Diagnosis

Diagnosis

The following signs or symptoms can be suggestive of cervical cancer:

  • Unusual or persistent vaginal bleeding (between periods, post-coital or post-menopausal bleeding)
  • Deep pain during intercourse
  • Persistent or unusual vaginal discharge (offensive and/or blood stained)

Please do not panic if you do experience any of these symptoms, though, as they can be caused by other conditions. If your 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 prevent cervical cancer is through the recommended 5-yearly Cervical Screening Test.

The current Australian guidelines are that women should have a HPV test every five years between the ages of 25-74 years old. HPV tests should also be taken as recommended by a Medical Practitioner.

This common test serves for early detection of cervical cancer, through identifying the presence of HPV. During a HPV test, a doctor or trained nurse uses a brush or spatula to gently take a collection of cells from the surface of the cervix; these cells will be sent to the laboratory for examination under a microscope.

If HPV is detected, your GP or gynaecologist will discuss whether you need treatment, further tests or another HPV test at an earlier interval than five years. Learn more about the HPV Test here.

Colposcopy

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.

Biopsy

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.

Cone biopsy

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.

Further tests

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)

Often doctors can use terms that are confusing or hard to understand. The glossary below lists some common medical terms in plain English.

Glossary of terms

Expand all
Adenocarcinoma
Abnormal cells in the glandular cells that line the cervical canal. These are mucous producing glands not to be confused with lymph glands.
AIS / Adenocarcinoma in-situ
This is a non-invasive, non-malignant condition where cancerous cells are found in the mucous producing glands that line the cervical canal.
Biopsy
A small sample of tissue is taken to be analysed and tested to determine if cancer or pre-cancer is present.
Brachytherapy
This is internal radiotherapy used to treat some stages of invasive, malignant cancer. It allows a higher dose of radiation to be placed directly where the tumour is/was.
CIN / Cervical Intraepithelial Neoplasia
is the term for abnormal cells on the cervix. These are caused by the HPV virus and are called pre-cancer.  This doesn’t mean that they will definitely become cancer but there’s a small chance that, if left untreated, they could develop further.
CIS / carcinoma in-situ
This is a non-invasive, non-malignant condition where cancerous cells are confined to the surface of the cervix. The term stage 0 used to be used to describe this but it’s been dropped as a classification in many countries because it causes confusion between invasive, malignant cancer and CIS.
Colposcopy
An instrument called a colposcope (like big binoculars) is used to look at the surface of the cervix. An acidic solution is painted onto the cervix and this causes any abnormal areas to turn white. The doc then takes a biopsy of these areas to be sent for analysis.
Cone biopsy / conization / cold knife cone
It’s a more extensive form of cervical biopsy that can be used for a deeper biopsy sample but is more often used as a treatment to remove pre-cancer or very early cancer. It can be used to remove adenocarcinoma higher in the cervical canal.
Cryotherapy
The use of extreme cold to remove abnormal cells. This is used for pre-cancer and very early cancer.
CT scan / Computerised tomography
It uses X-rays to make detailed pictures of parts and structures inside the body.
ECC / Endocervical Curettage
This is a procedure where the mucous membrane of the cervical canal is scraped using a spoon shaped instrument called a curette. This tests for abnormal cells in the cervical canal.
EUA / Examination under anaesthetic
This is done if the oncologist wants to have a more in depth look at the cervix or surrounding areas.
Hysterectomy
This surgery removes the cervix, the fallopian tubes, the uterus and may or may not remove the ovaries.
LEEP / LOOP / LLETZ
A low voltage electrified wire removes abnormal cells from the cervix. This is done for pre-cancer and very early stage cancer.
Monsels solution
This is a brown paste painted onto the cervix after a procedure. It helps stop bleeding and is passed out of the vagina looking like dark brown ground coffee.
MRI / Magnetic resonance imaging
. A scan that uses magnetic fields and radio waves to create a detailed image of the inside of the body. It can be used to help diagnose cancer, plan treatment and check how effective previous treatment has been.
NAD / no abnormality detected
This is the result we all want to hear at check-ups after surgery/treatment.
RH/Radical hysterectomy
This is not the same as a hysterectomy. This surgery removes the cervix, the fallopian tubes, the uterus, ovaries(optional), the top third of the vagina, the pelvic lymph nodes and the parametrium (tissues surrounding the uterus and separating the uterus from the bladder).
PET scan
Proton emission tomography. This shows what the body tissues look like and how they’re working. It can help diagnose and stage cancer. A tracer (glucose like substance) is injected into the body. Cancer cells react to this and are highlighted in the scan.
Squamous cell carcinoma
Abnormal squamous cells that cover the surface of the cervix.
Trachelectomy
Surgical removal of the cervix. This can be done for certain early cancer stages and preserves fertility. A cervical stitch (clerclage) is used to keep the area where the cervix was, closed during pregnancy.
Read a personal account of Sarah Maree Cameron’s (ACCF Ambassador) journey from diagnosis to treatment of cervical cancer.

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