Treatment options for cervical cancer : what is available?

What determines the treatment options for cervical cancer?

Treatment options for cervical cancer are mainly determined by:

  • The stage of the cancer at diagnosis
  • The patient’s age
  • Her general health
  • If she is still looking to conceive

What’s more, a patient might need several types of treatments, ranging from surgery, to radiation therapy, to chemotherapy, to targeted-therapy.

Patients may want to consider other unconventional options, such as taking part in clinical trials. In any case, the most important thing for a patient to keep in mind is to get a clear understanding of all the possible treatment options so as to make the right decision that best fits her needs.

Standard treatment options for cervical cancer

Surgery

Surgery – mainly used to attack pre-cancer or stage I, but can also be used in combination with other treatments. This procedure consists of removing the cancer that has not spread beyond the cervix through different surgical procedures such as:

  • Conization
    • Removing the cone shaped piece of abnormal tissue from the cervix. This tissue is then examined to check if the outer edges contain cancerous (or pre-cancerous) cells. Based on the results, the doctor can determine whether further treatment is needed or not.
    • Can be performed during pregnancy.
  • LEEP
    • The Loop Electrosurgical Excision Procedure uses an electrical thin wire hook to remove the cancer.
    • Used at stage 0, when the pre-cancerous cells are still at the surface layer of the cervix.
  • Cryosurgery
    • Killing the abnormal cells by freezing them with liquid nitrogen.
  • Hysterectomy
    • Removal of the uterus and the cervix through the vagina or through an abdominal incision. In case of a radical hysterectomy, the upper vagina, the lymph nodes and surrounding tissues are also removed. In some cases, a woman will also need to undergo a bilateral salpingo-oophorectomy (removal of the fallopian tube and the ovaries).
    • A woman’s sexual pleasure is not affected by this procedure.
    • Generally used with women who no longer want to conceive.
  • Trachelectomy
    • Removal of cervix and upper vagina, while preserving the uterus. Just like a hysterectomy, it is done through the vagina, or through the abdomen.
    • Here, women will not lose their ability to have children.
  • Pelvic exenteration
    • In addition to a radical hysterectomy, this procedure also calls for the removal of the bladder, vagina, rectum, and possibly part of the colon. Further procedures will need to take place to reconnect the missing organs.
    • Mostly practiced on recurrent or locally advanced cancers.

Radiation therapy

Radiation therapy – this consists of using high-energy X-rays to destroy cancer cells that have spread beyond the cervix or are too big for a surgical intervention. It may also be used in addition to surgery or in combination with chemotherapy. Radiation can be used for stages I, II, III and IV.

The 2 most common types of radiation therapy for cervical cancer are:

  • External beam radiation therapy (EBRT)
    • Using an external X-ray-like machine outside the body, with a strong radiation dose.
    • Each session only lasts a few minutes, with treatment lasting up to 7 weeks.
  • Brachytherapy
    • Also known as internal radiation therapy, since a radioactive device is placed inside the body through the vagina, near the cancer.
    • This approach can be executed on both inpatients and outpatients.

Chemotherapy

Chemotherapy – using anti-cancer drugs to destroy cancer cells intravenously or orally. It is generally recommended when the cancer has spread to the rest of the body. Chemo may also be used to enhance the results of radiation or as a precautionary measure following surgery.

Targeted therapy

Targeted therapy – using anti-cancer drugs that specifically targets cancer cells or inhibits blood vessel growth (angiogenesis), therefore eliminating the nourishment of the affected cells. This may be used in combination with chemo, or alone.

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Medically reviewed on Jan 5 2017

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