Cervical Cancer Treament Types
Cervical cancer detected in its early stages can be cured with treatment and close follow-up. Treatment choices for cervical cancer may include one or more of the following therapies:
- Surgery to remove the cancer
- Radiation therapy to treat the cancer itself or other organs affected by the cancer
- Chemotherapy to help make the cancer more sensitive to radiation therapy and to treat cancer that has spread (metastasized)
The choice of treatment and the long-term outcome (prognosis) of cervical cancer depends on the type and stage of cancer. The patient's age, overall health, quality of life, and desire to be able to have children must also be considered. Treatment choices for cervical cancer may be a single therapy or a combination of therapies, such as:
- Surgery to remove the cancer.
- Cone biopsy to remove the cancer
- Radical trachelectomy to remove the cervix, part of the vagina, and the pelvic lymph nodes (lymph node dissection) but not the uterus
- Simple hysterectomy to remove the uterus and cervix
- Modified radical hysterectomy and lymph node dissection to remove the cancer
- Radiation therapy, which uses high-dose X-rays or implants in the vaginal cavity to kill cancer cells.
- Chemotherapy, which uses medicines to kill cancer cells.
Surgery to remove the uterus and cervix (hysterectomy) may be done through an incision in the belly. For early-stage cervical cancer, laparoscopic surgery may be possible. This is done with several small incisions in the belly for a tiny camera and special instruments. During a hysterectomy, the surgeon may also remove the fallopian tubes and ovaries.
Chemotherapy may be given at the same time as radiation therapy (chemoradiation). Compared with radiation alone, chemoradiation improves survival. It is usually used as the primary therapy or after a hysterectomy.
Most treatments for cervical cancer cause side effects which may include
- Chemotherapy: loss of appetite, nausea, vomiting, diarrhoea, mouth sores, or hair loss.
- Radiation therapy: fatigue, skin irritation, or changes in the bowel or urinary habits.
- Surgery: Depends on the surgery used to treat the stage of the cancer.
Treatment for pregnant women
Recommended treatments are the same for pregnant women as for non-pregnant women. Treatment for early-stage cervical cancer may be delayed until after delivery if the pregnancy is in the third trimester. A vaginal delivery may be possible.
For all stages of cervical cancer, treatment will be managed by a team of physicians specializing in cancer and high-risk pregnancies. Treatment for cervical cancer may cause problems such as an early delivery or even the loss of the baby. Treatment will consider the recommendations for the specific stage of cancer, the development of the baby, and the mother's preferences.
After initial treatment for cervical cancer, it is important to receive follow-up care. The oncologist or gynaecologic oncologist should schedule regular check-ups that will include:
- A pelvic exam and Pap test every 3 to 6 months for the first 2 years.
- After the first 2 years, a pelvic exam and Pap test every 6 months for another 3 to 5 years.
- After 5 years, a pelvic exam and Pap test every year.
Follow-up tests that may be recommended include an abdominal and pelvic computed tomography (CT) scan to monitor whether cancer has spread to other organs in the abdomen or pelvis. If respiratory symptoms are present, a chest X-ray may be done to determine whether cancer has spread to the lungs.
Treatment if the condition gets worse
Cervical cancer can return after treatment. About 35% of women with cervical cancer will have persistent or recurrent disease. The chance that the cancer will return depends on the stage of the initial cancer: cancer found early is less likely to come back than cancer found at a later stage. Thus, the prognosis for recurrent cervical cancer depends greatly on how much the cancer has spread when the recurrence is diagnosed.
The goal of treatment of advanced-stage cervical cancer that has spread outside the pelvis is to control symptoms, reduce complications, and increase comfort (palliative care). It is not intended to cure the disease. Palliative care may include:
- Radiation therapy.
- Chemotherapy medicines.
- Medicines for symptoms such as nausea or pain.