Treatments for Cervical Cancer
Prior to the 1960s, cervical cancer was the leading cause of cancer death for women in the United States. Since then, survival rates have climbed, largely due to early detection and treatment. When caught early, cervical cancer responds well to treatment and can be cured.
Learn more about common cervical cancer treatments and the many factors that doctors and patients consider when choosing a treatment plan.
Factors That Affect Cervical Cancer Treatment
Cervical cancer treatment is tailored to the patient. Before recommending a treatment plan, your doctor will consider:
Your cervical cancer stage. Doctors classify cancer according to the size and location of the tumor(s). There are four stages. Stage I (1) cervical cancer is confined to the cervix; stage II has spread into the vagina; stage III has spread farther into the vagina or pelvic region or into lymph nodes; stage IV (4) cervical cancer has spread to other parts of the body. Cancer treatment guidelines recommend different treatment combinations for different cancer stages.
Your type of cervical cancer. There are two main types of cervical cancer: adenocarcinoma and squamous cell carcinoma. Cervical cancer tumors may also be positive or negative for high- or low-risk human papilloma virus (HPV) strains. These factors may influence response to treatment.
Your age and overall health. Young, healthy people are generally better able to withstand aggressive cancer treatment than older women or women with multiple pre-existing medical conditions.
Your desire to have children. Removal of the entire uterus (including cervix) is one treatment option. However, if the affected individual wants to become pregnant in the future, the medical team will explore other treatment alternatives first.
Surgery for Cervical Cancer
Removal of the cancerous tissue is often the first step of cervical cancer treatment. Procedures doctors use to treat cervical cancer include:
Conization is removal of a cone-shaped piece of tissue from the cervix. Doctors use a scalpel or laser to remove the cancerous tissue.
Loop electrosurgical excision procedure (LEEP) is removal of cancerous tissue using an electrified wire loop.
Cryosurgery is the application of extreme cold to kill cancer cells.
Hysterectomy is removal of the uterus. For cervical cancer, surgeons perform a simple, or total, hysterectomy (uterus and cervix removal) or radical hysterectomy (removing the uterus, cervix, and top of vagina). Sometimes, the ovaries, fallopian tubes, and surrounding ligaments and tissues are also removed.
Stage I cervical cancer can often be treated with surgery alone.
Radiation for Cervical Cancer
Physicians use two types of radiation to treat cervical cancer:
External radiation therapy uses a machine located outside the body to deliver radiation. The patient typically is positioned on a table during treatment.
Internal radiation therapy uses radioactive substances inside sealed containers that are placed in the body near the cancer. Because the cervix is located deep inside the body, internal radiation may allow effective treatment of the cancer without damaging other tissue. Gynecologic cancer specialists consider brachytherapy far better than external beam radiation therapy treatments for curing cervical cancer. Unfortunately, brachytherapy is not as widely available as external radiation therapy.
Radiation therapy is often used to treat stage II and stage III cervical cancer. It is also sometimes used to ease symptoms in patients with stage IV cervical cancer. Radiation is frequently used in conjunction with chemotherapy.
Chemotherapy for Cervical Cancer
Chemotherapy is medication that kills cancer cells. Some chemotherapy comes in pill form and some require intravenous administration (infusion) delivered directly into the bloodstream. Cisplatin and 5-fluorouracil are two common chemotherapy drugs for cervical cancer.
Sometimes, chemotherapy is given before surgery to shrink the tumor and make it easier to remove.
Targeted Therapy and Immunotherapy for Cervical Cancer
Cancer research has led to the development of additional effective cervical cancer treatments, including targeted therapy and immunotherapy.
Targeted therapy is the use of a medication or other substance to destroy cancer cells without killing other cells. (Side effects are still possible.) Monoclonal antibody therapy is a type of targeted therapy. Doctors use bevacizumab, a type of monoclonal antibody that inhibits tumor blood supply, to treat cervical cancer that has spread or recurred after initial treatment, such as surgery combined with chemotherapy and/or radiation.
Immunotherapy drugs help the immune system detect and kill cancer cells. Pembrolizumab is an immunotherapy medication that can be used to treat cervical cancer that returns after initial treatment.
A potential cure on the horizon is a gene-editing technique (CRISPR) to block the HPV genes responsible for cervical cancer. Initial results in a mouse model of cervical cancer are promising.
Widespread HPV vaccination may someday dramatically decrease the demand for cervical cancer treatment. According to the National Cancer Institute, Gardasil and Cervarix (two commercially available HPV vaccines) provide nearly 100% protection against infection with HPV types 16 and 18, the types most commonly associated with cervical cancer (and oral cancer). As more people are vaccinated, cervical cancer rates will likely decline.