Cervical cancer is the growth of abnormal cells in the lining of the cervix.
Cancer most commonly begins in the area of the cervix called the transformation zone, but it may spread to tissues around the cervix, such as the vagina, the ligaments around the cervix, or into the lower uterus (womb).
In its early stages, cervical cancer usually has no symptoms. The only way to know if there are abnormal cells in the cervix (a pre-cancer), which may develop into cervical cancer, is to have a cervical screening test.
If symptoms of cervical cancer are present, they usually include:
- Vaginal bleeding between periods, after menopause, or during or after sexual intercourse (post coital bleeding),
- pain during sexual intercourse
- an unusual vaginal discharge
- heavier periods or periods that last longer than usual
If your cervical screening test suggests that you have a higher risk of developing cervical cancer, or you have symptoms of cervical cancer, you will be referred to Dr Farrell for a thorough examination to confirm the diagnosis of precancerous changes or cervical cancer. This initially requires a colposcopy and biopsy, but may then require a day surgical procedure such as a LLETZ or cone biopsy to be sure.
All pathology results are reviewed weekly by expert gynaecological pathologists and presented by Dr Farrell at a multidisciplinary team (MDT) meeting to ensure the highest possible standards of care are maintained.
If you have a confirmed cervical cancer, the treatment will depend on how big the tumour is and the position of the tumour. Initial tests will include a blood test, and imaging which may include a CT scan, an MRI, and/or a PET/CT scan. It may be necessary to perform an examination under anaesthetic (EUA) to determine the extent of the tumour by a pelvic examination, a cystoscopy (looking in the bladder with a cystoscope), and/or a proctoscopy (looking in the lower bowel with a proctoscope).
Surgery or chemoradiation (a combination of radiation and low dose weekly chemotherapy to make the radiation more effective) are the mainstays of treatment, and the choice of treatment will depend on the stage of the cancer and other individual factors.
Surgery may involve a fertility sparing operation (see below), a simple hysterectomy, or a radical hysterectomy, with or without removal of your ovaries, and with or without removal of your lymph nodes. The choice of surgery will depend on the stage and type of cancer, your fertility wishes, and your age.
A radical hysterectomy is a surgical procedure that is performed only by certified gynaecological oncologists. It involves removal of the cervix and the uterus with a cuff of tissue around the cervix and upper vagina. The procedure involves careful dissection of tissue around the ureters (tubes that carry urine from the kidney to the bladder), which is extremely important to be done properly to give the best chance of removing all of the cancer cells. Certified gynaecological oncologists, such as Dr Farrell, have special training to perform this procedure adequately and safely.
Fertility sparing procedures for appropriate tumours are possible. This may include a large cone biopsy, a simple trachelectomy, or a radical trachelectomy, with or without removal of lymph nodes. All treatment decisions will be individualised to suit patient needs and requirements.
Dr Farrell will coordinate follow up after treatment is completed with 3 monthly reviews for 2 years then 6 monthly reviews for a further 3 years at minimum.
For more information follow the link to the Cancer Council Booklet for cervical cancer information on this website.