Cervical cancer starts in the cervix, the lower part of the uterus that connects to the vagina. Cancer of the cervix happens when normal cells in the cervix change into abnormal cells that start to spread and grow out of control.
In its early stages, cervical cancer may not cause any symptoms. Common symptoms of cervical cancer include vaginal bleeding that occurs:
These symptoms can also happen for other reasons, so it may not necessarily be cancer. However, if you experience vaginal bleeding at these times, see your GP.
Diagnosis of cervical cancer requires tissue diagnosis in the form of a biopsy from the cervix. The biopsy can be done in the clinic or, in some cases, you may require a LLETZ procedure or cone biopsy. LLETZ stands for Large Loop Excision of Transformation Zone.
Cancer staging is the process doctors use to determine how far a cancer has spread.
Staging for cervical cancer involves a clinical examination, in our Rooms or under anaesthetic. You may need to undergo imaging in the form of a CT scan, MRI scan or PET scan.
The treatment that’s best for you depends primarily on the stage of your cancer, your age and other health-related issues. Your treatment options also depend on whether you want to get pregnant in the future.
Early-stage cervical cancer that appears to be limited to the cervix can be treated by surgery. The extent of the surgery depends on the size of the cancer and whether you want to preserve your fertility.
The common procedures are:
Pelvic lymph nodes removal
In most cases, women also need removal of the pelvic lymph nodes to determine whether the cancer has spread beyond the cervix to the lymph nodes. It can be difficult to see if there’s cancer in your lymph nodes using scans. Lymph nodes or lymph glands are tiny kidney-shaped water pumps that act as immune filters in our body.
Radiotherapy and chemotherapy
Some women who’ve had surgery still need additional treatment with radiotherapy and/or chemotherapy to reduce the possibility of the cancer returning.
Cervical cancer that can’t be safely removed by surgery or has shown signs of spread outside the cervix is usually treated with concurrent chemotherapy and radiotherapy. This involves radiation therapy to the pelvis along with a small dose of chemotherapy that improves the response of cancer cells to radiation treatment.
The role of sentinel lymph node detection at the time of surgery for cervical cancer is still under evaluation.
We offer sentinel lymph node dissection as part of a full lymph node assessment and are happy to discuss its role in your treatment of cervical cancer.
We encourage you to ask any questions you may have during your diagnosis and treatment.
You may have questions regarding the stage of cancer, treatment options, fertility preservation, seeking a second opinion, risks of treatment, involvement in trial therapies, impact on sexual function or where to seek further information.
Yes, Dr Vivek Arora believes in a multidisciplinary approach to give you the best possible outcome. He discusses your diagnosis and consults with the Gynaecological Oncology Multidisciplinary Team at the Royal Hospital for Women in Randwick.