Cervical Cancer

• What is cervical cancer?
• Is cervical cancer difficult to detect?
• What are the symptoms of cervical cancer?
• What causes cervical cancer?
• What can I do?
• How is cervical cancer treated?

What is cervical cancer?

Cervical cancer is cancer of the neck of the womb (cervix). Half of all cancers of the female reproductive system are in the cervix.

Is cervical cancer difficult to detect?

No. In fact cervical cancer is one of the easiest cancers to detect thanks to the PAP smear test. This test checks the cervix for abnormal, pre-cancerous cells that could eventually develop into cancerous cells. It is estimated that smear tests can detect up to 90% of cervical cancers.

However, the mortality figures for cervical cancer in Ireland are certainly not good news. Figures from the World Health Organisation (WHO) show that Ireland's mortality rate with regard to cervical cancer is higher than the EU average. Approximately 70 women in the Republic die from cervical cancer each year.

While the Department of Health estimates that around 60% of these deaths could be prevented by mass screening for women over the age of 25, currently, no national screening service exists in the Republic. (People living in Northern Ireland can avail of Britain's National Cervical Programme, which has been in place since 1988).

The first phase of the Irish Cervical Screening Programme will began in the MidWestern Health Board area (Limerick, Clare and North Tipperary) in October 2000, and the national roll-out of the scheme is awaited.

What are the symptoms of cervical cancer?

Some cancers of the cervix produce no symptoms. Most cancers of the cervix cause the woman to bleed after sex and to bleed between her periods. These can also be signs of a carcinoma in situ (CIN), which is a pre-cancerous condition, although the earlier pre-cancerous changes (dysplasia) do not cause any symptoms. This is why it is necessary to have regular smears to detect it.

If left untreated, the cancer spreads from the surface of the cervix into the deeper parts of the cervix and then out into the pelvic tissues, causing pain. Eventually the cancer may spread to the bladder, rectum and surrounding pelvic tissue, causing symptoms such as pain or bleeding from the rectum after a bowel movement or pain or difficulty urinating.

What causes cervical cancer?

Cervical cancer is almost certainly the result of some process that occurs during sexual intercourse. Over the years different components of the male ejaculate have been implicated. Nowadays, it would seem to be associated with infectious organisms, more specifically some strains of the human papillomavirus (HPV).

There are a number of risk factors associated with this form of cancer:

• Being a carrier of particular strains of the human papillomavirus (HPV) (the virus that causes genital warts) is the main risk factor.
• Being a smoker increases a woman's chances of developing cervical cancer.
• Having multiple sexual partners (or if your male partner has had multiple partners).
• A history of cancer of the vagina or uterus.
• A history of abnormal smear test results.
• Being HIV positive.

What can I do?

It is essential that you have regular smear (PAP) tests. If you are over the age of 25, consult your doctor about having a smear test. If you have had smear tests before, make sure you continue to have them at least every five years.

How is cervical cancer treated?

The earlier the condition is diagnosed, the better the outcome. Pre-cancerous changes, if detected on a smear test can be treated by destruction either by using heat, cold or laser therapy to destroy the affected tissue.

The outcome for early cancer, confined to the cervix, is very good. Depending on the site and spread, a cone biopsy may remove all the diseased tissue or a hysterectomy may be required. The five year survival rate is up to 80% in early cancers.

More advanced cancers will be treated with radiotherapy or radiotherapy combined with surgery. The outcome is those with more advanced disease is not as good as that for early cancer.

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Anonymous   Posted: 01/02/2006 20:33

treatment of cin 111 result of smear test

Anonymous   Posted: 09/03/2006 13:33

I had a smear test in January 2005, I received the results in May and was told that the test was contaminated as I had bled during the procedure, I had a repeat test in June 2005 and received the results in December 2005 which showed cin1, I was told to come back in February for a repeat test and this test again showed cin 1. I have now been told to come back again in six months. I am worried that as my test in January 2005 was contaminated that the abnormalities could have been missed and that therefore this has been going on for over a year. |I know that cin 1 indicates very mild abnormalities but this doesn't really put my mind at ease and I'm not sure how comfortable I am waiting another six months for a repeat test. Would it be unreasonable to request further tests at this stage or should I relax and wait the six months?

Scooby  Posted: 22/03/2006 16:51

I had a lletz/cone biopsy 4 months ago as I had cin3. Prior to the lletz I had been having stomach cramps & feeling nautious in the morning. All that went but has now returned. Is it possible that the tissue that is regrowing could be abnormal causing me to feel sick. I am due a colonoscopy in May but am wondering if I need to bring this forward.

Anonymous   Posted: 26/04/2006 13:55

I had a lletz last january and 3 checkups afterwards, the level of cin increased during these checkups and last i spoke to the hosp i was cin2 again, I was asked to come in for a colp within a few weeks but i had just found out i was pregnant, the doctor insisted that i have it done before 20 wks so my treatment can start as soon as i have the baby. I am due in next week for this. I am very worried about the levels of abnormal cells increasing so quickly after the lletz and also about the treatment... I have already had a lletz, what other treatment could i possibly need if the cin is higher now?

anonymous  Posted: 11/05/2006 21:19

i would like to know this too what other treatment could be necessary and when. how many lletz can u have. how fast can abnormal or CIN cells turn cancerous.

Debbie  Posted: 02/08/2006 13:49

I have just been told have CIN 3 and am booked for a colcoscopy in 4 weeks time. My doctor said this will show how big the affected area is. When I asked worst case scenario she said minor surgery if large area affected. Is this minor surgery a cone biopsy? I've been reading up and aparently a cony biopsy can cause problems if get pregnant in the future as far as carrying a baby full term. Is this true. Also is it very painful i.e. how long would you need off work and can you drive etc? If anyone has had this procedure any information would be very welcome as I have 4 weeks to wait to see the specialist.

sUNSHINE  Posted: 07/08/2006 21:11

I had a Colposcopy 4 weeks ago and was called back to hospital on Thursday to be told I have CIN3 and CGIN (small area). As shocked as I am (previous smear was clear 3 years ago) I had LLETZ there and then. I have to wait four weeks for lab results of cells taken and then a further colposcopy in 3 months time. I am extremely anxious as the thought of cancer scares me having lost two siblings to cancer (not cervical). I presume this is a normal reaction to such news, just feel extremely anxious all the time.

Michelle(WIL48908)  Posted: 08/08/2006 10:00

I am due to have a colposcopy tomorrow and i am very anxious about it, i have severe diskaryosis - cin3. Should i be worried!!!

connie  Posted: 28/08/2006 18:17

i am 32, mother of 3 children, last march was when i had my first & only smear test..after a lot of coaxin from my mother...i just got news today that i have to go for a colposcopy because my test showed that i had CIN3. how serious is this?...should i be worried?...im a bit 'green' on this topic!!! kind regards connie

woody  Posted: 29/08/2006 22:24

hi i had a colposcopy in july and was told to come bak in 6mths for another smear then got a letter saying iv got to go bak in sept they tell me iv not got cancer but i no ive got severe diskaryosis cin 3 im quite worried as i thought the colposcopy was it so am panicking a bit has anyone else been recald

woody  Posted: 02/09/2006 15:09

hi connie i had a colposcopy in july i also have cin3 i am 35 and have 2 children the colposcopy is not as bad as i thought it would be you are not in pain when you have it done because if they are going to take a tissue sample the wil numd you first that doesnt hurt but it is the stangest sensation i have ever felt but they need to sort it the whole appointment for me took about half an hour but i have been recalled again for september i dont know what they will do then.good luck

anxious  Posted: 08/09/2006 09:02

Hi, I had a smear test last week. my last one was 8 years ago. i had a miscarriage 6 weeks ago and that prompted me to go for a smear. i am a big worrier and the more i read the worse i get. should i be worried

connie  Posted: 08/09/2006 10:51

hi woody, hope everything goes well for you, can you tell me what is lletz treament?

kathleen(LWF44673)  Posted: 08/09/2006 12:18

Ive had my third cervical smear done in the past twelve months, all with the same results cell changes. I was telephoned by the doctor who took the smear 4 weeks ago telling i had been referred to outpatients in UCHG.I am still waiting for the appointment and i am getting worried as i read about other symptoms which i have such as bleeding from the rectum after bowel movement and pain. I feel that time is important and the sooner i am seen , i can find out exactly what is going on.

woody  Posted: 08/09/2006 18:57

hi connie im not sure what letz treayment is it is probably similar to what i had i had i dle which is a dialhermy loop excision which is where they take a sample of tissue is taken from your cervix once you are numb you dont feel a thing when i go i could be offered the same again o cone biopsy where they knock you out and take a bigger sample or a hysterectomy i have been told my cells are quite high up so i think i just need to be prepared for anything keep me posted how you get on.i find it comforting to know that so many people go through the same thing again good luck

ash  Posted: 12/09/2006 11:11

Hi. Just got my smear result. CIN 3. Worried sick of course. But midwife from coombe just rang me and kind of put my mind at ease. I was worried about waiting 6 weeks for colposcopy appointment but she said it can take years to develop into cancer. Does anyone know if they would ever consider giving you some kind of sedation for the colposcopy. I'm such a wimp!

scooby  Posted: 12/09/2006 12:11

HI, I had this done & the colposcopy is not a problem. To get it removed I had a Lletz Proceedure & I was out cold for that. I dont think I would like to have to do it awake so if you speak to them they may sedate you. Thankfully all was fine when I went back to get all checked out after the lletz.

ash  Posted: 12/09/2006 14:12

thanks scooby. Did you have the lletz on the same day as colposcopy?

scooby  Posted: 12/09/2006 14:42

HI, Yep they did it all in one day & it was no problem. I was back in work the day after. Good Luck with it but try not to worry so much. You'd be surprised how many women have to get this done.

ash  Posted: 13/09/2006 15:30

Hi Scooby. Sorry more questions! When you had the colposcopy were you then offered a general for the lletz or did you request it. Because i dont this everyone gets a general for this. I know I'd like one but just wondering is it standard?

caroline(cdunlea)  Posted: 13/09/2006 16:30

HI, Not sure if it makes a difference but I was private & it was standard for my doctor to give General Anestetics, I have heard of other people getting it done under local. I would ask them & I am sure they will give it to you if you request it. When is your Appt.

ash  Posted: 13/09/2006 16:57

Hi Caroline. Its at the end of October. Have myself in a tizzy about it and if i thought I could just get a general I could relax a bit. Suppose i could ring them, i was just wondering do many people get this option

lou  Posted: 25/09/2006 14:18

Hi, just spoke to a friend this weekend who has said she has severe cin3 I want to be as supportive as I can but I know very little about it... Can anybody tell me what a lletz & colposcopy are?

Debbie  Posted: 13/10/2006 16:07

For anyone worrying about Colposcopy or LETZ, I have had colposcopy which was just like a smear and no pain and just Tuesday this week had LETZ. It was not half as bad as I expected. The procedure only took about 5 minutes in total. Theu used spray to numb the area. I did feel pain but literally only for 10 seconds and its well worth it and not screaming in pain. Now for my question. I was told I could bleed for six weeks but luckily as yet nothing. I was terrrified but it really is nothing to worry about. I actually did not realise this was another test (biopsy). I thought that was it all over and done with but now wondering will they come back with bad news. I am telling myself very unlikely they will come back with bad news and the test just a precaution. Has anyone had bad news from the LETZ sample?

amd  Posted: 07/02/2007 16:06

i am only 18 years old and i was treated for abnormal cells just yesterday, im pretty aware of what its all about as i have done lots of research regarding it, however i dont know how serious it actually is in the long run, is there ne1 with a sucess story out there as my biggest fear is not being able to have kids!!

meggy  Posted: 16/09/2007 14:02

Hi i was told quiet a few months ago i had cin3 cells. I'm 28 with 3 children and have had lots of trouble with everything, with my bowels and really bad abdominal pain feeling sick being tired and major back ache. I also get a lot of thrush like symptoms which i keep treating and have no joy. I am due to be treated for the cells and would like to know if all my symptoms could be to do with this as I am having treatment for these issues and not feeling any better is there anyone that can give me an insite into this as when I recall this has been ongoing now for 5 years and I'm scared thank you and I'm extremely grateful for your comments !!

meggy  Posted: 16/09/2007 14:09

hi its me again i was just woundering i have an appointment for the begining of october for what i was told was treatment for cin3 cells at the colposcopy clinic is this a treatment or is this just another test as i feel like i dont know what treatment i will be having as my letter does not say thanks

meggy  Posted: 16/09/2007 14:13

hi amd i thought i would leave a message to put your mind at ease i have a lot of friends that have had treatment for abnormal cells and sucessfully gone on to have lots of children i hope this puts your mind at ease and good luck with the future hun xx

Melanie  Posted: 15/10/2007 22:50

Hi, To put your mind at ease, in 1998 I was diagnosed with cervical cancer and was devastated. Within 1 week I had a hysterectomy and felt that I just wanted the cancer removed. I have never been better since. I had spent 15 years having smear tests with abnormal results and since I have had the operation I have never felt better. Lots of years of wondering and now bliss!! I promise.

Anonymous   Posted: 29/10/2007 04:22

Hi all. Someone I know suffered from ovarian cancer a few years ago. she had been trying to have children for a few years and when she finally fell pregnant it made her life more happy you could see it in her eyes. the only reason she found out she had cancer was because she was pregnant. once she found out the light in her eyes were gone she thought she was never going to have any kids because they said she either has to have an abortion or go as far along as possible before it is too late to save her life. they said that she might lose the baby but she risked her life just so she could have her. the baby was born at twenty five weeks and survived she is very healthy now though and the baby is now about three years old

kw  Posted: 28/04/2008 21:20

Just had the LLETZ treatment done today, it was so painful. I'm not a wimp and can withstand pain but this was unbearable. I was given an anethestic but it only numbed me slightly, the doctor was at the procedure for about 20 minutes he took tissue samples, i am dreading going back in 6 months time if i have to through that pain again, i'd feel like not turning up!

connie  Posted: 30/04/2008 16:40

KW, its a pity that you felt the pain, i had lletz early december 07, they cut away the cells, to be honest i felt no pain whatsoever, the doc told me to cough & whn i did this..this was whn he cut away, i felt nothing. it did help that i took somting to relax me, as i am very shy at going through procedures like this. my question is & i hope that it will be answered is that any time i have intercourse i bleed afterwards, even though i waited the recommended 6wks, it now 5 months & im still bleeding for days at a time...and my periods are much heavier!!

AB  Posted: 19/05/2008 12:13

Kw, and other ladies in that position, don't consider not turning up for your next appointment BUT meet with your doctor beforehand and discuss pain relief. This is not about being a wimp or anything like that, it is about getting the right pain relief FOR YOU - not for them. Don't be fobbed off with a topical aneasthetic second time round as for some people this is simply not enough. There is no medical reason for you to be in pain and if you have to insist on being admitted and having a general aneasthetic, then INSIST on it.

anne(LUW75328)  Posted: 17/09/2008 09:40

hi.i have had unusual period this month-they are normally very heavy but this month they were not.then a week after i finished i had a bleed a sort of of pink colour.and i feel somethings not quite right,have been having abdominal pain.got a smear booked last one was a year ago where they found slight abnormalities. im terrified.im 37 have 2 children aged 17 and 11

suzz  Posted: 20/09/2009 23:36

HI very worried  had smear test 3 months ago at GPs found some changes sent to the hospital last week, thought i was just having a check up ended up having LLETZ tretment on first vist , i was in shock nothing was explained to me the doctor said i needed the treatment done stright away . i will get tests back in 2 months . anybody with similar case. really worried. im 35 with 4 children

diskodolly  Posted: 01/12/2009 21:04

hi just on the subject of having treatment, i have for the last 2 years had cin 1 and have had 2 colposcopies that have not needed letz. i had my smear in november am due to have a colposcopy again in january, 2 of my friends told me terrifing stories of having it done, one was up in the stirrups for 2 and a half hours and is afraid to go back for a smear even and she's a nurse, so my question is can you get sedation if you request it, i am by no means a baby ive had 5 major operations but i know i would panic if i was having it done, when i asked the nurse about this she just dismissd me and told me its not painful at all. ive been told if it cin 1 again 3rd time they may treat me to get it over and done with. does anyone know of somewhere that offers sedation when having it done there is an old post by a girl caroline who had sedation  so i wonder where she had it. i am presently attending tallagh but would be willing to travel.

Anonymous  Posted: 02/12/2009 12:07

Hi DISKODOLLY, yes you can ABSOLUTELY have sedation if you wish in order to have Lletz. have your referring doctor / gyne put in writing on your referral letter and INSIST on it if you have to. You are the patient it is your right. You could also have it done under general anaesthetic an this should e avaialble at nay hospital - particularly one as big as Tallaght. Regardless of what the nurse THINKS about it it is not her treatment or her cervix.

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