What are the symptoms of cervical cancer?
Most women who have abnormal cell changes feel well and have no symptoms at all. Irregular bleeding, discomfort or bleeding after sex, unusual vaginal discharge, pelvic pain, excessive tiredness, swollen legs or backache may be signs of cervical cancer. These symptoms can also be due to other more common problems, but you should still have them checked by your doctor.

What tests are available?
There are a number of tests used to detect any unusual cell changes or cervical cancer. The tests may not be very pleasant but are designed to be as quick and as painless as possible. It helps to understand exactly what the tests involve. Having a partner or friend with you can give you extra support at the time.

If cervical cancer is suspected or diagnosed you will be referred to a doctor who specialises in treating women with cervical cancer—a gynaecological oncologist.

Colposcopy
If an abnormality is found on your Pap test, an examination called a colposcopy will be needed. With this examination the doctor uses an instrument called a colposcope which is like a pair of binoculars on a stand. The colposcope allows the doctor to have a magnified view of the cervix to check the extent and nature of any problem. As with a Pap test, the doctor puts a speculum into your vagina to hold the walls slightly apart.

For a colposcopy you may be referred directly to a colposcopy clinic or to a doctor or gynaecologist experienced in colposcopy. Sometimes it is necessary to have a biopsy taken at the same time.

Punch or target biopsy
In this type of test a sample of tissue—about the size of a match head—is removed from your cervix during a colposcopy and sent to a laboratory for examination. As you may feel a little pain when the biopsy is taken, ask the doctor to tell you when this might happen. To allow your cervix to heal, your specialist will advise you about whether, and for how long, you should avoid sexual intercourse and the use of tampons.

At the time of your colposcopy your specialist may be able to give you some idea of what diagnosis to expect. However your official diagnosis will take several days, sometimes longer, which can be stressful. Talk with someone you feel comfortable with or contact the Cancer Helpline on 13 11 20. You may also want to talk to someone from a cervical cancer support group.

Cone biopsy
Some women may need to have a further test called a cone biopsy to assist with diagnosis. In this test, a larger sample of tissue is taken than for a punch biopsy. A cone biopsy can be done with local anaesthetic or with a general anaesthetic and usually requires a day or overnight hospital stay.

Further tests
If you are diagnosed with dysplasia (abnormal cells) you may not need any further tests. However you may need treatment to remove these abnormal cells from the cervix. If you have been diagnosed as having microinvasive or invasive cervical cancer, you may need further tests which may include some or all of the following.

IVP
An IVP (intravenous pyelogram) is a special X-ray of your kidneys, bladder and ureters (the tubes that connect the kidneys to the bladder). An IVP can be done in a hospital X-ray department or at a special clinic. You may be asked to go on a low fibre diet and take something to help empty your bowels before you have the IVP.

Before the test, a special dye that shows up on X-ray is injected into a vein in your arm. This dye concentrates in your kidneys, ureters and bladder so that the X-rays can show any problems. An IVP should not cause any side effects. Instead of an IVP, some specialists recommend an ultrasound—another type of test to check your kidneys.

CT scan
A CT (computerised tomography) scan is usually done at a hospital or special clinic and involves taking special X-rays at different positions to build up a 2- and 3-dimensional image of the body.

Examination under anaesthetic
You will usually be admitted to hospital as a day-patient for this examination. While you are under anaesthetic your specialist will examine your bladder, bowel, vagina and pelvic area very carefully. A punch biopsy of your cervix may also be performed.