Obstetrics & Gynaecology Search
Obstetrics & Gynaecology Obstetrics & Gynaecology
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
Abortion does not drive depression risk
Tristan Manalac, 12 Jun 2018
Women who receive abortions appear to be significantly more likely to use antidepressants, although this pattern of use has less to do with the termination of pregnancy than with other risk factors for depression, according to a recent study.
Severe anaemia doubles antenatal, postnatal mortality risk
Rachel Soon, 14 Jun 2018

Severely anaemic women have twice the risk of dying during or after pregnancy compared to women without anaemia, reveals a major international study.
Incomplete antenatal steroid course tied to neurodevelopmental impairment in preemies
Tristan Manalac, 10 Jun 2018
Neurodevelopmental impairment (NDI) is common among preterm very-low birth weight (PT/VLBW) infants, according to a recent Singapore study, which additionally reports that the male sex and lack of antenatal steroids (ANS) are risk factors for delayed cognitive skills.
Intrathecal morphine tied to high pruritus incidence in parturients
Audrey Abella, 08 Jun 2018
A high incidence of pruritus was found among parturients (ie, women about to give birth) following the administration of intrathecal morphine during spinal anaesthesia for Caesarean section (CS), according to a Singapore study.