Cervical Cancer Prevention - Colposcopy

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• 0:03Introduction
• 0:26What a colposcopy is
• 1:36Biopsy results
• 3:07Treatment options
• 3:31Cryotherapy and LEEP
• 5:03Final advice

Full transcript

1. 0:03Introduction

   Hi, I'm Dr. Taz Varkey. Today I would like to talk to you a little bit more about what happens if you have an abnormal Pap smear. So in prior videos I talked about HPV, how it causes cervical cancer, how we use the Pap smear to detect precancerous cells, and how the HPV vaccine helps us prevent HPV. But today I want to talk about what happens when the Pap smear is abnormal.

2. 0:26What a colposcopy is

   So usually your doctor will call you and tell you to come back in for a procedure called a colposcopy, and the colposcopy is just a procedure where we use a colposcope. This is the colposcope, and the colposcope is just a microscope on a stand, and this doesn't touch it, we keep it out on the outside while the patient is up on the bed, and I look through this colposcope, these lenses, and this magnifies the cervix and allows me to look for any abnormalities on the cervix.

3. 0:50

   If I see any, I'll take some little biopsies of them. Now, we call them biopsies, but they're really just samplings of skin. The amount of tissue I take off the cervix is about the same as this, as if someone fell and skinned their knee.

4. 1:13

   It's just a little bit. It's often even hard to see in the jar that we send off. So most people don't describe this as exceedingly painful, but it might be crane being a little uncomfortable. It only lasts a few minutes. Once we get that tissue, we send it off to the lab, and the pathologist at the lab has to look at the tissue and can give us one of five reports back.

5. 1:36Biopsy results

   The first report would be normal. The second, HPV changes. The third, fourth, and fifth will be precancerous readings. This would be grade 1, grade 2, or grade 3 precancer, otherwise known as mild, moderate, or severe. And if the result we get back is mild precancer or less, then we just ask the patient to come back in a year for a follow-up Pap smear.

6. 2:00

   Now you might wonder, if one of the reports is mild precancer, why would we just watch that? Well, the reason is most of the mild precancerous growths will go away on their own within a couple of years, if not a year.

7. 2:22

   In fact, the rate of resolution of mild precancer is about 60 to 70 percent of the time, and in fact, if it's going to go to cancer, it only happens about 0.3% of the time, and that can take several years, maybe five to ten years, for it to go to cancer. So though we never want to ignore mild precancer, we always want to see you back in a year to make sure it's not progressing sooner than expected.

8. 2:44

   It almost always goes away. So that's why if you have mild precancer, HPV infected cells, or just normal tissue on the biopsies, they'll just say, see you in a year, or that's what they should say to you anyways. But if you have moderate or severe precancer, otherwise known as grade 2 or grade 3, then the doctor is going to call you back in to talk to you about your treatment options.

9. 3:07Treatment options

   Now what those options should be observation, because depending on your age and the type of HPV that was found and other such factors, they may offer you the option of observation, because even those moderate to severe precancerous lesions can go away on their own, but a higher percentage of these could go to cancer someday. So most doctors will offer you some type of treatment.

10. 3:31Cryotherapy and LEEP

    And the treatment options that are then discussed would include, most commonly, a procedure called cryotherapy, which is where we freeze the cervix. We've got a cold probe on the cervix and we leave it there for a few minutes. And or a procedure called the LEEP procedure, which stands for loop electro excisional procedure, and the LEEP procedure, also done in the office, we inject the cervix with some lidocaine and that numbs the cervix.

11. 3:54

    And then we use a little hot wire, it's got cautery on it, and we shave off the extra, extra small edge of the outer part of the cervix, and we send that off to the lab for analysis, mostly just to make sure we got it all. So it's an office procedure.

12. 4:16

    Both the cryotherapy, the freezing, and the LEEP are office procedures, and they both just take maybe 10 to 15 minutes, and both are often curative. In other words, when I follow up with a patient 6 months later for a Pap smear, the Pap smear has gone back to normal and the HPV virus is gone, and that's because the virus was replicating in the growth on the cervix that we removed.

13. 4:39

    So that's what we most often do. Sometimes doctors will take you to the operating room to do the LEEP procedure, or maybe if they feel it's necessary to cut out the cervix season and I instead of the cautery, but that all depends on various factors and the type of precancer that we're looking at. So that's it, I hope this was helpful today. You know, the bottom line is if you have an abnormal Pap and you need a colposcopy, please don't panic.

14. 5:03Final advice

    It's a quick procedure. Even though nobody wants to go through it, it's much, much better than dealing with an advanced precancer that could one day go to cancer. So if you have any further questions, please be sure to ask your doctor, because I certainly can't cover everything in these videos, but thank you so much for tuning in, and please don't forget to subscribe.