If you have an abnormal Pap test and other symptoms of cervical cancer, your gynecologist will want to find out more about your medical history and your family’s. They’ll likely run more tests to find out if you have cancer cells in your cervix, and check your lymph nodes to see if cancer has spread.
Some of the tests your gynecologist might use to check for cancer cells include:
Colposcopy. During this test, your doctor will use an instrument called a colposcope, which looks a lot like a microscope, to get an up close look at your cervix. You’ll lie on an exam table and they’ll use a speculum to keep your vagina open. Next they’ll rub a solution of acetic acid (similar to vinegar) on your cervix. This liquid can help them see any abnormal cells. It might burn a little.
Cervical biopsies. Your doctor might also remove a small piece of tissue during your colposcopy to check for cancer. This is known as a colposcopic biopsy. Other types of biopsies include:
- Endocervical curettage uses a thin instrument called a curette to take a sample of cells from the inside of your cervix.
- Loop electro-surgical excision procedure (LEEP) uses a thin wire heated by an electric current to remove cells.
- Punch biopsy uses a tool called biopsy forceps to remove tissue.
Cone biopsy. is another, more invasive, way for your doctor to take a tissue sample, so it’s usually performed in a hospital. It can also treat some early-stage cervical cancers. Your doctor removes a cone-shaped piece of tissue from your cervix with either a LEEP, scalpel or laser.
Cells taken from your cervix from any type of biopsy will be sent to a lab and checked under a microscope for signs of cancer. You might have mild cramps and bleeding after these procedures.
• What If it’s Cancer?
If your biopsy shows you have cervical cancer, the next step is to see if it has spread, and where. Your doctor might order one or more of these tests:
Cystoscopy and proctoscopy. These tests both use a lighted tube to see if the cancer has spread into your bladder and rectum.
Chest X-ray. A chest X-ray will look to see if cancer has spread to your lungs.
Positron emission tomography (PET). Your doctor might order a PET scan if they think your cancer has spread but isn’t sure where. It uses a type of radioactive sugar that cancer cells absorb. A special camera can spot the cells that have absorbed the sugar.
• What Does ‘Stage’ Mean?
After all of the tests results are back, your doctor will use them to determine if and how far your cancer has spread, which will show them what stage it is in. Staging classifies the cancer by how much is in your body and where it has spread when it’s diagnosed. Knowing the stage can help your medical team plan the right treatment for you.
Stages of cervical cancer are:
Stage 0. Cancer is only on the surface of the cervix and has not grown into deeper tissues.
Stage I. The cancer has grown into the cervix and may be growing into the body of the uterus. It may also have spread to nearby lymph nodes but has not spread distantly.
Stage II. The cancer has spread outside of the cervix and uterus. It may have reached the upper part of the vagina. It may involve local lymph nodes but has not spread to distant sites.
Stage III. The cancer has spread to the lower part of the vagina or the walls of the pelvis. It may or may not involve the nearby lymph nodes but has not spread to distant sites.
Stage IV. This is the most advanced stage. The cancer has spread to other parts of the body, like the bladder, rectum, lungs, liver, or distant lymph nodes.
Your stage of a cancer won’t be changed if your cancer gets worse or comes back. Your doctor will always refer to it by the stage it was when it was diagnosed.
• What’s a Colposcopy?
A colposcopy is a simple procedure that lets your doctor get a good look at your cervix. The exam takes 5 to 10 minutes, and is a lot like getting a Pap smear. One of the biggest differences is your doctor uses a special magnifying instrument called a colposcope.
You usually get a colposcopy if you had some sort of abnormal results on your Pap test so your doctor can further diagnose any problems.
• How Is It Done?
Your doctor will have you lie on an exam table, and they’ll use a speculum to keep your vagina open. Next, they’ll dab a cotton swab in a vinegar-like solution and use it to wipe your cervix and vagina. It may burn a little, but it’ll help them see any cells that don’t look normal.
Then, they’ll use the colposcope to examine your cervix and vulva.
• Do I Need a Cervical Biopsy?
Only if your doctor finds something that doesn’t look normal during your colposcopy. If they find several areas that don’t look right, they’ll biopsy those, too.
Your doctor will do the biopsy right after your colposcopy. They’ll use a sharp tool to take a sample of tissue from the abnormal area. It’ll be uncomfortable — you’ll feel pressure or mild cramps. But it shouldn’t hurt.
• What Do the Results Show?
The biopsy samples will be sent off for testing. The results will give your doctor an idea of what steps they should take next.
If they’re able to remove all the abnormal cells during the biopsy, you may not need more treatment.
They may also suggest one of the following options to remove the cells and prevent cervical cancer:
Cone biopsy. Your doctor cuts a cone-shaped piece of tissue from your cervix to remove any precancerous cells. The abnormal ce;lls are typically precancerous or cancerous.
Cryotherapy. Your doctor uses liquid gas to freeze abnormal cells from your cervix.
Loop Electrosurgical Excision Procedure (LEEP). Your doctor removes abnormal cells with a wire loop that carries an electric current.
• What’s the Recovery Time?
With both the colposcopy and the cervical biopsy, you should be able to go back to work or school right away. But don’t put anything inside your vagina — tampons, creams, etc. — and don’t have intercourse for at least 48 hours after your biopsy.