Cervical Cancer Treatment Options
There are several treatment options for women with cervical cancer. Whether the cancer has spread and the size of the tumor are two factors that significantly influence the type of treatment used. Treatment options may also vary depending on if you would like to become pregnant someday.
A gynecologic oncologist is typically the type of physician who will finalize the stage, perform surgery and lead the team on other types of cancer treatments that may be needed.
Surgery for Cervical Cancer
Surgery is very common, especially in earlier stages of cancer.
- Conization: This procedure can be used in a biopsy and removes the cancerous cells including those that can only been seen by a microscope.
- Radical trachelectomy: The surgeon removes the cervix, part of the vagina, and the lymph nodes in the pelvis. This option is for women with small tumors who want to get pregnant later on.
- Total hysterectomy: The surgeon removes the uterus and cervix.
- Radical hysterectomy: The surgeon removes the cervix, some tissue around the cervix, the uterus, and part of the vagina.
With either radical or total hysterectomy, the surgeon may remove other tissues:
- Fallopian tubes and ovaries: The surgeon may remove both ovaries and fallopian tubes this surgery is called a salpingo-oophorectomy.
- Lymph nodes: The surgeon may remove the lymph nodes near the tumor to see if they contain cancer. If cancer cells have reached the lymph nodes, it means the disease may have spread to other parts of the body.
The right type of surgery for every woman is depending on the stage and future plans for getting pregnant. Talk to your gynecologic oncologist about options.
Radiation Therapy for Cervical Cancer
Radiation therapy for cervical cancer has advanced recently with an internal, high-dose radiation therapy now available. Women with early-stage cervical cancer may choose radiation therapy instead of surgery. It also may be used after surgery to destroy any cancer cells that remain in the area. Women with cancer that extends beyond the cervix may have a combination of chemotherapy and radiation therapy.
Radiation therapy affects cells only in the treated area using high-energy rays to kill cancer cells.
Two types of radiation therapy to treat cervical cancer. Some women receive both types. These include:
- External radiation therapy: A large machine directs radiation at your pelvis or other tissues where the cancer has spread. The treatment usually is given in a hospital or clinic. You may receive external radiation five days a week for several weeks. Each treatment takes only a few minutes.
- Intracavitary radiation therapy: A thin tube is placed inside the vagina. A radioactive substance is loaded into the tube. You may need to stay in the hospital while the radioactive source is in place (up to three days). Or the treatment session may last a few minutes, and you can go home afterward. Once the radioactive substance is removed, no radioactivity is left in your body.
Chemotherapy for Cervical Cancer Patients
For the treatment of cervical cancer, chemotherapy is usually combined with radiation therapy. For cancer that has spread to distant organs, chemotherapy alone may be used.
Chemotherapy uses drugs to kill cancer cells. The drugs for cervical cancer are usually given through a vein (intravenous). You may receive chemotherapy in a clinic, at the doctor's office, or at home. It’s often given in combination with another treatment.
Targeted Therapy Approved for Cervical Cancer Treatment
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming healthy cells.
Monoclonal antibody therapy is a type of targeted therapy that uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.
Bevacizumab is a monoclonal antibody that binds to a protein called vascular endothelial growth factor (VEGF) and may prevent the growth of new blood vessels that tumors need to grow. Bevacizumab is used to treat cervical cancer that has metastasized (spread to other parts of the body) and recurrent cervical cancer.
Immunotherapy Approved for Cervical Cancer Treatment
Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer.
Pembrolizumab, an immune checkpoint inhibitor therapy, is available to women whose cervical cancer has spread or is recurring. PD-1 is a protein on the surface of T cells that helps keep the body's immune responses in check. When PD-1 attaches to another protein called PDL-1 on a cancer cell, it stops the T cell from killing the cancer cell. PD-1 inhibitors in the immunotherapy attach to PDL-1 and allow the T cells to kill cancer cells.