Treatment & Management

of Cervical Cancer

In general treatment for cervical cancer may require surgery, radiation, chemotherapy or a combination.  The specific treatment depends on the stage of the cancer and its genomic profile.

Surgery

Early-stage cervical cancer is typically treated with surgery to remove the uterus (hysterectomy). A hysterectomy can cure early-stage cervical cancer and prevent recurrence. But removing the uterus makes it impossible to become pregnant.

  • Simple hysterectomy. The cervix and uterus are removed along with the cancer. Simple hysterectomy is usually an option for very early-stage cervical cancer.
  • Radical hysterectomy. The cervix, uterus, part of the vagina and lymph nodes in the area are removed with the cancer.

Learn more about surgery here.

Radiation

Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer cells. Radiation therapy may be used alone or with chemotherapy before surgery to shrink a tumor or after surgery to kill any remaining cancer cells.

Learn more about radiation here.

Precision Cancer Medicines

The purpose of precision cancer medicine is not to categorize or classify cancers solely by site of origin, but to define the genomic alterations in the cancers DNA that are driving that specific cancer.  Precision cancer medicine utilizes molecular diagnostic testing, including DNA sequencing, to identify cancer-driving abnormalities in a cancer’s genome. Once a genetic abnormality is identified, a specific targeted therapy can be designed to attack a specific mutation or other cancer-related change in the DNA programming of the cancer cells. Precision cancer medicine uses targeted drugs and immunotherapies engineered to directly attack the cancer cells with specific abnormalities, leaving normal cells largely unharmed. Precision medicines are being developed for the treatment of cervical cancer and patients should ask their doctor about whether testing is appropriate.

Learn more about precision cancer medicines here.

Chemotherapy

Chemotherapy uses medications, usually injected into a vein, to kill cancer cells. Low doses of chemotherapy are often combined with radiation therapy, since chemotherapy may enhance the effects of the radiation. Higher doses of chemotherapy are used to control more advanced cervical cancer.

Treatment of Cervical Cancer by Stage

Stage 0: Precancerous lesion involves only the cells on the surface of the cervix.

Stage I: Cancer is confined to the cervix, and may be evident only under microscopic evaluation (stage IA) or apparent by visible or physical examination (stage IB).

Stage II: Cancer has spread beyond the cervix to involve the tissues surrounding the cervix (parametria) or the upper portion of the vagina.

Stage III: Cancer spreads beyond the cervix to the lower vagina or to the sides of the pelvis, or causes a blockage of drainage from the kidney, a condition called hydronephrosis.

Stage IV: Cancer invades structures adjacent to the cervix such as the bladder or rectum or has spread to other parts of the body such as the liver or lungs.

Recurrent/Relapsed: Cervical cancer is still detected or has returned (recurred/relapsed) following an initial treatment with surgery, radiation therapy, and/or chemotherapy.

Next: Surgery for Cervical Cancer
Radiation Therapy for Cervical Cancer
Precision Cancer Medicine for Cervical Cancer

References

https://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site