What are the treatment options?
The treatment options for cervical cancer depend on the stage of the cancer. Cervical cancer is relatively easy to treat if it is caught at an early stage.
Patients who have a small, early-stage cancer may be treated surgically with a hysterectomy (removal of the uterus and cervix). Different types of hysterectomy might be recommended based on the extent of the cervical cancer. Surgery may be performed via a traditional open incision in the abdomen or using a minimally invasive technique such as laparoscopy or robotic technology. The choice of approach depends on many issues including your surgeon’s preference and experience, the size of the cancer, and your specific anatomy. This decision should be further discussed with your doctor.
Surgical Options that Preserve Fertility
Any surgery on the cervix carries specific risks for future pregnancies, which your doctor will review in detail. In addition, preserving part of the cervix or uterus can be associated with an increased risk for cancer recurrence. Each patient’s individual situation has to be reviewed to give her the best information for making a decision about the correct procedure for her.
- Cervical conization: This surgery removes a cone-shaped section of the cervix. It can be used to diagnose how far a cancer has progressed or to treat precancerous cervical changes or very early cancers.
- Radical trachelectomy: This surgery removes the cervix and surrounding tissues but leaves the uterus in place to preserve the possibility of a future pregnancy for patients who have an early stage of cancer.
- Simple hysterectomy: This surgery removes the uterus and cervix without removal of additional tissue on the side of the cervix or any vaginal tissue. This procedure is reserved for patients with a very early cancer that can only be seen microscopically.
- Radical hysterectomy: This surgery removes the uterus, cervix and some of the tissue surrounding the sides of the cervix (parametrium). A small portion of the top of the vagina will also be removed. This is the most common surgery for cervical cancer that can be done in patients whose tumor is generally less than 4 cm. This surgery usually requires the postoperative use of a catheter in the bladder for seven to 14 days. Radical hysterectomy is a more complex and extensive procedure than a simple hysterectomy.
- Pelvic lymph node dissection: Lymph node dissection offers a way to assess whether cancer has spread outside the cervix via the lymph nodes. Lymph channels act like a sewer system for organs, draining lymph fluid away into lymph nodes.
Radiation, Chemotherapy or Both
Cervical cancer is also treated with radiation, chemotherapy or both to kill cancer cells and prevent them from spreading. Depending on the stage of the cancer, radiation can be administered externally (using a machine outside the body), internally (by placing an instrument loaded with radiation directly into or near the cancer), or both in combination. Chemotherapy uses drugs to kill cancer cells. Chemotherapy drugs can be taken by mouth or injected into a vein or muscle, in which case they travel through the bloodstream and can affect cancer anywhere in the body.
New treatment options for cervical cancer patients are currently being explored in clinical trials.