Is spotting normal after cervical cancer surgery?

Question

Hi doctor,

I am in my mid-50s. I was diagnosed with cervical cancer, stage 1B2, last year. I underwent a radical hysterectomy in May of the same year. Since then, I have been on strict follow-up with my doctor, including MRI or CT scans every three months. Seven months ago, I had an MRI of the pelvis, and the results were clear. However, last week I noticed spotting. I am now concerned and would like to know what could be wrong with me.

Please help me.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

Well, I am deeply concerned about your worries. According to your history, you had cervical carcinoma, stage 1B2, which is an invasive cancer with a depth of 2 to 4 cm. If you are currently experiencing per vaginal (PV) spotting and discharge, these are not good signs and should be evaluated urgently.

There could be local causes of spotting, such as:

Trauma or intercourse.
Ulceration in the vaginal vault.
Chronic cervicitis.

However, there is also a possibility that the cancer has progressed. Potential stages include:

Stage 2A: Involvement of the upper two-thirds of the vagina.
Stage 2B: Involvement of the parametrium.
Stage 3A: Involvement of the lower one-third of the vagina.

I strongly advise you to return to your gynecologist as soon as possible. After reviewing your history, they will likely perform the following:

General physical examination: Systemic examination, including:

Central nervous system.
Cardiovascular system.
Respiratory system.
Abdominal examination.

Local gynecological examination, including:

Per speculum examination.
Bimanual pelvic examination

Further investigations will then be conducted to reach a diagnosis. Please do not delay. Visit your gynecologist at the earliest opportunity.

I have made everything clear. If you have any further questions, please do not hesitate to contact me.

I hope this answer helps you.

Thank you.