Cervical cancer

Cervical cancer is a very rare complication of a very common viral infection.

Each year, about 2,800 women in the UK are diagnosed with cervical cancer. Having regular cervical smears is the most effective way of preventing cervical cancer because any minor changes are picked up early; can be monitored/ treated to help prevent them developing into cancer. Sited on Macmillan website, for more information.

The cervix is made up of 2 different types of cells Squamous cells and Columnar/Glandular cells. The two main types of cervical cancer are Squamous Cell Carcinoma and Adenocarcinoma. When cancer of the cervix has been diagnosed further tests may be needed to stage the cancer. Staging cancer described its size and whether it has spread, which will indicate what treatment may be needed.

There are 4 stages which then have sub-divisions:

Stage 1 The cancer cells are only within the cervix.
Stage 1A The cancer can only be seen with a microscope or colposcope.
Stage 1A1 - The cancer is 3mm or less deep and 7mm or less wide.
Stage 1A2 - The cancer is between 3-5mm deep and 7 mm or less wide.
Stage 1B The cancer growth is larger but still confined to the cervix.
Stage 1B1 The cancer is not larger than 4cm.
Stage 1B2 The cancer is larger than 4 cm.
Stage 2 The cancer has spread to surrounding structures such as the upper part of the vagina or tissues next to the cervix.
Stage 2A The cancer has spread into the upper part of the vagina.
Stage 2A1 The tumour size is not larger than 4cm.
Stage 2A2 The tumour size is larger than 4cm.
Stage 2B The cancer has spread into the tissues next to the cervix.
Stage 3 The cancer has spread to areas such as the lower part of the vagina, or tissues at the sides of the pelvic area.
Stage 3A The cancer has spread into the lower part of the vagina.
Stage 3B The cancer has spread through the tissues at the side of the pelvic area and may press on one of the urethras (the tubes through which the urine passes from the kidneys to the bladder). If the tumour is causing pressure on a urethra there may be a build up of urine in the kidney.
Stage 4 The cancer has spread to the bladder or bowel or beyond the pelvic area.
Stage 4A The cancer has spread to nearby organs such as the bladder and bowel.
Stage 4B The cancer has spread to more distant organs such as the lungs, liver or bone.

Sited: Macmillan booklet : Understanding cervical cancer.

At The Whittington Hospital we treat up to stage 1A1, usually by carrying out a Laser cone treatment (See information under Types of Treatment). Other stages are referred to the Cancer Specialist Site for North London University Hospital London (UCL).

After having treatment for Stage 1A1 you will have regular follow-up appointments at the colposcopy clinic for 5 years, which includes colposcopy examination, smear and HPV tests. If these remain Negative after 5 years you will be discharge for annual smears with your GP for 5 years.
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