Treating abnormal cells in the cervix

Source: http://www.nhs.uk/Conditions/Colposcopy/Pages/Treatment.aspx
Date: 14 Jan 2011
You may require treatment if the results of your colposcopy indicate that you have abnormal cells in your cervix.
The type of treatment recommended will depend on the number of abnormal cells in your cervix and how advanced the abnormalities are.
The aim of treatment is to remove the abnormal cells while minimising any damage to healthy tissue. Treatment is nearly always 100% successful, and it is unlikely that any cell changes will occur again.
Timing of treatment
It may be possible for you to have treatment at the same time as your colposcopy. This may be more convenient for you than having to make another appointment for treatment at a later date.
Some women find that waiting for treatment causes anxiety, and they prefer to be treated as soon as possible. Others prefer to have time to think about their treatment and schedule it for another time.
Some types of treatment that are more intensive cannot be done on the same day as a colposcopy. Your colposcopist will advise about the best time for your treatment to be carried out. They will also be able to discuss the treatment options with you, and what each type of treatment involves.
Some of the available treatments are discussed below.
Large loop excision of the transformation zone (LLETZ)
In the UK, large loop excision of the transformation zone (LLETZ) is the most common treatment for abnormal cervical cells.
LLETZ can sometimes be carried out at the same time as a colposcopy and involves cutting out the area of the cervix where the abnormal cells have developed. This is done using a thin wire loop that is heated with an electric current. The loop is also used to seal the wound.
LLETZ usually takes 5-10 minutes. It is often carried out under local anaesthetic (medication that numbs the area). The procedure is not usually painful, although you may feel some pain that is similar to period pain.
If a larger area of the cervix needs to be treated, the procedure will take longer and you may need a general anaesthetic (where you are put to sleep).
You will need to bring a sanitary towel with you as you will bleed after having LLETZ. You may also have some light bleeding for several weeks after the procedure.
After having LLETZ you should avoid:
• using tampons for four weeks after LLETZ (use sanitary pads instead)
• having sexual intercourse for four weeks following LLETZ
• heavy exercise
These all increase your risk of developing an infection after the procedure has been carried out.
Diathermy is a treatment similar to LLETZ. It also uses an electric current to destroy abnormal cervical cells.
Cone biopsy
It is not possible to carry out a cone biopsy at the same time as a colposcopy. A cone biopsy is a minor operation that usually requires an overnight stay in hospital.
A cone biopsy is carried out under general anaesthetic. A cone-shaped piece of tissue is cut away from your cervix. The section of tissue that is taken may include the whole area of cervix where the abnormal cells are located. The tissue will be sent to a laboratory for closer examination under a microscope.
Following a cone biopsy, a piece of gauze (a dressing made of absorbent material) may be placed in your vagina to help stop any bleeding. If you require a gauze pack, you may also need to have a catheter inserted (a thin tube that drains urine from your bladder) as the pack can sometimes press on your bladder.
It is normal to bleed for up to four weeks after having a cone biopsy. You may also have some period-like pain, although any discomfort should only last for a couple of hours. Painkillers can be used to help ease the pain.
Take plenty of rest during the first week after having a cone biopsy. You will not need to stay in bed but you should avoid tasks such as heavy lifting. Also avoid vigorous exercise and having sex during the first four to six weeks after the biopsy. After this time, the tissue in your cervix should have healed.
While recovering from your operation you may also find it useful to arrange for a relative or friend to stay with you for a few days to help out with any difficult tasks.
Other treatments
Abnormal cells can be removed from your cervix in several other ways. Your doctor can give you more information and advice about the procedures that are briefly outlined below.
Cryotherapy
Cryotherapy is a form of treatment that involves freezing and destroying any abnormal cells. During the procedure, you will lie on a couch and a doctor will insert an instrument called a speculum into your vagina. They will then freeze and destroy any abnormal cells.
During cryotherapy, liquid carbon dioxide is passed through a probe and directed at the abnormal cells. The tissue will be frozen for two to three minutes, and the process may be repeated if necessary.
You may feel period-like pain during cryotherapy, and for a short time after the treatment has finished.
Laser treatment
Laser treatment involves the doctor using a laser to pinpoint and destroy any abnormal cells on your cervix. A local anaesthetic will be used to numb the area that is being treated.
The abnormal area will be burned away using a hot beam of light produced by the laser. There may be a burning smell during this procedure, but this is normal and nothing to be worried about. You can return home as soon as the laser treatment is finished.
Cold coagulation
Cold coagulation involves applying a heat source to the cervix that burns away and removes the abnormal cells. You may feel period-like pain during cold coagulation treatment, and for a short time afterwards.
Hysterectomy
A hysterectomy (surgically removing your womb) will only be considered if abnormal cells on your cervix have been found more than once or if they are severely abnormal.
Removing your womb will also only be an option if you have decided not to have any more children and you have had the menopause.
After treatment
Following treatment on your cervix, you are likely to be advised to avoid:
• using tampons for four weeks after your treatment
• having sexual intercourse for four weeks after your treatment
• going swimming for two weeks after your treatment
Ask your GP or call the clinic if you have any questions about the colposcopy examination, biopsy procedure, your results or possible treatment options for abnormal cervical cells. Your GP or staff at the clinic will be able to answer any queries or discuss any of your concerns.