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Cervical Cancer Singapore

Wide Range of Preventive & Curative Treatments for Cervical Cancer

Treatment Depends on the Stage of Cervical Cancer

  • Pre-Cancer: This usually involves the removal of abnormal cells from the cervical lining through local ablative or excision procedures; which prevents the progression of pre-cancerous cells into cancerous cells.
    • Cone Biopsy (Conization), LEEP/LEETZ, Laser Surgery, Thermal Coagulation
  • Early Stage Cancer: This usually involves the removal of the uterus (hysterectomy), trachelectomy or radiation therapy, sometimes with chemotherapy.
  • Late Stage Cancer: This usually involves concurrent radiotherapy and chemotherapy; and in cases of recurrent cervical cancer, a pelvic exenteration may be recommended.
Treatment Depends on the Stage of Cervical Cancer

Cone Biopsy (Conization)

This is generally regarded as a more extensive form of a typical cervical biopsy—a cone-shaped wedge of abnormal cervical tissue will be removed from the cervix and sent for examination. A cone biopsy is usually used to remove abnormal tissue high in the cervical canal. In most cases, this procedure is performed in the clinic as an outpatient day-surgery procedure under local anaesthesia. It is rarely necessary to have a general anaesthesia. A cone biopsy can be used for both diagnostic and treatment purposes, as abnormal cervical tissue are removed.

  • When is a cone biopsy done?
    • When there are pre-cancerous cells found on the cervix, repeated abnormal Pap results, or when the full extent of the affected area cannot be seen during a colposcopy (the canal leading from the vagina through the cervix and into the uterus).
  • How is it performed?
    • It can be performed in 3 main ways (with anaesthesia):
      • With a heated electrical loop wire (LEEP or LLETZ)
      • With a surgical knife
      • With a laser
    • A special solution (Monsel’s solution) will be applied afterwards to reduce bleeding; and other pain relief methods will be prescribed.


LEEP (Loop Electrosurgical Excision Procedure)—also known as LLETZ (Large Loop Excision of the Transformation Zone)—is a method of removing abnormal tissue growth in the cervix called cervical intraepithelial neoplasis (CIN). With the use of local anaesthetic, an electrically charged wire loop is used to remove the abnormal cells, and bleeding is stopped using electrocautery and/or the application of Monsel’s solution. LEEP/LLETZ is also one of the most commonly used methods to treat high-grade cervical dysplasia (CIN2 and CIN3) discovered during a colposcopic examination.

  • Laser Surgery

    A laser can be used to treat pre-cancerous and other conditions on the cervix. Due to its precision, this method is usually used during the pre-cancerous and early stage of cervical cancer, and involves using a focused carbon dioxide laser beam to burn off or cut off the abnormal cells on the cervix.

    In many cases of precancer (CIN 2-3), the disease only involves the outer part of the cervix and so it may not be necessary to excise a large part of the cervix. Using a laser to destroy the abnormal cells can effectively treat the CIN and yet preserved the function of the cervix for future pregnancy.

    Numbing medicine will be applied to the cervix beforehand so you don’t have to worry about pain. The laser beam also causes little to no damage to healthy cells, thus recovery is fast.

  • Thermal Coagulation

    This is another procedure that can be used to destroy pre-cancer cells on the cervix. It uses a heated probe applied to the cervix for about 1-2 minutes. No anaesthesia is required.

    This is usually used during the pre-cancerous stage, where abnormal cells have only been found on the surface of the cervix.

  • Hysterectomy

    This is the usual treatment for early-stage cervical cancer. In very early-stage cancer, a simple hysterectomy that involves removing the womb and cervix, and occasionally the fallopian tubes and ovaries, may suffice.

    In advanced stage 1 and some early stage 2 cervical cancer, a radical hysterectomy involving the removal of the cervix, womb, top of the vagina, surrounding tissue, lymph nodes, fallopian tubes and, sometimes, ovaries, are all removed.

  • Trachelectomy

    This is usually only suitable if the cancer is diagnosed at a very early stage, and offered to women who still want to have children in the future and want their womb preserved.

    During the procedure, the cervix and upper part of the vagina are removed, leaving the womb intact, which will then be reattached to the lower part of the vagina.

    It must be noted, however, that the surgeon cannot guarantee that you will definitely be able to get pregnant in the future, and even if you do, you will have to deliver via caesarean section.

  • Pelvic Exenteration

    This is a major procedure that is only recommended when the patient suffers from recurrent cervical cancer; and if the cancer has returned, but has not spread past the pelvis.

    This procedure involves the possible removal of the vagina, bladder, rectum, and the cancer itself. Stomas are then created to allow you to pass urine and bowels out of your body into colostomy bags.

  • Radiotherapy

    This may be used on its own or together with surgery recommended for early-stage cervical cancer. In advanced-stage cervical cancer, it may be used concurrently with chemotherapy.

    High-energy waves may be beamed directly into the pelvis in order to destroy cancerous cells; or a radioactive implant may be placed next to the tumour through the vagina.

    Lasting on average 5 to 8 weeks, radiotherapy aims to destroy cancer cells, though it inevitably also affects some nearby healthy cells. These side effects may be temporary or permanent, and it is best to seek your doctor’s advice on what your options are.

  • Chemotherapy

    Chemotherapy can either be combined with radiotherapy or used own its own. It is usually administered through an intravenous drip with the aim of destroying cancer cells. However, as with radiotherapy, chemotherapy often inevitably affects some neighbouring healthy cells as well, thus side effects are common. However, upon the completion of chemotherapy, most side effects should subside.

Our Team Will Walk You Through This Journey

Whether it is pre-cancer, early-stage cancer or advanced-stage cancer, our medical team comprising a gynaecologist and dedicated nurses will work closely with you, personalize a treatment and rehabilitation plan for you, and provide emotional support for you from the moment you enter our care until you are discharged with a new lease in life.

What Causes Cervical Cancer?
Dr Quek Swee Chong
Dr Quek is an experienced gynaecologist of over 20 years with a specialized interest in the prevention and treatment of cervical cancer.

To that end, he serves on the board of the International Federation of Colposcopy & Cervical Pathology, and his extensive research and humanitarian work centre around HPV and cervical cancer as well.