Cervical Cancer Treatment Option Overview

by National Cancer Institute

(Page 3 of 3)

There are different types of treatment for patients with cervical cancer.

Different types of treatment are available for patients with cervical cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.

Three types of standard treatment are used:

Surgery

Surgery (removing the cancer in an operation) is sometimes used to treat cervical cancer. The following surgical procedures may be used:

Conization: A procedure to remove a cone-shaped piece of tissue from the cervix and cervical canal. A pathologist views the tissue under a microscope to look for cancer cells. Conization may be used to diagnose or treat a cervical condition. This procedure is also called a cone biopsy.

Total hysterectomy: A surgical procedure to remove the uterus, including the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.

Bilateral salpingo-oophorectomy: A surgical procedure to remove both ovaries and both fallopian tubes.

Radical hysterectomy: A surgical procedure to remove the uterus, cervix, and part of the vagina. The ovaries, fallopian tubes, or nearby lymph nodes may also be removed.

Pelvic exenteration: A surgical procedure to remove the lower colon, rectum, and bladder. In women, the cervix, vagina, ovaries, and nearby lymph nodes are also removed. Artificial openings (stoma) are made for urine and stool to flow from the body to a collection bag. Plastic surgery may be needed to make an artificial vagina after this operation.

Cryosurgery: A treatment that uses an instrument to freeze and destroy abnormal tissue, such as carcinoma in situ. This type of treatment is also called cryotherapy.

Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.

Loop electrosurgical excision procedure (LEEP): A treatment that uses electrical current passed through a thin wire loop as a knife to remove abnormal tissue or cancer.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

New types of treatment are being tested in clinical trials.

Information about ongoing clinical trials is available from the NCI Web site.

Treatment Options by Stage

Stage 0 Cervical Cancer (Carcinoma in Situ)

Treatment of stage 0 cervical cancer may include the following:

• Loop electrosurgical excision procedure (LEEP).
• Laser surgery.
• Conization.
• Cryosurgery.
• Total hysterectomy for women who cannot or no longer want to have children.
• Internal radiation therapy for women who cannot have surgery.

Stage IA Cervical Cancer

Treatment of stage IA cervical cancer may include the following:

• Total hysterectomy with or without bilateral salpingo-oophorectomy.
• Conization.
• Radical hysterectomy and removal of lymph nodes.
• Internal radiation therapy.

Stage IB Cervical Cancer

Treatment of stage IB cervical cancer may include the following:

• A combination of internal radiation therapy and external radiation therapy.
• Radical hysterectomy and removal of lymph nodes.
• Radical hysterectomy and removal of lymph nodes followed by radiation therapy plus chemotherapy.
• Radiation therapy plus chemotherapy.
• A clinical trial of high-dose internal radiation therapy combined with external radiation therapy.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Stage IIA Cervical Cancer

Treatment of stage IIA cervical cancer may include the following:

• A combination of internal radiation therapy and external radiation therapy.
• Radical hysterectomy and removal of lymph nodes.
• Radical hysterectomy and removal of lymph nodes followed by radiation therapy plus chemotherapy.
• Radiation therapy plus chemotherapy.
• A clinical trial of high-dose internal radiation therapy combined with external radiation therapy.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Stage IIB Cervical Cancer

Treatment of stage IIB cervical cancer may include internal and external radiation therapy combined with chemotherapy.

Stage III Cervical Cancer

Treatment of stage III cervical cancer may include internal and external radiation therapy combined with chemotherapy.

Stage IVA Cervical Cancer

Treatment of stage IVA cervical cancer may include internal and external radiation therapy combined with chemotherapy.

Stage IVB Cervical Cancer

Treatment of stage IVB cervical cancer may include the following:

• Radiation therapy as palliative therapy to relieve symptoms caused by the cancer and improve quality of life.
• Chemotherapy.
• Clinical trials of new anticancer drugs or drug combinations.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Treatment Options for Recurrent Cervical Cancer

Treatment of recurrent cervical cancer may include the following:

• Pelvic exenteration followed by radiation therapy combined with chemotherapy.
• Chemotherapy as palliative therapy to relieve symptoms caused by the cancer and improve quality of life.
• Clinical trials of new anticancer drugs or drug combinations.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

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