Treatment of cervical cancer will depend on a number of factors, including:
- The stage of the cancer
- The size of the tumor
- The patient's desire to have children
- The patient's age and overall health
Whether or not surgery is part of treatment, and the type of surgery, depends on the size and stage of cervical cancer. Very early lesions may be treated with a cone biopsy or simple hysterectomy (removal of uterus.) For cancers for up to 4 cm in size, a radical hysterectomy may be appropriate.
Radical hysterectomy: The surgeon removes the cervix, uterus, part of the vagina and the tissues surrounding the cervix called the parametria. At the same time, the surgeon also removes nearby lymph nodes. Depending on a woman's age and the size of the tumor, she may also have a bilateral salpingo-oophorectomy (removal of the ovaries and fallopian tubes).
Radiation therapy is used for cancers that are greater than 4 cm or have spread beyond the cervix (II, III or IV).
Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or shrink the tumor. Radiation therapy is used instead of surgery in most cases. However, it is sometimes necessary after surgery if it is discovered that the cancer has spread outside the cervix, or to reduce the risk that a cancer will come back after surgery.
Often, radiation therapy is combined with chemotherapy to enhance the effects of the radiation.
There are two types of radiation therapy:
- External radiation therapy uses a machine outside the body to send radiation toward the cervical cancer. Internal radiation therapy uses a small amount of radioactive material that is delivered directly to the tumor using implants.
- Internal radiation therapy implants are inserted through the vagina into the cervix, where they are placed next to the tumor while the patient is under anesthesia. The implants stay in place for a few days.
Chemotherapy uses drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing. Chemotherapy can be given by mouth or injected into a vein or muscle. In most cases, it is given to a patient through a vein during an outpatient visit using systemic chemotherapy. The drugs enter the bloodstream and can reach cancer cells throughout the body.
Almost all cervical cancer patients in good medical condition who are receiving radiation, will be offered chemotherapy in addition to radiation therapy.