Cervical Cancer, Screening, Prevention and Vaccination

Screening, Prevention and Vaccination

1. PAP smears

Regular Pap smears are still the best way to prevent cervical cancer. Whether you are looking at just having a Pap smear annually or as part of a broader screening program, we are confident that we will be able to meet these needs comfortably.

Did you know?

• Women who have regular Pap smears are at lowest risk for having cancer of the cervix.
• Women who smoke have a higher risk of developing cervical cancer.
• Women who started having intercourse at a young age (younger than 16 years of age at first intercourse) have a higher risk of developing cervical cancer.
• Being infected with high-risk HPV types for a long period of time can increase a woman’s risk of developing cervical cancer.

2. HPV vaccines

Whether you are a young woman interested in HPV vaccination for yourself or a fastidious mother concerned about protecting your daughters against the threat of cervical cancer and genital warts in later life, our team of specialists will help you decide if HPV vaccination is right for you.

Did you know?

• HPV only infects humans and prefers to infect the skin cells of the genitals.
• There are some 200 sub-types of HPV.
• Only 15 of these 200 sub-types have been implicated in cervical cancer.
• HPV infection is very common in the general population.
• Most women (>95%) are able to clear this viral infection on their own without the need for special vaccines or medicines.
• Only a very small percentage of women who are infected by HPV go on to develop cervical cancer.

At NUH Women’s Centre, we are committed to providing innovation-driven healthcare to our patients. We are able to perform not only commercially available HPV testing but also HPV specific genotyping which identifies not only the broad risk type but the specific identity of the Human Papillomavirus (HPV) in question.

3. Colposcopy

Most abnormal Pap smear reports will need to be verified by a simple procedure known as colposcopy. Images of the cervix are stored digitally as a useful part of your medical record. These digitally archived images will never fade and can be referred to at any time. This enables our team of women’s cancer specialists to track your progress and recovery and to ensure that you continue to remain disease-free and well.

Did you know?

•  Colposcopy is performed with the aid of a magnifying scope to allow the cervix to be examined under good light and magnification.
• Colposcopy helps identify areas of the cervix that may undergoing pre-cancerous change which can then be treated, thus preventing cancer from developing.
• Colposcopy has been around since the early 1920s and still remains one of the most useful tools in detecting and preventing cervical cancer.
• That a dilute solution of acetic acid (otherwise known as vinegar) is used to help identify areas of the cervix that have undergone pre-cancerous change.

Symptoms

Women with pre-cancerous changes or even early cervical cancer usually do not have any symptoms.

You should consult your women’s healthcare provider promptly if you are experiencing:

• Irregular menstrual-like bleeding or unexplained vaginal bleeding
• Vaginal bleeding after sex
• Persistent strong smelling vaginal discharge

Spread and Stages

Cervical cancer develops slowly. It develops from a few abnormal cells into a tumor over several years. That is why regular yearly Pap smears are very effective in reducing a woman’s risk of developing cervical cancer.

Did you know?

• Cervical cancer spreads outwards from the cervix to affect the bladder and rectum.
• Cervical cancer has a very prolonged and distinct pre-cancerous phase.

Therapeutic options

Pre-cancerous changes of the cervix are easily treated. All the following options are available at NUH and can be easily completed in the clinic or as a day surgery.

These options include:

•  Laser ablation. Where the pre-cancerous changes are completely removed using laser energy. This can be easily done in the clinic without the need to be put to sleep or for general anesthesia.
• Cold coagulation. Where heat is applied to the pre-cancerous areas of the cervix cauterizing and destroying these abnormal areas on the cervix. This procedure is also easily performed in the clinic.
• LEEP or Loop Electro-Excision Procedure. Where a powered loop device removes abnormal or pre-cancerous areas of the cervix and cauterizes at the same time resulting in virtually no blood loss.
• Laser conization
• Needle conization
• Cold knife conization

Cancer of the cervix is usually treated with:

• An operation known as a hysterectomy where the womb is removed together with the cervix. More complex surgery will be necessary for the effective treatment of cancer that has spread more extensively outside the cervix.
• Radiation combined with chemotherapy for advanced cervical cancer where surgery cannot remove all the cancer.

Prognosis

Here are some some quick facts about outcomes after cervical cancer and pre-cancer treatment.

• Having regular Pap smears effectively identifies when pre-cancerous changes are occurring on the cervix.
• Pre-cancerous changes are easily and quickly treated in the specialist clinic.
• When pre-cancerous changes are effectively treated, cancer is prevented.
• Early stage cancer when treated, results in a better than 90% chance of completely being cured of the disease.
• Late stage cancer of the cervix is still a very treatable condition and response rates are good when both chemotherapy and radiation treatments are given.