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Cervical Cancer Singapore

Cervical cancer is one of the most treatable cancers, especially when detected early. Gynaecologists can develop effective treatment plans based on factors such as the stage of the cancer, the patient's overall health, and individual preferences, such as preserving fertility.

Wide Range of Preventive & Curative Treatments for Cervical Cancer

Treatment Depends on the Stage of Cervical Cancer

  • Pre-Cancer: This usually involves the removal of abnormal cells from the cervical lining through local ablative or excision procedures; which prevents the progression of pre-cancerous cells into cancerous cells.
    • Cone Biopsy (Conization), LEEP/LLETZ, Laser Surgery, Thermal Coagulation
  • Early Stage Cancer: This usually involves the removal of the uterus (hysterectomy), trachelectomy or radiation therapy, sometimes with chemotherapy.
  • Late Stage Cancer: This usually involves concurrent radiotherapy and chemotherapy; and in cases of recurrent cervical cancer, a pelvic exenteration may be recommended.
Treatment Depends on the Stage of Cervical Cancer

Cone Biopsy (Conization)

This is generally regarded as a more extensive form of a typical cervical biopsy—a cone-shaped wedge of abnormal cervical tissue will be removed from the cervix and sent for examination. A cone biopsy is usually used to remove abnormal tissue high in the cervical canal. In most cases, this procedure is performed in the clinic as an outpatient day-surgery procedure under local anaesthesia. It is rarely necessary to have a general anaesthesia. A cone biopsy can be used for both diagnostic and treatment purposes, as abnormal cervical tissue is removed.

  • When is a cone biopsy done?
    • When there are pre-cancerous cells found on the cervix, repeated abnormal Pap results, or when the full extent of the affected area cannot be seen during a colposcopy (the canal leading from the vagina through the cervix and into the uterus).
  • How is it performed?
    • It can be performed in 3 main ways (with anaesthesia):
      • With a heated electrical loop wire (LEEP or LLETZ)
      • With a surgical knife
      • With a laser
    • A special solution (Monsel’s solution) will be applied afterwards to reduce bleeding; and other pain relief methods will be prescribed.
LEEP/LLETZ

LEEP/LLETZ

LEEP (Loop Electrosurgical Excision Procedure)—also known as LLETZ (Large Loop Excision of the Transformation Zone)—is a method of removing abnormal tissue growths in the cervix called cervical intraepithelial neoplasia (CIN). With local anaesthetic, an electrically charged wire loop is used to remove the abnormal cells, and bleeding is stopped with electrocautery and/or the application of Monsel’s solution. LEEP/LLETZ is also one of the most commonly used methods to treat high-grade cervical dysplasia (CIN2 and CIN3) discovered during a colposcopic examination.

LEEP/LLETZ
  • Laser Surgery

    A laser can be used to treat pre-cancerous and other conditions in the cervix. Due to its precision, this method is usually used during the pre-cancerous and early stages of cervical cancer, involving a focused carbon dioxide laser beam to burn off or cut off the abnormal cells in the cervix.

    In many cases of precancer (CIN 2-3), the disease only involves the outer part of the cervix and so it may not be necessary to excise a large part of the cervix. Using a laser to destroy the abnormal cells can effectively treat the CIN and yet preserved the function of the cervix for future pregnancy.

    Numbing medicine will be applied to the cervix beforehand so you don’t have to worry about pain. The laser beam also causes little to no damage to healthy cells, thus recovery is fast.

  • Thermal Coagulation

    This is another procedure that can be used to destroy pre-cancer cells on the cervix. It uses a heated probe applied to the cervix for about 1-2 minutes. No anaesthesia is required.

    This is usually used during the pre-cancerous stage, where abnormal cells have only been found on the surface of the cervix.

  • Hysterectomy

    This is the usual treatment for early-stage cervical cancer. In very early-stage cancer, a simple hysterectomy that involves removing the womb and cervix, and occasionally the fallopian tubes and ovaries, may suffice.

    In advanced stage 1 and some early stage 2 cervical cancer, a radical hysterectomy involves the removal of the cervix, womb, top of the vagina, surrounding tissue, lymph nodes, fallopian tubes, and sometimes the ovaries.

  • Trachelectomy

    This is usually only suitable if the cancer is diagnosed at a very early stage and offered to women who still want to have children in the future and want their wombs preserved.

    During the procedure, the cervix and upper part of the vagina are removed, leaving the womb intact, which will then be reattached to the lower part of the vagina.

    It must be noted, however, that the surgeon cannot guarantee that you will definitely be able to get pregnant in the future, and even if you do, you will have to deliver via caesarean section.

  • Pelvic Exenteration

    This is a major procedure that is only recommended when the patient suffers from recurrent cervical cancer; and if the cancer has returned, but has not spread past the pelvis.

    This procedure involves the possible removal of the vagina, bladder, rectum, and the cancer itself. Stomas are then created to allow you to pass urine and bowels out of your body into colostomy bags.

  • Radiotherapy

    This may be used on its own or together with surgery recommended for early-stage cervical cancer. In advanced-stage cervical cancer, it may be used concurrently with chemotherapy.

    High-energy waves may be beamed directly into the pelvis in order to destroy cancerous cells; or a radioactive implant may be placed next to the tumour through the vagina.

    Lasting an average of 5 to 8 weeks, radiotherapy aims to destroy cancer cells, though it inevitably also affects some nearby healthy cells. These side effects may be temporary or permanent, and it is best to seek your doctor’s advice on your options.

  • Chemotherapy

    Chemotherapy can either be combined with radiotherapy or used on its own. It is usually administered through an intravenous drip to destroy cancer cells. However, as with radiotherapy, chemotherapy often inevitably affects some neighbouring healthy cells; thus, side effects are common. However, upon the completion of chemotherapy, most side effects should subside.

Our Team Will Walk You Through This Journey

Whether it is pre-cancer, early-stage cancer, or advanced-stage cancer, our medical team—comprising a gynaecologist and dedicated nurses—will work closely with you to provide personalised treatment and rehabilitation plan and emotional support for you from the moment you enter our care until you are discharged with a new lease on life.

Pain Management in Cervical Cancer Patients

Most cervical cancer patients will experience pain at some point, either as a result of the disease itself or due to the treatments they undergo. Common types of pain associated with cervical cancer include:

  • Pelvic Pain – Pressure or heaviness in the lower abdomen or pelvic area. The pain may persist continuously or occur sporadically.
  • Lower Back Pain – Pelvic pain that extends to the lower back, varying in intensity from mild to severe.
  • Leg Pain – This pain develops when the tumour presses on or spreads to sensitive nerves in the pelvic region that could lead to pain radiating down the legs.
  • Pain During Sexual Intercourse – Also known as dyspareunia, this pain or discomfort occurs when the tumour infiltrates the reproductive organs and surrounding tissues.
  • Pain During Urination – This pain occurs when the tumour has spread to nearby tissues or organs, such as the bladder or urinary tract.

Fortunately, there are various medications available that can control and alleviate cervical cancer pain. These include:

  • Acetaminophen – Also known as paracetamol, this provides relief from mild cervical cancer pain.
  • NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) – These medications, including aspirin and ibuprofen, help lower inflammation along with mild to moderate pain.
  • Opioids – These prescription medications are used to manage moderate to severe pain. They can be taken either on their own or in combination with non-opioid drugs.

Managing Side Effects of Cervical Cancer Treatments

Though necessary, cervical cancer treatments can come with side effects. Here are some common ones and how to manage them:

  • Fatigue – Many cancer patients feel persistently tired or weak. To manage this, rest regularly and try light activities like short walks.
  • Nausea and Vomiting – Chemotherapy and radiation can cause nausea, which can be alleviated with anti-nausea medications and dietary changes.
  • Skin Changes – Certain treatments, such as radiation therapy, may cause skin irritation, dryness, and discolouration. Use prescribed creams and protect the area from the sun.
  • Bowel and Bladder Changes – Treatment may cause diarrhoea, constipation, or incontinence. Follow dietary advice, medications, and pelvic floor exercises as needed.
  • Changes in Menstruation Cycle – Irregular periods or cessation of menstruation may occur. Your gynaecologist will advise and manage your situation accordingly.
What Causes Cervical Cancer?

Our Colposcopy Specialist,

Dr Quek Swee Chong

Consultant Obstetrician, Gynaecologist and Colposcopist
MBBS (Dublin), MRCOG (UK), FAMS (Singapore)

For over 20 years, Dr Quek Swee Chong has been providing comprehensive, evidence-based treatments for cervical cancer in Singapore, including colposcopy, hysterectomy, and laser surgery, to effectively address the needs of his patients.

He has held numerous leadership roles as well as research contributions in the field of cervical cancer, both locally and internationally. As a dedicated cervical cancer specialist in Singapore, he combines his extensive expertise with a compassionate approach to deliver optimal outcomes and improved quality of life for those under his care.

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