cervical%20cancer%20-%20treatment
CERVICAL CANCER - TREATMENT
Patients w/ abnormal Pap smear are referred for colonoscopy to screen for presence of cervical cancer.
Colposcopic exam should include inspection of the transformation zone, definition of the extent of the lesion & biopsy of the most abnormal area for tissue diagnosis.
The earliest stages of cervical carcinoma are generally asymptomatic.
Watery vaginal discharge & postcoital bleeding or intermittent spotting may be present & are usually unrecognized by the patient.

Monitoring

Cervical Cancer Stage IA1

  • Follow-up visit every 3-6 months x 2 years, then every 6-12 months x 3-5 years, then annually
  • Cervical/vaginal cytologic exam annually as indicated
  • Consider complete blood count (CBC), blood urea nitrogen (BUN), creatinine every 6 months or as indicated
  • Imaging should be based on patient’s symptoms and concern for metastatic or recurrent disease
  • Educate patient on potential recurrence symptoms, effects of treatment, periodic self-examinations, and sexual health (eg use of vaginal dilator, vaginal moisturizers/lubricants)
  • Counsel patient on exercise, obesity, nutrition, lifestyle and smoking cessation

Cervical Cancer Stage IA2, IB1, IIA1

  • Follow-up visit every 3-6 months x 2 years, then every 6-12 months x 3-5 years, then annually
  • Cervical/vaginal cytologic exam annually as indicated
  • Consider CBC, BUN, creatinine every 6 months or as indicated
  • Imaging should be based on patient’s symptoms and concern for metastatic or recurrent disease
  • Educate patient on potential recurrence symptoms, effects of treatment, periodic self-examinations, and sexual health (eg use of vaginal dilator, vaginal moisturizers/lubricants)
  • Counsel patient on exercise, obesity, nutrition, lifestyle and smoking cessation

Cervical Cancer Stage IB2, IIA2, IIB, IIIA, IIIB, IVA

  • Follow-up visit every 3-6 months x 2 years, then every 6-12 months x 3-5 years, then annually
  • Cervical/vaginal cytologic exam annually as indicated
  • Consider CBC, BUN, creatinine every 6 months or as indicated
  • Imaging should be based on patient’s symptoms and concern for metastatic or recurrent disease  
    • At 3-6 months posttreatment completion, the following may be performed:
      • Stage IB2: Whole body PET/CT
      • Stage II-IV: Whole body PET/CT (preferred), CT with contrast of the chest, abdomen or pelvis, or MRI with contrast of the pelvis (optional)
  • Educate patient on potential recurrence symptoms, effects of treatment, periodic self-examinations, and sexual health (eg use of vaginal dilator, vaginal moisturizers/lubricants) 
  • Counsel patient on exercise, obesity, nutrition, lifestyle and smoking cessation

Metastatic Cervical Cancer

  • Follow-up visit every 3-6 months x 2 years, then every 6-12 months x 3-5 years, then annually
  • Cervical/vaginal cytologic exam annually as indicated
  • Consider CBC, BUN, creatinine every 6 months or as indicated
  • Imaging should be based on patient’s symptoms and concern for metastatic or recurrent disease
  • Educate patient on potential recurrence symptoms, effects of treatment, periodic self-examinations, and sexual health (eg use of vaginal dilator, vaginal moisturizers/lubricants)
  • Counsel patient on exercise, obesity, nutrition, lifestyle and smoking cessation
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Pearl Toh, 3 days ago
Pregnant women with inadequate knowledge on health are more likely to have undesirable maternal outcomes during delivery and adverse outcomes in their offspring than those who were well informed, according to a large cohort study presented at SMFM 2020 Annual Pregnancy Meeting.
12 Dec 2019
Rotavirus (RV) is highly contagious. Globally, 2 million children are hospitalized and more than 500,000 die annually from RV associated gastroenteritis. Therefore, vaccination is imperative for the prevention of RV infections.
Pearl Toh, 4 days ago
Use of virtual reality (VR) helps reduce pain during childbirth, and may present a novel nonpharmacologic approach to controlling labour pain, suggests a study presented at SMFM 2020 Annual Pregnancy Meeting in Grapevine, Texas, US.