Treating precancerous abnormalities
If any of the tests show precancerous cell changes, you may have one of the following procedures to remove the area of abnormal cells and prevent you developing cervical cancer.
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Also called loop electrosurgical excision procedure (LEEP), this is the most common way of treating precancerous changes of the cervix. The abnormal tissue is removed using a thin wire loop that is heated electrically. The aim is to remove all the abnormal cells from the surface of the cervix.
A LLETZ or LEEP is done under local anaesthetic in your doctor’s office or under local or general anaesthetic in hospital. It takes about 10–20 minutes. The tissue sample is sent to a laboratory for examination under a microscope. Results are usually available within a week.
Side effects of a LLETZ or LEEP
After a LLETZ or LEEP, you may have some vaginal bleeding and cramping. These side effects will usually ease in a few days, but you may notice some spotting for several weeks.
If the bleeding lasts longer than 3–4 weeks, becomes heavy or has an unpleasant smell, see your doctor. To give your cervix time to heal and to prevent infection, you should not have sexual intercourse or use tampons for 4–6 weeks after the procedure. You will also need to avoid swimming pools and spas.
After a LLETZ or LEEP you can still become pregnant, but you may have a slightly higher risk of having the baby prematurely. Talk to your doctor before the procedure if you are concerned.
This procedure is similar to a LLETZ. It is used when the abnormal cells are found in the cervical canal, for women who need a larger area removed or when early-stage cancer is suspected. In some cases, a cone biopsy is also used to treat very early-stage cancers, particularly for young women who would like to have children in the future.
A cone biopsy is usually done as day surgery in hospital under general anaesthetic. A surgical knife (scalpel) is used to remove a cone-shaped piece of tissue from the cervix (see page 30). A pathologist examines the tissue to make sure all the abnormal cells have been removed. Results are usually available within a week.
Side effects of a cone biopsy
After a cone biopsy, you may have some light bleeding or cramping for a few days. Avoid doing any heavy lifting for a few weeks, as the bleeding could become heavier or start again. If the bleeding lasts longer than 3–4 weeks, becomes heavy or has an unpleasant smell, see your doctor. You may notice a dark brown discharge for a few weeks, but this will pass. To give your cervix time to heal and to prevent infection, you should not have sexual intercourse or use tampons for 4–6 weeks.
A cone biopsy may weaken the cervix. You can still become pregnant after a cone biopsy, but you may be at a higher risk of having a miscarriage or having the baby prematurely. If you would like to become pregnant in the future, talk to your doctor before the procedure.
I had period-like pain for a few days after the cone biopsy but a hot water bottle and mild pain medicines helped a lot.Julie
This procedure uses a laser beam instead of a knife to vaporise or remove the abnormal cells.
A laser beam is a strong, hot beam of light. The laser beam is pointed at the cervix through the vagina. Laser surgery is done under either local or general anaesthetic. It takes about 10–15 minutes, and you can go home as soon as the treatment is over and you have recovered from the anaesthetic.
Laser surgery works just as well as LLETZ to remove precancerous cells and may be a better option if the precancerous cells extend from the cervix into the vagina or if the lesion on the cervix is very large.
Side effects of laser surgery
These are similar to those of LLETZ. Most women are able to return to normal activity 2–3 days after having laser surgery, but will need to avoid sexual intercourse for 4–6 weeks.
Podcast: Tests and Cancer
Dr Pearly Khaw, Lead Radiation Oncologist, Gynae-Tumour Stream, Peter MacCallum Cancer Centre, VIC; Dr Deborah Neesham, Gynaecological Oncologist, The Royal Women’s Hospital and Frances Perry House, VIC; Kate Barber, 13 11 20 Consultant, VIC; Dr Alison Davis, Medical Oncologist, Canberra Hospital, ACT; Krystle Drewitt, Consumer; Shannon Philp, Nurse Practitioner, Gynaecological Oncology, Chris O’Brien Lifehouse and The University of Sydney Susan Wakil School of Nursing and Midwifery, NSW; Dr Robyn Sayer, Gynaecological Oncologist Cancer Surgeon, Chris O’Brien Lifehouse, NSW; Megan Smith, Senior Research Fellow, Cancer Council NSW; Melissa Whalen, Consumer.
We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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