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
12 Aug 2019
Treatment with nebivolol yields more favourable changes in 24-hour, intradialytic and daytime systolic and diastolic blood pressure variability in patients with intradialytic hypertension, a study has found.
Stephen Padilla, 5 days ago
Early administration of recombinant human B-type natriuretic peptide (rhBNP) can lower the incidence of reperfusion injury for patients with ST-elevation myocardial infarction (STEMI) who are receiving percutaneous coronary intervention (PCI) treatment, according to a China study.
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
Yesterday
Pulmonary function has potential predictive value for future increases in arterial stiffness and its progression, as reported in a recent study.