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.

Cervical%20cancer%20-%20treatment Management

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
Acute diarrhoea is the second leading cause of death in children aged younger than 5 years, accounting for approximately 1.9 million deaths worldwide each year; however, diarrhoea is a preventable and treatable condition. In Malaysia, acute gastroenteritis accounts for about 1.3% of all deaths in children aged younger than 5 years annually. Diarrhoea is defined as the passage of three or more loose or watery stools within 24 hours, and it may be clinically categorised as either acute watery diarrhoea (AWD), acute bloody diarrhoea, persistent diarrhoea or diarrhoea with severe malnutrition.
01 Sep 2020
Acute diarrhoea is the second leading cause of deathin children aged younger than 5 years, accounting forapproximately 1.9 million deaths worldwide each year;however, diarrhoea is a preventable and treatable condition.In Malaysia, acute gastroenteritis accounts for about 1.3%of all deaths in children aged younger than 5 years annually.Diarrhoea is defined as the passage of three or more looseor watery stools within 24 hours, and it may be clinicallycategorised as either acute watery diarrhoea (AWD), acutebloody diarrhoea, persistent diarrhoea or diarrhoea withsevere malnutrition.