Reference Manual - IARC Screening Group

Pathophysiology of Cervical CancerCancerPostcryotherapyVisibly invasive cancercan have a variety ofappearances. Most commonly,if the cancer isearly, the cervix willappear densely white,with a thick, knobby massextruding from someportion of the cervix.Such masses may have a“cauliflower”-like appearanceand will bleed easilywith contact. Sometimescontact will cause fragmentsof the mass to breakoff, which can also causebleeding. A bimanual examwill confirm the presenceof an enlarged, hard cervix which, depending on the stage of progression,may or may not be mobile. In the photographs shown here, the visiblyapparent qualities described above are both present. In the top photo, afungating, white growth is seen. Abnormal vessels in the form of deepgrooves on the cervix are also visible. In the bottom photo, ahemorrhagic, cauliflower-like mass is seen protruding into the vagina.The mass is so large that the cervix itself cannot even be seen. If possible,patients with cervices such as these should be referred to a center wheretreatment such as radical surgery, radiation therapy or, in some cases,palliative measures can be undertaken.Cryotherapy creates an“iceball” on the cervix.Immediately after cryotherapy,almost the entirecervix will appear frozenand white. It will graduallythaw, producing a waterydischarge that may last forseveral weeks. As soon as1 hour after treatment, thetissue will begin to thaw.Some of the color willreturn to the tissue, but thetissue will be fragile andwill require a few weeks toheal.3-10 Cervical Cancer Prevention Guidelines for Low-Resource Settings