The prognosis, or outlook, for most cases of cervical cancer has never been better, according to specialists at Memorial Sloan Kettering Cancer Center in New York City. Your options may include several specialized treatments, including surgery, radiation, and chemotherapy. The best choices will depend on several factors:
The stage of the cancerWhether the cancer has spread to other parts of the bodyThe size of the tumorYour desire to have children in the future
Surgery for Cervical Cancer
If you have pre-cancerous cell changes in your cervix, your medical team may recommend one of the following surgical treatments: Cryosurgery: An instrument is used to freeze and destroy pre-cancerous tissue. Laser surgery: A narrow laser beam is used to destroy pre-cancerous tissue. A benefit of this treatment is that it destroys only diseased tissue, leaving healthy tissue unharmed. LEEP (loop electrosurgical excision procedure): An electrical current is directed through a thin wire hook to remove pre-cancerous tissue. Cone (or cone biopsy): Your doctor may use this procedure to remove all of the cancerous tissue. This is an option for small cancers and for women who want to preserve their ability to have children. For early-stage cervical cancer that hasn’t spread beyond the cervix, your medical team may recommend one of the following treatments, depending on your age and stage of the cancer: Hysterectomy: A surgeon will remove your uterus and cervix, leaving the vagina and nearby lymph nodes in place. The surgery may be done through the vagina or through an incision in your abdomen. Bilateral salpingo-oohorectomy: A surgeon will remove your uterus along with your ovaries and fallopian tubes. This reduces the risk of the cancer recurring in one of those organs. This procedure may be a good choice if you’re approaching menopause. Trachelectomy: If your cancer hasn’t spread beyond the cervix and is up to 2 centimeters wide, your doctor may recommend this procedure. A surgeon will remove your cervix but not your uterus. This procedure may be an option for younger women who want to preserve their ability to become pregnant. If your tumor is larger than 2 centimeters or has spread beyond the cervix, you may be a candidate for more extensive surgery, including the following procedures: Radical hysterectomy: A surgeon will remove your cervix and uterus along with the tissues that hold it in place in the pelvis, as well as the upper part of your vagina. Your ovaries may or may not be removed. Pelvic exenteration: This is the most extensive surgical option, removing the cervix, uterus, ovaries, vagina, and sometimes the bladder, urethra, or rectum. Depending on what organs are removed, you may need to use ostomy bags that collect your urine and feces. Laparoscopic retroperitoneal lymph node dissection: This procedure removes lymph nodes if the cancer has spread to them.
Radiation for Cervical Cancer
Radiation therapy may be used when cancer has spread beyond the cervix, or for tumors larger than 4 centimeters, say experts at the MD Anderson Cancer Center in Houston. Three types of radiation may be used: External radiation therapy: This treatment uses a machine outside the body that directs radiation toward the cancer. Internal radiation therapy implants (brachytherapy): Your doctor will insert implants through your vagina into your cervix, next to the tumor. You’ll stay in the hospital as long as the implants are in place, typically for a few days. Sometimes a high-dose treatment, which stays in place for a few minutes, can be done as an outpatient procedure (without a hospital stay). Intensity-modulated radiotherapy (IMRT): This is a tailored treatment that takes the exact shape of the tumor or affected lymph nodes into account.
Chemotherapy for Cervical Cancer
A key treatment for advanced cervical cancer is known as concurrent chemoradiation. This therapy combines chemotherapy with radiation therapy. The chemo helps the radiation work better, say experts at the American Cancer Society. The chemo part of the treatment may be given during the course of radiation. Drugs used in this treatment include:
Cisplatin, given weekly about 4 hours prior to radiation5-fluorouracil (5-FU), given along with cisplatin every 4 weeks during radiation
Other chemotherapy drugs may also be used to treat advanced cervical cancer. These include:
CarboplatinTaxol or Onxol (paclitaxel)TopotecanGemzar (gemcitabine)
Side Effects of Chemotherapy and Radiation
Depending on your exact course of treatment with chemotherapy or radiation, you may experience side effects that include:
Nausea and vomitingAppetite lossHair lossMouth soresFatigue
When chemotherapy is combined with radiation, the side effects can be more serious, according to the American Cancer Society. Nausea and exhaustion are often worse, and you may also experience diarrhea if the chemo is given at the same time as the radiation. Your medical team will monitor you for any side effects and can give you certain medicines to help improve the way you feel.
