Understanding Cervical Cancer -- Treatment
How Is Cervical Cancer Diagnosed?
Every woman should have a regular pelvic exam and Pap test, which tests a cervical cell sample for abnormalities. Together, these procedures detect cervical cancer 95% of the time, often long before the disease produces symptoms.
If your Pap test is abnormal, your doctor may test you again. Recently, some doctors have started to test for HPV at the time of Pap smear. If a high-risk type of HPV is found in women with an abnormal Pap test, doctors are more inclined to do a colposcopy (magnified exam of the cervix). If a second Pap test is abnormal or the HPV test is positive, your doctor will visually examine your cervix by colposcopy and take a tissue sample (biopsy) of any apparent abnormality for evaluation. If the biopsy confirms cancer, further tests will determine whether the disease has spread. These tests might include:
- Examination should include inspection, palpation, colposcopy, scraping of the inside of the canal of the cervix (endocervical curettage). Possible evaluation of the inside of the uterus with a camera (hysteroscopy) may also be done.
- A biopsy of the bladder and rectum will look for cancer spread to nearby organs. This is done via cystoscopy (a scope is placed through the urethra into the bladder to sample cells) or proctoscope. (a tube placed into the rectum to inspect and biopsy).
- Intravenous urography, a dye test to look at the urethra and bladder, looks for evidence of cancer spread.
- Barium enema and proctosigmoidoscopy, or sigmoidoscopy, which uses a thin, tube-like instrument to evaluate the rectum and colon.
- Chest X-rays look for spread of the cancer to the lungs and skeleton.
- Bone scans check the bones for cancer spread.
- Various radiologic tests can be performed to see the spread of the tumor: a CT scan, MRI, or PET scan checks for spread into the chest or abdomen or pelvis.
Your doctor may also order many blood and urine tests and liver and kidney function studies.
What Are the Treatments for Cervical Cancer?
The options for treating cervical cancer depend on the stage of the disease. The stage reflects the size of the tumor and how far it has spread throughout the body.
Most cases of cervical cancer are cured or controlled by surgery or a combination of surgery with radiation, often combined with chemotherapy to increase the potency of the radiation. A variety of complementary therapies when used along with these treatments might prove useful in easing side effects and improving overall health.
Women with genital warts and mild dysplasia should be carefully monitored for signs of cancer. Repeat Pap tests will be necessary for monitoring. Carcinoma in situ and severe dysplasia are normally treated surgically. Superficial tumors can be treated with radiation but are more often removed with a scalpel, a laser, controlled freezing, or cauterization.
If cancer has advanced deep into the cervix or spread to neighboring organs, hysterectomy -- removal of the cervix, uterus, and possibly other organs -- may be necessary. If cancer spreads beyond the pelvic area, radiation therapy and chemotherapy may relieve symptoms and suppress the spread but rarely result in cure. Any woman who has had dysplasia or cervical cancer should see her doctor regularly after treatment to check for recurrence.
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