Treating precancerous abnormalities
If any of the tests show precancerous cell changes, you may have one of the following treatments to prevent you developing cervical cancer.
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Also called loop electrosurgical excision procedure (LEEP), this is the most common way of removing cervical tissue to treat precancerous changes of the cervix. The abnormal tissue is removed using a thin wire loop that is heated electrically. The doctor aims 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 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. This will usually ease in a few days, but you may notice some spotting for 3–4 weeks. If the bleeding lasts longer than 3–4 weeks, becomes heavy or smells bad, see your doctor. To allow your cervix to heal and to prevent infection, you should not have sexual intercourse or use tampons for 4–6 weeks after the procedure.
After a LLETZ or LEEP you can still become pregnant, however 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, when early-stage cancer is suspected, or for older women needing a larger excision. In some cases, it is also used to treat very small, early-stage cancers, particularly for young women who would like to have children in the future.
The 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. The tissue is examined to make sure that all the abnormal cells have been removed. Results are usually available within a week.
Side effects of a cone biopsy
You may have some light bleeding or cramping for a few days after the cone biopsy. 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 a bad smell, see your doctor. Some women notice a dark brown discharge for a few weeks, but this will ease.
To allow 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.
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.
This procedure uses a laser beam instead of a knife to remove the abnormal cells or pieces of tissue for further study.
A laser beam is a strong, hot beam of light. The laser beam is pointed at the cervix through the vagina. The procedure is done under local anaesthetic. Laser surgery takes about 10–15 minutes, and you can go home as soon as the treatment is over.
Laser surgery works just as well as LLETZ 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.
A/Prof Penny Blomfield, Gynaecological Oncologist, Hobart Women’s Specialists, and Chair, Australian Society of Gynaecological Oncologists, TAS; Karina Campbell, Consumer; Carmen Heathcote, 13 11 20 Consultant, Cancer Council Queensland; Dr Pearly Khaw, Consultant Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; A/Prof Jim Nicklin, Director, Gynaecological Oncology, Royal Brisbane and Women’s Hospital, and Associate Professor Gynaecologic Oncology, The University of Queensland; Prof Martin K Oehler, Director, Gynaecological Oncology, Royal Adelaide Hospital, SA; Dr Megan Smith, Program Manager – Cervix, Cancer Council NSW; Pauline Tanner, Cancer Nurse Coordinator – Gynaecology, WA Cancer & Palliative Care Network, WA; Tamara Wraith, Senior Clinician, Physiotherapy Department, The Royal Women’s Hospital, VIC. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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