PATIENT INFORMATION. about CERVICAL CANCER

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Eunice Cannon
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1 PATIENT INFORMATION about CERVICAL CANCER

What is Cervical Cancer? The cervix is the lower part of the uterus (womb) connecting the body of the uterus to the vagina (birth canal). Cancer of the cervix can take many years to develop.

These pre-cancerous phases cause changes in the cervix known as Cervical Intraepithelial Neoplasia (CIN) and can develop to cancer if left untreated. Who is at risk?

2 What is Cervical Cancer? The cervix is the lower part of the uterus (womb) connecting the body of the uterus to the vagina (birth canal). Cancer of the cervix can take many years to develop. Before cancer occurs, the cervix undergoes pre-cancerous phases. These pre-cancerous phases cause changes in the cervix known as Cervical Intraepithelial Neoplasia (CIN) and can develop to cancer if left untreated. Who is at risk? Persistent Human Papillomavirus (HPV) infection Multiple sexual partners Early onset of sexual intercourse Usage of oral contraceptives Smoking History of sexually transmitted disease Weakened immune system e.g. HIV infection People who think they may be at risk should discuss this with their doctor. What are the signs and symptoms? Early cervical cancer may not show any noticeable signs or symptoms. Below are some symptoms of cervical cancer although other conditions may also cause those symptoms: Vaginal bleeding (Between periods or after sexual intercourse) Blood-stained vaginal discharge Pain during sexual intercourse A doctor should be consulted if the symptoms above occur.

3 What can you do to prevent Cervical Cancer? There are two ways to prevent cervical cancer: Go for regular Pap smear test Get vaccinated against the Human Papillomavirus (HPV) Uterus Brush Cervix Vagina Rectum A pap smear test is a simple procedure where cells are collected from the surface of the cervix and then sent to a laboratory to detect any abnormality. All sexually active women between 25 and 69 years old are advised to have a pap smear test regularly (every 3 years on average). If you have an abnormal pap smear, the doctor may do any of the following: Colposcopy The doctor uses a colposcope (a lighted, magnifying instrument) to check the vagina and cervix for abnormal areas. It is not inserted into the vagina. Cone Biopsy If the abnormal area cannot be seen properly with the colposcope, a cone biopsy may be carried out. The doctor will remove a coneshaped sample of tissue for the pathologist to examine under a microscope for any abnormal cells. This procedure is often done under a general anaesthetic. Cervical cancer is caused by a common virus called the Human Papillomavirus (HPV). Being vaccinated against HPV is recommended for all young women aged 10 to 25. Ideally the vaccine should be given before the first sexual contact. Currently available HPV vaccines are given as three injections over a six-month period.

How is Cervical Cancer diagnosed? If you present with any of the symptoms mentioned, the doctor will perform a pelvic examination and a biopsy of the cervix may be taken to look for cancer cells.

Factors other than the stage of the cancer that might have an impact on your treatment decision include your age, your overall health, and your own preferences.

4 How is Cervical Cancer diagnosed? If you present with any of the symptoms mentioned, the doctor will perform a pelvic examination and a biopsy of the cervix may be taken to look for cancer cells. What are the treatment options? There are different treatments available for cervical cancer depending on the stage of cervical cancer. Factors other than the stage of the cancer that might have an impact on your treatment decision include your age, your overall health, and your own preferences. The three main types of treatment include surgery, radiation and chemotherapy. Surgery Surgery is usually the first treatment for cancer of the cervix in the early stages (where cancer is confined to the cervix). The most common treatment is hysterectomy to remove the uterus (womb) and cervix. The neighbouring reproductive organs such as the ovaries and fallopian tubes may be removed. However this depends on other factors such as your age. Some patients with the earliest stage cervical cancers can be treated with cervical conisation (cone biopsy) or simple hysterectomy alone. Radiation Therapy Radiation therapy is a cancer treatment that uses high energy x-rays or other types of radiation to kill cancer cells or to keep them from growing. There are two types of radiation therapy external and internal. The way the radiation therapy is given depends on the type and stage of the cancer being treated. Radiation can be used after surgery for early stage cervical cancer. It is also the main treatment for later stage (stage 2 and above) cancers. For cervical cancer, when radiation is the main treatment, it is often given along with low doses of chemotherapy for it to work better. Chemotherapy Chemotherapy is the use of drugs to help kill cancer cells and shrink the size of the tumour. It is often combined with radiation therapy. Usually the drugs are given into a vein. Once the drugs enter the bloodstream, they spread throughout the body. In cervical cancer, chemotherapy is also given to women with advanced or recurrent cancer.

5 Support Group The Gyn Cancer TEAL Support Group was established in 2008 by a group of passionate nurses and doctors to provide peer support among women who are diagnosed with ovarian and other gynaecologic cancers at the National University Cancer Institute, Singapore (NCIS) located at the National University Hospital (NUH). TEAL is our awareness colour and also represents women who are Totally Empowered and Actively Living! Activities are conducted quarterly which include educational talks, seminars, workshops, excursions and year end parties. Membership is free. For more information, please call CancerLine Nurse at: (Mon Fri: 8.30am 5.30pm) or CancerLineNurse@nuhs.edu.sg. About NCIS The National University Cancer Institute, Singapore (NCIS) is the only comprehensive public cancer centre in Singapore treating both paediatric and adult cancers in one facility. Located at the National University Hospital (NUH), NCIS offers a broad spectrum of cancer care with expertise in prevention, screening, diagnosis, treatment, rehabilitation and palliative care. Contact Information National University Cancer Institute, Singapore (NCIS) Cancer Centres Kent Ridge Wing, Level 3 and 4 Radiation Therapy Centre (RTC) Kent Ridge Wing, via Linkway on Level 4 Opening Hours: 8:30am 5:30pm (Mon Fri: except on Public Holidays) For appointments, please contact Tel: (65) CancerApptLine@nuhs.edu.sg For International Patients and Visitors The International Patient Liaison Centre (IPLC) is a one-stop centre to support all the medical needs of our foreign patients. Tel: (65) (24-hour Helpline) Fax: (65) Website: For all other general enquiries, please contact National University Cancer Institute, Singapore (NCIS) 1E Kent Ridge Road, NUHS Tower Block, Level 7, Singapore ncis@nuhs.edu.sg Website:

Nearest MRT Station: Kent Ridge Station (Circle Line) Commuters can alight at the Kent Ridge Station right at the doorstep of the

For more information on specific directions to NCIS Clinics, log on to www.ncis.com.sg.

sg Information in this brochure is given as a guide only and does not replace medical advice from your doctor.

6 Nearest MRT Station: Kent Ridge Station (Circle Line) Commuters can alight at the Kent Ridge Station right at the doorstep of the NUH Main Building. Please exit the station via Exit A. For more information on directions to NUH, log on to For more information on specific directions to NCIS Clinics, log on to National University Hospital 5 Lower Kent Ridge Road, Singapore Tel: (65) Fax: (65) Website: Information in this brochure is given as a guide only and does not replace medical advice from your doctor. Please seek advice from your doctor if you have questions related to the surgery, your health or medical condition. Information is correct at time of printing (Mar 2012) and subject to revision without notice.

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