Medical Treatment for Cervical Cancer
Treatment for precancerous lesions differs from that of invasive cervical cancer.
Choice of treatment for a precancerous lesion of the cervix depends on a number of factors, including whether the lesion is low or high grade, whether you want to have children in the future, your age and general health, and your preference and that of your health care provider.
- If you have a low-grade lesion (CIN I, as detected by a Pap smear), you may not need further treatment, especially if the abnormal area was completely removed during biopsy. You should have regular Pap smears and pelvic exams, as scheduled by your doctor.
- When a precancerous lesion requires treatment, LEEP conization, cold knife conization, cryosurgery (freezing), cauterization (burning, also called diathermy), or laser surgery may be used to destroy the abnormal area while minimizing damage to nearby healthy tissue.
- Treatment for precancerous lesions may cause cramping or other pain, bleeding, or a watery vaginal discharge.
In some cases, you may choose to have a hysterectomy for precancerous changes, particularly if abnormal cells are found inside the opening of the cervix or you have severe or recurring dysplasia. This surgery is more likely to be done if you do not plan to have children in the future.
Diagnostic procedures, such as LEEP and cold knife conization, sometimes themselves may treat the cervical cancer, as well. Both involve taking tissue to evaluate. If the evaluation finds abnormal cells, but the cells do not extend into where the tissue was cut, only follow-up may be needed.
If there is uncertainty about whether all of the precancerous cells have been removed using LEEP or cold knife conization procedures, further treatments may be necessary.
Cryocautery may be used in some cases. In this procedure, a steel instrument is cooled to subzero temperatures by immersion in liquid nitrogen or a similar liquid. This ultracooled instrument is then applied to the surface of the cervix, freezing cells. They eventually die and are sloughed off, to be replaced by new cervical cells.
Tissue may also be removed by laser ablation. In this procedure, a laser beam is applied to either specific areas of cervical tissue or a whole layer of tissue at the surface of the cervix. The laser destroys these cells, leaving healthy cells in their place.
The success of cryocautery or laser ablation procedures is determined by a follow-up exam and Pap smear. Neither procedure is used to obtain tissue samples for evaluation; they only destroy the abnormal tissue. Therefore, the margins or edges cannot be inspected to make sure the cancer has not spread.
The most widely used treatments for invasive cervical cancer are surgery and radiation therapy. Chemotherapy or biological therapy also is sometimes used.