The treatment of cervical cancer depends on the stage of the cancer and other prognostic factors. In many cases, physicians will also perform some type of treatment on patients with pre-cancerous conditions to prevent these conditions from developing into cervical cancer. For patients with invasive cervical cancer, the main types of treatment include surgery, radiation therapy, and/or chemotherapy. As with many other types of cancer, the earlier cervical cancer is detected, the greater the chances for successful treatment and survival.
Cauterization (also called diathermy) involves burning off abnormal cervical cells using heat, electricity, or chemicals. The procedure is most commonly used on patients with pre-cancerous cervical conditions. Cauterization can be performed in a physician’s office or outpatient section of a hospital with minimal discomfort. However, in some instances, cauterization may cause scarring that could interfere with future Pap smear interpretation.
Cryosurgery is performed by inserting a special metal probe called a cryoprobe through the vagina so that it directly touches the cervical lesion. Once the probe is properly positioned, liquid nitrogen is sent through the probe. The temperature of liquid nitrogen is approximately –256 degree Fahrenheit or –160 degrees Celsius, cold enough to freeze and destroy the desired cervical tissue. Cyrosurgery is commonly used to treat pre-cancerous cervical conditions (such as cervical neoplasia) before they have a chance to develop into cervical cancer. The procedure may also be used to treat early-stage cervical cancer.
Cryosurgery can be performed in a physician’s office (typically by a gynecologist). The most common side effect of cyrosurgery is mild cramping; severe discomfort does not usually occur. Women are typically able to resume normal activities immediately after the procedure, although they are usually advised to refrain from sexual intercourse and douching for several weeks after surgery. During the weeks following surgery, most women who undergo cryosurgery experience a watery discharge in which the dead cervical tissue is expelled.
Laser surgery involves using a focused laser beam to burn off abnormal cervical cells or to remove a sample of cervical tissue for examination in a pathology laboratory. Laser surgery is a quick procedure that does not usually damage the surrounding tissue. The procedure can be performed in a physician’s office or outpatient section of a hospital. Recovery time is usually very fast. Laser surgery is usually performed on patients with pre-cancerous or non-invasive forms of cervical cancer.
A cone biopsy removes a piece of tissue which is cylindrical or cone shaped. The procedure is usually performed to diagnose cervical cancer but can also be used as a treatment if the cancer is small enough to be completely removed during biopsy. After the tissue is removed, it is analyzed in the pathology laboratory to determine whether cancer is present. There are two main methods used to perform cone biopsy. The LEEP (also called LLETZ) method, short for loop electrosurgical excision procedure, removes tissue by using a wire that is heated by an electrical current. Patients are given local anesthesia and the procedure can be performed quickly in a physician's office. Another method of cone biopsy involves using a surgical scalpel or laser to remove the tissue. This procedure typically requires general anesthesia and may be performed in a hospital or outpatient facility. However, an overnight hospital stay is not usually required.
The most common side effects of cone biopsy include cramping/discomfort and moderate or mild bleeding for a few weeks after the procedure. Patients should avoid sexual intercourse, tampons, and douching until the incision is completely healed, which may take several weeks. Patients should also discuss other possible side effects of cone biopsy treatment prior to the procedure.
The advantages of cone biopsy are that it provides a large sample of tissue for analysis and it can sometimes completely remove the cancer so the patient does not need additional surgery. However, because complications from cone biopsy are possible, women should discuss all aspects of the procedure with their physician before undergoing biopsy. If a cone biopsy is recommended after abnormal Pap smear results, a patient may wish to ask if a colposcopy (looking at the cervix with magnification) or cervical biopsy would be an appropriate alternative (if they have not already been performed), based on her individual case.
