Cervical Cancer

• Cervical cancer is the growth of abnormal cells in the lining of the cervix.

• Signs and Symptoms:

1. vaginal bleeding between periods

2. menstrual bleeding that is longer or heavier than usual

3. pain during intercourse

4. bleeding after intercourse

5. pelvic pain

6. a change in your vaginal discharge such as more discharge or it may have a strong or
unusual color or smell

7. vaginal bleeding after menopause.

Causes of cervical cancer

• persistent infection with some high-risk types of the human papillomavirus (HPV)

• Smoking – other main risk factor

• Weakened immune system

• if the mother was prescribed diethylstilbestrol (DES), an artificial form of the female hormone
estrogen during pregnancy (between 1939 and 1971).

Diagnosis

Colposcopy with biopsy

Large loop excision of the transformation zone (LLETZ) or cone biopsy

• the most common method to remove cervical tissue for examination and treating precancerous
changes of the cervix.

• It is usually done under a local anesthetic.

• A cone biopsy is used where there are abnormal glandular cells in the cervix or if early-stage
cancer is suspected.

Treatment

• early and non-bulky disease (less than 4cm) – surgery, sometimes with chemoradiation therapy
afterwards

• If the tumour is small, a cone biopsy may suffice; in some cases hysterectomy (surgical removal
of the uterus) is required.

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• locally advanced disease, a combination of radiation therapy (radiotherapy) and chemotherapy
(cisplatin).

• metastatic disease, the treatment is chemotherapy (platinum/fluorouracil) or palliative care

alone

Staging Classification

• Stage I, the carcinoma is strictly confined to the cervix.

• Stage II, the carcinoma invades beyond the uterus but not the pelvic wall or vagina.

• Stage III, the tumor spreads to the pelvic wall and/or the vagina, and/or causes
hydronephrosis of the kidneys.

• Stage IV, the tumor has extended beyond the pelvis and involves the bladder or rectum.

• Surgical Procedures for Cervical Cancer

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References:

Cancer Council. (2023). Types of Cervical Cancer. https://www.cancer.org.au/cancer-information/types-

of-cancer/cervical-cancer.

DYSIS Medical Inc. (2023). Colposcopy. https://dysismedical.com/patients/colposcopy/

Fat, L. S. (2021 June 20). Loop Electrosurgical Excision Procedure (LEEP/LLETZ) for CIN.
https://obgyn.com.my/loop-electrosurgical-excision-procedure-leep-lletz-for-cin/

Hinkle, J.L., Cheever, K.H., & Overbaugh, K. (2022). Brunner & Suddarth’s Textbook of Medical and
Surgical Nursing 15th edition. Wolters Kluwer

Thank you!

Discussed by:
Dr. Nerie C. Avecilla
April 6, 2024