Cervical cancer

Diagnosis

Epworth uses a range of diagnostic tests to thoroughly investigate signs and symptoms of underlying health concerns.

Below is an overview of common tests used to diagnose cervical cancer.  

Physical examination

Your GP or specialist may perform an exam called a colposcopy. This allows your doctor to view the tissue and any abnormal cells in the cervix and vagina.  

Blood test

Your doctor may order several blood tests to check your overall health and to detect proteins produced by cancer cells. These proteins are called tumour markers. 

Biopsy

Tissue samples are taken and looked at under a microscope to determine if cancer cells are present. Biopsies will be performed on the cervix via colposcopy. 

CT scan

Computerised tomography (CT scan) uses X rays to compile three-dimensional pictures of the inside of your body to look for cancer in lymph nodes or other organs.

MRI scan

Magnetic resonance imaging (MRI scan) creates detailed cross-sectional pictures using magnet and radio waves.

PET-CT scan

Positron emission tomography (PET-CT scan) provides more detailed information by highlighting cancer cells which use more glucose than normal cells. 

Staging - Investigating the extent of the cancer

During your initial diagnostic tests, your care team may be able to stage your cancer at the same time during a biopsy or CT, MRI, or PET scans. 

What does my cancer stage mean?

Staging is a term used to describe the size of the cancer and whether it has spread. Staging helps your care team and specialists to create a unique treatment plan.

Stage 1

Early cancer where the tumour is found only in the tissue of the cervix.

Stage 2

Cancer has spread from the cervix to the upper two thirds of the vagina or other tissue nearby.

Stage 3

Cancer has spread to the lower third of the vagina and/or the tissue on the pelvic wall or to lymph nodes in the pelvis or abdomen or the urinary system.

Stage 4

Sometimes called advanced cancer, stage 4 means cancer has spread to the bladder or rectum (stage 4A) or beyond the pelvis to the lungs, liver or bones (stage 4B).

Treatment

At Epworth, our specialised Gynaecology Cancer Centre will provide you with a team of experts who work together to create a treatment plan that considers your needs and circumstances.

Why choose Epworth for cancer care?

Treatment overview

Depending on the stage of your cancer, you may be recommended treatment for precancerous abnormalities, surgery, or a combination of chemotherapy and radiotherapy. Some cancers are cured with surgery alone and others require a combination of treatments. 

• Cervical abnormality treatment
  During diagnostic tests your doctor may discover abnormalities in your cervix that can be treated before cancer develops. 
  • Large loop excision of the transformation zone (LLETZ)
    LLETZ is the most common way of treating precancerous changes to the cervix. A thin wire loop is heated electrically and used to remove the abnormal tissue.
  • Laser surgery
    A laser beam (hot light beam) is used to vaporise or remove the abnormal cells.
    
     
• Surgery
  Surgery is first line treatment for cervical cancer that has not spread beyond the cervix. This would usually involve a total hysterectomy to remove the uterus and cervix.
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• Radiotherapy
  Radiotherapy is the use of radiation (X-rays) to kill or injure cancer cells. Depending on the type and location of your cervical cancer, your treatment team may recommend radiotherapy. 
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• Chemotherapy
  Chemotherapy is a common form of treatment that involves the use of anti-cancer drugs to kill or slow the growth of cancer cells. Chemotherapy is often used alongside other treatments such as radiotherapy and surgery. 
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Multidisciplinary Team (MDT) Assessment and Plan of Treatment

You will have access to an MDT to plan the management of your cancer. All members of the MDT have a special interest in gynaecological cancer, and include:

• Gynaecological oncologists
• Medical oncologists
• Gynaecologic clinical nurse specialists/oncology liaison nurse
• Gynaecologic histopathologists/cytologists
• Physiotherapists
• Radiologists
• Research staff
• Radiation oncologists
• Genetics counsellors
• Social workers
• Psychiatrist/psychologist
• Pastoral Care

Surgery

Why choose Epworth to perform cancer surgery?

Our gynaecological oncologists perform more than 1,000 major gynaecological cancer operations each year. Epworth was the first private hospital group in Victoria to treat gynaecological cancers using robot-assisted surgery.

Types of cervical cancer surgery:

• Sentinel lymph node dissection
  This procedure is performed to identify whether the cancer has spread from the cervix to the nearest lymph node. If this lymph node contains cancer cells, the surgeon may recommend chemo-radiation treatment instead of surgery, to stop the cancer spreading further through the body.
• Trachelectomy
  In rare cases, a trachelectomy to remove part or all of the cervix and upper vagina may be performed. This is not common but may be offered to young women with early-stage cancer who still wish to have children. 
• Radical hysterectomy
  A radical hysterectomy, removing the uterus, cervix, soft tissue around the cervix, the top of the vagina and the fallopian tubes is the standard surgery for most cervical cancers. Some women may keep their ovaries, but not if there is concern that the cancer could have spread to the ovaries or for women who have been through or are approaching menopause.
  
  

Radiotherapy

Epworth oncologists use radiation to cure, control and reduce gynaecological cancer cells for our patients. 

Radiotherapy at Epworth

Epworth offers patients radiotherapy through our provider, Icon. As Australia’s largest dedicated cancer care provider, Icon has a long history of delivering exceptional cancer care to the Australian community.

Supported by the latest world-class technology and evidence-based techniques, Icon’s highly experienced team of radiation oncologists, radiation therapists, physicists and nurses are committed to providing compassionate, exceptional care for patients and their loved ones.

What is radiotherapy?

Radiotherapy is the use of radiation to treat and manage cancer.

What are the side effects of radiotherapy?

Side effect types and duration will vary from person to person, some general side effects may include:

• Fatigue
• Skin irritation
• Feeling weak
• A stinging sensation when urinating
• Diarrhoea

Will I need radiotherapy?

Your oncologist will speak with you to decide whether radiotherapy is the right treatment option for you.

Chemotherapy

Your medical oncologist will oversee your chemotherapy. These specialists work closely with surgeons, radiation oncologists, physicians, nurses, and allied health professionals to ensure that all elements of your care are coordinated.

Your medical oncologist will explain and discuss current treatment recommendations and the opportunity to participate in appropriate clinical trials.

What is chemotherapy?

Chemotherapy is a common form of treatment that involves the use of anti-cancer drugs to attack cancer cells. Chemotherapy is often used alongside other treatments such as radiotherapy and surgery.

How will I receive my treatment?

The treatment can be given orally, through an intravenous cannula, direct introduction to the affected organ/tissue or as a cream. Chemotherapy is often given in courses or cycles with periods of rest in between, allowing normal cells to recover.

Are there different types of chemotherapy?

Yes, there are many different types of chemotherapy. Your care team will explain which chemotherapy is best for your circumstance.

Will I need chemotherapy?

If you have been diagnosed with gynaecological cancer, your Epworth oncologist will discuss with you if chemotherapy is suitable for your treatment needs.

What are the side effects of chemotherapy?

Our team is here to support you throughout your cancer journey and will help you prevent and manage these potential and often temporary side effects.

Side effects may include:

• Nausea and vomiting
• Diarrhoea or constipation
• Fatigue
• Hair loss
• Muscle weakness
• Skin sensitivity to sunlight
• Dry or tired eyes
• Loss of appetite

Epworth Wig salons

Head wear and wigs are offered to all Epworth patients experiencing hair loss at our convenient on-site salons. This service is provided via the generosity of our Epworth Medical Foundation donors so there is no cost to patients.

How do I prepare for chemotherapy?

• The Gynae Clinical Nurse Consultant and Oncology Liaison Nurse Consultant will provide education and a support pack for your information and explain the chemotherapy process.
• You may be able to use “cold caps” to prevent hair loss or may like to be fitted for a wig prior to starting chemotherapy in case you need it.
• Recovering from surgery, eating well, staying well hydrated, sleeping and exercising will all play a part in preparing for chemotherapy.
• You may choose to have your chemotherapy at one of Epworth’s Day Oncology Units or a unit closer to your home.
• If you have children or grandchildren from babies to age 18, you may like to read the Cancer Council book: Talking to Kids About Cancer. The ward team can provide a copy.