Treatment of abnormal cervical cells
If screening shows that you have abnormal cells in your cervix, the doctor or nurse you see in the colposcopy clinic (colposcopist) may recommend that you have them treated. The aim of treatment is to remove or destroy the abnormal cells in your cervix. However, the first step is to be sent for a colposcopy.
Types of treatment for CIN
The treatment you will be offered depends on how many abnormal cells you have in your cervix and how advanced the changes are. Your colposcopist will advise you on the specific treatment you will require during your colposcopy appointment.
Large loop excision of the transformation zone (LLETZ)
Also known as LEEP or diathermy loop biopsy, this procedure uses a small wire loop and an electrical current to cut away the affected area of tissue and seal the wound at the same time. The advantage of this treatment is that the cells are removed rather than destroyed, so the tissue can be sent for further tests to confirm the extent of the cell changes and make sure the area of your cervix that contains the cells has been removed. To read more about LLETZ click here to download an information sheet.
Cone biopsy
A cone of tissue is cut away from your cervix to remove all the abnormal cells. It allows the doctor to remove a slightly larger part of the cervix than with a loop (LLETZ) biopsy. A cone biopsy allows for the cells at the edges of the specimen to be seen clearly through a microscope ensuring that all of the biopsy can be examined be histopathologist.
A cone biopsy is usually carried out under a general anaesthetic (very small cone biopsies can be performed under local anaesthetic). A vaginal pack will sometimes be put in place in theatre while you are under anaesthetic. This is like a long bandage that puts pressure on the biopsy site and so helps stop any bleeding (a bit like putting pressure on a cut to stop it bleeding). This is removed before you go home. It is advisable to have some painkillers at home (such as you would take for period pains) as some women experience a deep ache and/or tenderness in their pelvis. It is not unusual to feel tired for a few days or even a week or so following a general anaesthetic.
Cryotherapy
A cold probe is used to freeze away the abnormal cells in the cervix.
Laser treatments
This is sometimes called laser ablation. Lasers pinpoint and destroy abnormal cells in the cervix. If necessary, a laser can also be used to remove a small piece of the cervix itself.
Cold coagulation
This procedure involves applying a hot probe to the cervix, which burns away and removes the abnormal cells.
A local anaesthetic (where the area is numbed but you are still awake) is given before any of the treatments described above. A cone biopsy may require a general anaesthetic (where you are asleep).
Summary
Your colposcopist should provide you with additional information on the treatment that you will be having. Remember to ask if you have questions.
Bleeding (at the time of treatment or in the two to three weeks afterwards) or infection (more often in the two weeks after) is not uncommon after treatment for abnormal cells of the cervix. Always contact your GP or colposcopist if you are experiencing any problems after treatment. There is no reason to put up with discomfort that can easily be treated.
Generally, a single, straightforward localised treatment to the cervix is very unlikely to adversely affect a woman's fertility or her ability to have a normal pregnancy.
Four to six months after your treatment, you will be asked to have another colposcopy and screening and a further follow up may be advised once the results of colposcopy or/and screening are received. Occasionally CIN or CGIN are not all removed at the first treatment. This is because the treatment is a balance between removing all the abnormal cells, without removing too much normal cervix. Put simply - it is always easier to take a bit more away in the future, than it is too stick a bit back on! If there are still abnormal cells left at follow up, then a further treatment can be done. At the follow up visit, they will repeat a cervical screening to see if it has gone back to normal. This is why the appointment is for six months time. There is also a small chance that CIN or CGIN may come back in the future. It is therefore really important to keep going for your cervical screening, so that you can have further treatment if necessary.
Remember if you have been found positive for abnormal cervical cells you do not have cancer. Treatment for abnormal cervical cells is usually very effective and it is estimated that early detection and treatment can prevent up to 75% of cervical cancers from developing.
