Cervical Cancer Detection
Although many research institutions are investigating new methods for detecting abnormal cells on the cervix, the Pap smear remains the best known way to detect cervical cancer and dysplasia. Newer Pap smears, known as the Thin Prep, are able to better localize the abnormal cells and may test for HR-HPV types.
Screening and Diagnosis
If you have an abnormal Pap smear, your doctor may suggest a colposcopy. A colposcopy is a test used to examine the cells of the cervix by directly viewing them with the aid of a microscope. This allows for better distinction between abnormal areas of the cervix and normal reactive processes. A biopsy may be taken from an area of the cervix that appears abnormal.
If a biopsy is taken, a small amount of tissue will be sent to a pathologist to rule out cancer. This biopsy can be performed painlessly in Dr. Ivy’s office. Only a biopsy can prove or disprove the existence of cancer.
Treatment of Dysplasia
Depending on the degree of abnormality (dysplasia), Dr. Ivy will recommend certain treatments. These include:
Cryotherapy: This procedure involves using an extremely cold applicator that is placed directly on the area that contains the dysplasia. This is routinely used to treat early abnormalities, but can be used safely in more advanced cases as well and is typically performed in Dr. Ivy’s office.
LEEP (Loop Electro-Surgical Excision Procedure): The LEEP is performed using a small heated wire. It removes a small, specific amount of tissue from the cervix. This procedure is often curative for greater degrees of dysplasia. This is routinely performed in Dr. Ivy’s office and does not require anesthesia.
Cold Knife Cone Biopsy: During this procedure, a cylinder-shaped sample of the cervix is removed in the operating room. This is similar to a LEEP, but requires use of anesthesia and can also be curative for even the very earliest stage of cervical cancers.
Cystoscopy and Proctoscopy: These are procedures that look into the bladder and rectum. You may undergo such a procedure if Dr. Ivy suspects your cancer is locally advanced. These procedures are routinely performed in the operating room.
Doctors today have access to a multitude of imaging technologies. Each imaging modality has its strengths and weaknesses. They are most often employed to learn more about the extent of disease and for treatment planning. Imaging techniques used by Dr. Ivy to determine the course of treatment include:
Chest X-ray: This is a classical imaging technique. A chest x-ray looks for cancer within the lungs.
Computed Tomography (CT) scan: This test is commonly used to create a whole body image that looks for tumor location and spread. A CT scan is also frequently used in treatment planning for radiation therapy in advanced stages of cervical cancer.
Magnetic Resonance Imaging (MRI): An MRI is best used to determine the local advancement of a tumor. MRIs often provide the doctor with similar information to a CT scan.
Positron Emission Tomography (PET) scan: A PET scan is a new technique that uses radiolabeled sugars to identify tumor cells within the body. When a PET scan is coupled with a CT scan, it provides your surgeon with a very accurate picture of tumor size, location and spread.