Cervical Care Approach

​If you have been having regular pap smear tests, it does not mean that you have cancer if you get an “abnormal” pap smear test result. The pap smear is known as a screening test which means that it is a “positive” or “abnormal” result just means that there needs to be confirmation of whether disease is present or not. This confirmation in cervical cancer screening comes in the form of a colposcopic examination, often known simply as “colpo” or “colposcopy”. At the NCIS, our Cervical Cancer Care Team specialists are all well-equipped with a wealth of experience in diagnosing cervical cancer and pre-cancer through careful colposcopic examination and biopsy.

A colposcopic examination is exactly like having a pap smear test done except that cervix is examined under a strong light through a magnified scope from outside the body. This allows the cervix to be examined for areas that may appear to be the source of the abnormal cells that were picked up on the pap smear. If there is an area that is suspicious for pre-cancerous or cancerous change, a small portion of these abnormal areas on the cervix may be collected in a procedure known as a punch biopsy. If you do undergo this procedure, you may expect some momentary discomfort and vaginal spotting for a day or so after the procedure. The tissue that is collected is important and sent to the lab for examination under a microscope to determine the extent of pre-cancerous change.

If the biopsy result shows that there is indeed an area of pre-cancer on the cervix, your specialist may recommend a simple office procedure to arrest or stop the pre-cancerous change from worsening and eventually becoming cancer. These simple office procedures can either be ablative, which means that abnormal areas on the cervix are destroyed, or excision, which means that the abnormal areas are separated from the normal cervix by fine cutting or excision. Office procedures are simple, effective and do not require anesthesia or hospitalization.

Here are some commonly performed office procedures at the NCIS for cervical pre-cancer, and what to expect after each procedure.

This procedure is actually hot. A special instrument known as a cold coagulator is placed in contact with the abnormal area of the cervix and delivers heat to the abnormal area coagulating any abnormal tissue which then slowly sloughs off over the next few days and is eventually replaced by healthy tissue. Women who have cold coagulation can expect some crampy discomfort during the procedure which lasts about 2 minutes. There may be watery or mucoid discharge over the next 7-10 days accompanied by some spotting or bleeding as the cervix heals.

The Loop Electro-Excision Procedure (LEEP) is a procedure where a high-energy loop or wire device is used to cleanly and bloodlessly remove a portion of the cervix that is diseased or unhealthy, leaving behind only healthy tissue. This is a very effective way to treat pre-cancer of the cervix and also provide tissue that can be further analysed by an NCIS specialist pathologist in the lab to better understand exactly what kind of pre-cancerous change in taking place in the cervix. The entire procedure takes 3-5 minutes and most of the women who undergo the procedure at the NCIS report little or no pain during the procedure.

Some spotting and light menses-like bleeding usually starts 2-3 days after the procedure and is part of the normal healing process after a LEEP. Women who have the LEEP at the NCIS can also expect some brown or black discharge after the procedure as a solution known as Monsell's solution is typically applied to the cervix to prevent bleeding and promote healing after the procedure.

A carbon-dioxide laser produces enough energy to completely vaporize any pre-cancerous changes on the cervix. Laser vaporization is a very effective way to completely treat pre-cancerous changes of the cervix. The laser allows precise treatment of the pre-cancerous areas of the cervix without affecting the normal tissue of the cervix. Laser ablation typically takes about 3-5 minutes to complete and is a procedure offered at the NCIS that most women are able to undergo without too much discomfort.

The women we care for may have ovarian cancer, but the disease is only one part of a whole person who is a living, breathing and feeling entity. At the NCIS, we believe in not only treating cancer but making people whole after their time with us, and this starts with having a team of dedicated healthcare professionals support each and every aspect of the whole person as we journey with our patients through diagnosis, treatment, recovery and beyond.

This team of emotional health specialists are an important component of the ovarian cancer care solution. Quite simply, a fit emotional state ensures a healthy immune system that fights cancer more effectively. Effective emotional assessment and support is a complex, constantly evolving process and something the Women’s Emotional Health team does exceptionally well, supporting a growing community of healthy, happy ovarian cancer survivors, one woman at a time. Our patients are supported through a combination of CARE therapy, hypnotherapy and medical therapeutics. At the NCIS, we are proud of the important work that our WEHS team does, and our cancer survivors agree!

Lymphoedema is a complex and potentially debilitating condition that develops as a result of cancer surgery and therapy in some patients. At the NCIS, we believe that the best treatment is prevention! This belief is embodied in the creation of the Total Lymphoedema Clinic (TLC) to support all the women living with cancer that we care for at the NCIS who may be at risk for lymphoedema. The team at the TLC consists of surgeons, physicians, physiotherapists, nurses and occupational therapists who are all committed to one thing, helping our patients come out of ovarian cancer care WHOLE and functional with sub-specialty professionalism and a little Tender Loving Care.

At the NCIS, we love our nurses for one very simple reason. Our Advanced Practice and Specialty nurses translate all the expertise available at NUH in to the care that our patients receive. The women living with ovarian cancer that walk in our doors walk out whole because of the dedication and professionalism that these cancer professionals show all day, every day. Effective cancer care is an incredibly complex process which our Advanced Practice and Specialty nursing team has the training, education and expertise to understand, coordinate and help deliver to the women receiving care for ovarian cancer at the NCIS. It’s no wonder that the NCIS cancer survivors hug a cancer specialty nurse wherever they meet one!

This team of dedicated professionals is behind the NCIS' success in treating advanced stage cervical cancer. The use of ionizing radiation in the battle against cervical cancer is constantly evolving. The treatments offered to patients today would have been unimaginable till quite recently. An important example of this evolution in radiation therapy is the use of High-Dose Rate or HDR brachytherapy for cervical cancer. Treatments that traditionally required patients to be bed bound for two days can now be completed in less than half an hour. What this means for the women we care for at the NCIS is much less time in hospital, not allowing cervical cancer to interrupt the business of living full productive lives.