Treatment for abnormal cervical cells
Treating abnormal cells after cervical screening
If cervical screening finds abnormal cells on the cervix, you may be offered treatment.
Abnormal cells such as CIN usually affect a small area where the outer cervix meets the cervical canal. Most treatments aim to remove or destroy only this small area of abnormal cells. This means nearby healthy areas of cervix are not likely to be damaged.
Types of treatment
There are different types of treatment. You usually only need one treatment to remove the abnormal cells completely. Your doctor will explain what type of treatment they suggest for you.
This may depend on the treatments your local hospital can provide. It may also depend on the type of abnormal cells and the area of the cervix that is affected.
Treatments that remove the abnormal cells
Treatments that remove the abnormal area include:
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LLETZ
A large loop excision of the transformation zone (LLETZ) removes abnormal cells from the cervix using a thin loop-shaped tool.
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Cone biopsy
A cone biopsy is a small operation to remove an area of the cervix.
After these treatments, the removed area of tissue is sent to a laboratory. It is checked to confirm the type of abnormal cell changes.
Sometimes, a type of surgery called a hysterectomy is used to remove the whole cervix and womb. This is not a common treatment for abnormal cells. Your doctor will explain if they think it is right for you.
Treatments that destroy the abnormal cells
Treatments that destroy the cells in the abnormal area include:
- laser therapy
- cold coagulation
- cryotherapy.
Laser therapy
Cold coagulation
Cryotherapy
A small probe is used to freeze the abnormal cells on the cervix. You may be given a local anaesthetic, but often this is not needed.
What to expect during treatment
Getting ready for any of these treatments is similar to having a colposcopy. When you are ready, you undress from the waist down. You then lie on your back on an examination couch. Some clinics have couches with foot or leg supports that you can rest your legs up on. You will be asked to lie with your knees bent and apart.
The doctor or nurse gently puts an instrument called a speculum into the vagina. This holds the vagina open so that they can see the cervix. It should not hurt but sometimes it can feel uncomfortable.
You may find this type of treatment upsetting or embarrassing. Your healthcare team will try to help. Let them know how you are feeling and tell them if you have any questions or worries. If you want to bring someone with you for support during the treatment, this can usually be arranged.
After your treatment
If you have a general anaesthetic, you will stay in hospital for the day or overnight after your treatment. If you have a local anaesthetic, you will be able to go home the same day.
You may feel fine after your treatment. But you may feel slightly unwell for a few hours after the local anaesthetic. It is a good idea to have the day off work, in case you need to go home and rest. You may want to arrange someone to help you home.
You may have some period-like pains for a few hours after the treatment. Some bleeding or discharge after treatment is normal. This usually stops within 4 weeks, but may last up to 6 weeks. The bleeding should not be heavier than a moderate period and should get steadily lighter.
You should contact your GP or the clinic where you had your treatment if:
- the bleeding gets heavier – for example, completely soaking a pad within 2 hours
- the discharge smells unpleasant
- you have a fever or temperature
- you have severe pain
- you are worried for another reason.
It will take a few weeks for the cervix to heal. Your doctor or nurse will probably advise you not to have penetrative sex for at least 4 weeks after your treatment. This allows the cervix to heal properly. You may also be advised not to use tampons or swim for 4 weeks, and to wash or shower rather than have a bath.
Your treatment should not affect your ability to enjoy sex after the cervix has healed.
Fertility and pregnancy after treatment
Your treatment should not affect your ability to get pregnant.
Very rarely, the cervix can become tightly closed after treatment. This is called stenosis. It may make it harder for sperm to enter the womb and so can affect your chances of getting pregnant naturally. Tell your doctor if your periods stop after treatment or you have worse period pain than usual.
Removing some of the cervix may also make it slightly weaker. This depends on how much needs to be removed. You may be more likely to give birth early if the cervix is weakened. Some women may be referred to a local specialist maternity service for closer monitoring during pregnancy. Your doctor can tell you more about this.
About our information
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References
Below is a sample of the sources used in our cervical cancer, cervical screening and CIN information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
GOV.UK. Cervical screening: programme overview. Updated 18 November 2019. Available from www.gov.uk/guidance/cervical-screening-programme-overview (accessed March 2020).
GOV.UK. Colposcopic diagnosis, treatment and follow up. Updated 5 February 2020. Available from www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management/3-colposcopic-diagnosis-treatment-and-follow-up (accessed April 2020).
Marth C, Landoni F, Mahner S, et al. Cervical cancer: ESMO clinical practice guidelines. Annals of Oncology, 2017; 28, suppl 4, iv72–iv83. Available from www.esmo.org/guidelines/gynaecological-cancers/cervical-cancer (accessed October 2020).
Reed N, Balega J, Barwick T, et al. British Gynaecological Cancer Society (BGCS) cervical cancer guidelines: recommendations for practice. 2020. Available from www.bgcs.org.uk/wp-content/uploads/2020/05/FINAL-Cx-Ca-Version-for-submission.pdf (accessed October 2020).
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.
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