If early cell changes develop into cervical cancer, the most common symptoms that might be present are:
- Vaginal bleeding between periods or after menopause
- Pain during intercourse
- Excessive tiredness
- Lower back pain
- Bleeding after intercourse
- Unusual vaginal discharge
- Leg pain or swelling
Please don’t panic if you do experience any of these symptoms, however, as they can be caused by other conditions. If the symptoms are ongoing, or if you’re worried, make an appointment with your general practitioner (GP). If necessary, your GP will refer you for further tests.
Cervical cancer does not usually carry any external symptoms until it is in advanced stages, and so the best way to detect changes to the cervix cells is through the recommended 2-yearly Pap test.
The current Australian guidelines are that women should have a Pap test every two years between the ages of 18-70 years old, or from when they become sexually active, whichever comes first. Pap tests should also be taken as recommended by a Medical Practitioner.
This common test serves for early detection of cervical cancer. During a Pap test, a doctor or trained nurse uses a brush or spatula to scrape some cells from the surface of the cervix; these cells will be sent to the laboratory for examination under a microscope.
The current Cervical Screening Program has been in affect since 1991, prompting a recent review to ensure it is as effective as possible in light of new research and technology. In April 2014, the Medical Services Advisory Committee (MSAC) released the results of their review, including recommendations for how the Program may be improved. The most significant recommendation The Committee has put forward is that screening be changed to now include HPV Tests, which if implemented will be performed from the age of 25 every 5 years. For more information on these proposed changes please visit: http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/ncsp-renewal
If abnormal cells are detected, your GP or gynaecologist will discuss whether you need treatment, further tests or another Pap test at an earlier interval than two years. Learn more about the Pap test.
If your Pap smear results show a high-grade abnormality or you have had symptoms of cervical cancer, you will need to have further tests to confirm the diagnosis. In some cases, you may be referred to a gynaecological oncologist.
A colposcopy can help identify where abnormal or changed cells are located and what they look like. In this procedure, the doctor puts a speculum into your vagina and uses a colposcope to see a magnified picture of your cervix, vagina and vulva. Before the test, the doctor may coat your vagina and cervix with a fluid that will highlight any abnormal areas, and may take a tissue sample (biopsy). Some colposcopes are fitted with a camera connected to a TV screen, so you can watch if you’d like to. You may experience some mild discomfort for 10–15 minutes while the colposcopy is performed.
A biopsy is commonly used to remove cervical tissue for further examination. Biopsies are typically done in a clinic and the results are usually available in a week. You may feel uncomfortable for a short time when the tissue is removed. Afterwards, you may experience some pain, similar to menstrual cramping. You may also have some bleeding or other vaginal discharge for a few hours, but these side effects will soon disappear. To allow the cervix to heal and to reduce the chance of infection, you will probably be advised not to have sexual intercourse or use tampons for 2–3 days. Check with your doctor.
Large loop excision of the transformation zone (LLETZ)
LLETZ is another form of tissue removal technique using a loop of wire carrying an electric current to cut out the abnormal tissue from the cervix. Sometimes the doctor can carry out this procedure as part of a colposcopy and remove all visible abnormal cells. The 10 minute procedure can be performed under a local anaesthetic in a clinic or under a general anaesthetic at the hospital. After a LLETZ, you may have some vaginal bleeding and cramping. This will usually ease in about two weeks. To give your cervix time to heal and to prevent infection, you shouldn’t have sex or use tampons for 4–6 weeks.
A cone biopsy is used to determine how deeply cancer cells have spread into tissue beneath the surface of the cervix. A cone biopsy is also performed to treat very early and very small tumours. Further treatment is needed for tumours that are larger. This procedure removes a cone-shaped piece of tissue containing the abnormal cells from the cervix. It is performed under a general anaesthetic and involves a day or overnight stay in hospital. Cone biopsy results are usually available within a week.
If a biopsy shows you have cervical cancer, other tests may be needed to determine if the cancer has spread to other parts of the body.
- Blood tests
- Chest x-ray
- CT scan (computerised tomography scan is a type of x-ray)
- MRI scan
- PET scan (positron emission tomography scan)
Read a personal account of Sarah Maree Cameron’s (ACCF Ambassador) journey from diagnosis to treatment of cervical cancer.