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Treatment

Treatment for precancerous abnormalities

Not all precancerous abnormalities need treatment and those that do can be treated quite easily and very successfully. The type of treatment you receive following an abnormal Pap smear will depend upon the type of abnormality.

If your Pap smear indicates a low-grade abnormality, you will enter a period of watchful waiting, where your health care provider will recommend you undertake annual Pap smears. In most cases this abnormality will disappear. However, in some cases it will persist and you will need further investigation.

If your Pap smear identifies a high-grade abnormality you will be referred for colposcopy, which may identify the need for a biopsy or treatment. Treatment may include wire loop excision, cone biopsy, laser or diathermy. These are all methods for removing the abnormal cells. Further information on these treatments can be found at www.cancerscreening.gov.au

In most cases, treatment by large loop excision of the transformation zone (LLETZ), or loop electrosurgical excision procedure (LEEP), cone biopsy or laser surgery (which uses a laser beam to make bloodless cuts in tissue, or to remove a surface lesion such as a tumour) will remove a precancerous lesion and no further treatment will be required.

Uncommonly, a very small cancer may be discovered in the pathology specimen and further treatment may be required, depending on the size and nature of the cancer tissue.

Treatment for early stage or localised cervical cancer

If you are diagnosed with invasive cervical cancer, your doctor will advise you on the best treatment for your cancer. This will depend on the results of your tests, which will show where the cancer is in your body. It will also depend on your age, your general health, and your preferences. The treatment that is best for you will be discussed with you by your specialist doctors, who most commonly work together in what is known as a multidisciplinary team.

This information covers the treatments recommended for women with early stage cervical cancer or localised cervical cancer which has not spread beyond the pelvis and local lymph nodes.

Some patients with very early-stage cervical cancer may be recommended to have surgery. The majority of patients will be recommended to have a combination of radiotherapy and low-dose chemotherapy (known as chemoradiation).

Occasionally all three treatments may be required. When surgery is performed, tests on tissue removed during the operation may lead your doctors to recommend chemoradiation as well. This is not very common.

All these treatments are explained in more detail later in this information.

After the initial treatment, some women may have additional treatment (called adjuvant therapy) to increase the chances of a cure.

Treatment given before the main treatment is called neoadjuvant treatment. Neoadjuvant treatment is not routinely used for cervical cancer at present. The possible benefit of neoadjuvant or adjuvant chemotherapy is being investigated.

If you have not yet gone through menopause, radiotherapy and chemotherapy will cause your ovaries to stop working. Your treatment team will talk to you about hormone replacement therapy, which may be more effective if started before treatment.

If you are of childbearing age and think you may yet wish to have children, your treatment team will discuss any fertility sparing options available to you. If you are pregnant, your treatment will depend on the stage of the cancer and the stage of the pregnancy. For cervical cancer found to be at a very early stage or for cancer found during the last trimester of pregnancy, it may be possible to delay treatment until after the baby is born.

You can ask to see a psychologist or counsellor at any stage in your treatment to talk about how you are feeling. A social worker can also help you and your family with practical and financial matters.

If you want to try complementary therapies to help manage symptoms and side effects, it is important that you discuss this with your doctors and health professionals.