Receiving a diagnosis of cervical cancer can be scary and uncertain for many individuals. With advancements in medical technology, the diagnosis and treatment options for cervical cancer at an early stage has opened up many possibilities for successful treatment. Becoming familiar with your options for treating cervical cancer will help patients and their families make informed decisions, which will help them feel more confident as they go through the process of obtaining and receiving treatment.
Cervical cancer is located in the cervix (the lowest part of the uterus where it connects to the vagina). Treatment for cervical cancer will vary based on several circumstances: the size and stage of your cancer, how healthy you are, your age, and whether or not you wish to retain your ability to have children. This guide contains definitions of the major treatments for cervical cancer and information you will want to know before starting treatment.
How is the Cervical Cancer Staging?
- Stage A – The cervix only has cancer.
- Stage B – The cervix has cancer, and it confirms cancer has spread beyond the cervix to the pelvic wall or lower vagina.
- Stage C – The cancer is localised to the area around the cervix but extends to other local areas as well, including lymph nodes.
- Stage D – The cancer is distant, spreading to other organs, such as the bladder, rectum, lungs, or liver.
What are the treatment options for Cervical Cancer?
- The cone biopsy procedure removes a conical-shaped abnormal tissue of the cervix, and is generally used when the diagnosis is in the early stages of development, or when advanced but precancerous changes exist. A cone biopsy is a minimally invasive surgical procedure that has a high chance of saving a woman’s fertility and is successful with small, localised cancers.
- A hysterectomy is a surgical procedure to remove the uterus and cervix. A hysterectomy can be performed as a simple hysterectomy or a radical hysterectomy, depending on the extent of the disease. Simple hysterectomy involves the removal of the cervix and uterus, while radical hysterectomy involves the removal of the uterus, cervix, surrounding tissues and a portion of the vagina. Hysterectomy has a good chance of being successful when performed for an early-stage cancer and decreases the likelihood of a recurrence; however, a hysterectomy will eliminate a woman’s ability to have children, making it important to discuss fertility prior to having a hysterectomy.
- For women who want to maintain the ability to have children, a trachelectomy may be performed. A trachelectomy involves the removal of the cervix, while leaving the uterus intact, and has a good success rate and the ability to carry future pregnancies for selected early-stage cases.
- High-energy rays are used to kill cancer cells in radiation therapy; it can be used alone or combined with chemotherapy for more advanced stages of cervical cancer. There are two main types of radiation therapy: External Beam Radiation Therapy (EBRT), which delivers radiation from outside the body directly to the cancer site, and Brachytherapy (also referred to as Internal Radiation), in which the radioactive material is placed near the cervix or directly into the cervix.
- Chemotherapy consists of using drugs that kill cancer cells or stop their growth. Generally, chemotherapy is used for advanced stages of cervical cancer or with radiation therapy (termed chemoradiation). Furthermore, chemotherapy drugs can be administered through an IV infusion or by oral tablets. Common chemotherapy drugs used in the treatment of cervical cancer include cisplatin and carboplatin.
- Targeted therapy is a treatment that focuses on the specific proteins and/or pathways that enable cancers to grow. This type of therapy is different from chemotherapy in the sense that it specifically targets cancer cells, thereby limiting the amount of damage caused to healthy cells. Bevacizumab is commonly used as a targeted therapy drug for the treatment of cervical cancer and is often used in combination with chemotherapy for advanced cervical cancer.
- Immunotherapy is a relatively new treatment that assists the body’s immune system in recognising and attacking cancer cells. For recurrent cervical cancer and/or metastatic cervical cancer, immunotherapy is typically recommended for patients unable to benefit from other forms of treatment.
Young women diagnosed with cervical cancer often have concerns about fertility in the future. Depending on how far the disease has progressed and what kinds of treatments will be utilised to treat it, there may be opportunities for preserving their ability to bear children. Patients should discuss with their physician the possibility of: Fertility-sparing Surgery, Egg or embryo preservation, and Reproductive Plans After Treatment.
Open and honest communication with the doctor will help the patient to make good choices based upon her individual desires and goals for the future. The likelihood of good cervical cancer outcomes is significantly improved with early detection. Routine tests, such as pap smears and HPV tests, can find irregularities in a woman’s cervix that may indicate a future diagnosis of cancer, or may detect an existing cancer in the earliest stages of development.
Understanding the different types of treatments available for cervical cancer will empower the patient to make informed decisions about their care. Just as the course of the disease will differ for each individual woman, the course of treatment for each woman will also be different based on her individual circumstances.
Treatment may be by means of surgery, radiation therapy, chemotherapy, targeted therapy, and/or immunotherapy. Due to the earlier diagnosis, the expertise of the medical professionals who will be caring for the patient, and the availability of emotional support, many women diagnosed with cervical cancer will successfully navigate through the process of dealing with their cancer and will return to a higher quality of life when their treatment is successfully completed.