervical cancer diagnosed?

Cervical cancer can be diagnosed early through regular screening. If you are sexually active, screening should be performed every 3 years until the age of 30, and subsequently every 5 years if test results are normal.

Diagnostic tests for cervical cancer include:

• Pap smear – This is used to detect potentially pre-cancerous and cancerous cells in the cervix. During a Pap smear, the doctor will use an instrument called a speculum to hold the walls of the vagina open in order to examine the cervix. A soft brush or spatula is then used to collect sample cells of the cervix.
• HPV test – This detects the presence of HPV and helps to identify its type. This is important as some HPV strains are more likely to cause cervical cancer. It may be performed at the same time as a Pap smear, or it may be recommended if your Pap smear shows the presence of abnormal cells.
• Colposcopy – This stains the cells in the cervix with a dye, which are then viewed through a microscope and magnified to check for abnormal cells. This is done if the results for the HPV test or the Pap smear test are abnormal.

These screening methods aim to detect pre-cancer of the cervix – known as cervical intraepithelial neoplasia. If detected as a pre-cancer, treatment is usually via a day surgery, and it will not affect the patient’s fertility.

However, if you are presenting symptoms of cervical cancer, there is a higher chance of your condition being cancerous. To confirm the diagnosis, consult a gynaecologist to assess any obvious growths on the cervix that may need to be biopsied.

If early cancer is proven on biopsy, further testing is needed to determine the stage for cancer treatment.

How is cervical cancer treated?

Treatment depends on the stage of cervical cancer. The methods include:

Localised procedures

Local ablative or excision procedures may be used to treat pre-cancers to remove abnormal cells before they become cancerous. These procedures include conisation, cryosurgery or cauterisation, which have minimal impact on surrounding healthy tissues.

Surgery

Surgical treatment for cervical cancer is only possible if the disease is still confined to the cervix (less than Stage 2). It usually involves removing the uterus, cervix and surrounding tissue, in a procedure known as radical hysterectomy.

This has implications for the patient’s fertility, and the surrounding tissue removal makes the hysterectomy more complex compared to the hysterectomy done for other common conditions such as fibroids.

Radiotherapy

Radiotherapy uses high-energy X-rays to prevent the further growth of cancer. It may be done externally, with a machine that targets the radiation directly at the tumour, or it may be done internally using a small capsule containing radioactive material that is inserted into the cervix.

Chemotherapy

Chemotherapy uses powerful medications to kill cancer cells. It may be recommended for more advanced cancer or if cancer has spread to other parts of the body.

Chemotherapy and radiotherapy are the main treatments for more advanced stages of cervical cancer, rather than surgery.

Immunotherapy

Immunotherapy is also known as biological therapy. This treatment uses your own immune system to target cancer cells and prevent their growth. It may be recommended if chemotherapy is deemed not effective for the patient.