by Mary Calvagna, MS
En Espaol (Spanish Version) The diagnosis of cervical cancer usually begins in your doctors office during a routine pelvic exam and Pap test. (To learn about the pelvic exam and Pap test, see cervical cancer screening .) If your Pap test shows abnormal changes or unhealthy cell growth in the cervix, your doctor will need to perform further testing to determine if you have cancer, an infection, or some other condition.
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First, the doctor will take your complete personal and family medical history, including information about possible risk factors related to cervical cancer. You will also have a physical exam.
The initial diagnosis of cervical cancer can come from the screening Pap test done in the physicians office. However, additional diagnostic tests are necessary to determine both the type and extent of tumor to plan effective treatment.
Diagnostic tests will determine the nature of the abnormal cell growth of the cervix. Diagnostic tests include:
Colposcopy In this procedure, the doctor uses a colposcope, an instrument that shines a light on the cervix and magnifies the view, to examine your genitals, vagina, and cervix closely.
How it works: The doctor places the speculum into your vagina and opens it slightly to see the cervix. A vinegar solution is swabbed onto the cervix and vagina. This solution makes abnormal tissue turn white so the doctor can identify the areas that need to be evaluated. If abnormal cells are found during a colposcopy, the doctor may do a biopsy.Biopsy During a biopsy, the doctor removes a small amount of cervical tissue for examination. There are several procedures used to obtain biopsies, including: Cone biopsy (also known as cold cone biopsy or cold knife cone biopsy) a procedure that uses a laser or a surgical scalpel to remove tissue Loop electrosurgical excision procedure (LEEP) a procedure that uses an electric wire loop to slice off a thin, round piece of tissue Endocervical curettage a procedure that uses a small, spoon-shaped instrument called a curette to scrape tissue from inside the cervical opening If the area of abnormal cell growth is small, these biopsy procedures may be able to remove all of the affected area. The tissue removed during biopsy is sent to a laboratory to be analyzed. StagingIf cancer is found, your prognosis and treatment depend on the location, size, and stage of the cancer and your general health.
Staging is a careful attempt to determine whether the cancer has spread and, if it has, what body parts are affected. Additional tests to determine staging may include: Urine and blood testsAdditional physical exam, including another pelvic exam in the operating room under anesthesiaX-rays of various parts of the body, including lungs, bladder, kidney, lymph nodesBarium enema to check intestines and rectum, helps to show the lower gastrointestinal tract on an x-ray CT or CAT scana series of x-rays put together by a computer to make detailed pictures of areas inside the bodyUltrasonographya procedure in which sound waves are bounced off tissues and the echoes produce a pictureMRI a procedure in which a magnet linked to a computer is used to create detailed pictures of areas inside the body The following staging system is used to classify cancer of the cervix: Stage 0The abnormal cells are found only in the first layer of cells lining the uterus.Stage ICancer involves the cervix but is still confined to the uterus. This stage has six levels depending upon the size of the cancer: IA, IA1, IA2, IB, IB1, and IB2.Stage IICancer has spread to nearby areas but is still inside the pelvic area. This stage has two levels depending upon whether the cancer has spread to the vagina: IIA and IIB.Stage IIICancer has spread throughout the pelvic area. This stage has two levels depending on whether there is the cancer has spread to the vagina or bladder: IIIA and IIIB.Stage IVCancer has spread to other parts of the body. This stage has two levels depending on which organs the cancer has spread to: IVA and IVB. References:
American Academy of Family Physicianswebsite. Available at: http://www.aafp.org/online/en/home.html . American Cancer Societywebsite. Available at: http://www.cancer.org/docroot/home/index.asp . National Cancer Institutewebsite. Available at: http://www.cancer.gov/ . The National Womens Health Information Center website. Available at: http://www.4woman.gov/ . Last reviewed April 2007 by Barbara Harty-Golder, MD, JDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
