Treating cervical cancer
Treatments for cervical cancer are simplest and most effective when they're started early.
Like most cancers, cervical cancer is easiest to treat when it's caught early. The farther the cancer has spread, the more complex treatment becomes.
The early stages
When abnormal cells are found only on the surface of the cervix, this may be called cervical precancer or a cervical intraepithelial lesion (CIN).
At this point treatment options usually include:
- Loop electrosurgical excision procedure (LEEP), in which a doctor uses an electric wire loop to slice away a thin piece of tissue.
- Cryotherapy, or freezing the abnormal tissue.
- Laser therapy, which uses a beam of intense light to destroy the abnormal tissue.
- Conization, which removes a cone-shaped piece of cervical tissue. Doctors may also use this procedure to check for cancer.
Cryotherapy and LEEP can be done in a doctor's office. Conization and laser therapy are done in a hospital.
If abnormal cells spread beyond the surface of the cervix into deeper tissue or to other organs, it's called invasive cervical cancer.
The four main treatment options at this point are surgery, radiation, chemotherapy and targeted therapy. Two or more of these treatments may be used together.
Surgery for cervical cancer can range from removing a small amount of tissue to removing several organs in the pelvis, depending on how far the cancer has spread.
Surgical options include:
- Any of the procedures used for cervical precancer.
- A simple hysterectomy to remove the uterus.
- A radical hysterectomy, which removes the uterus, cervix, part of the vagina, and nearby tissues and ligaments. The ovaries, fallopian tubes, or nearby lymph nodes may also be removed.
- Pelvic exenteration. In addition to the organs and tissues removed in radical hysterectomy, this surgery also removes the bladder, vagina, rectum and part of the colon.
Radiation therapy uses rays of intense energy to damage or destroy cancer cells.
External radiation therapy uses a machine to direct radiation at a specific point in the body. Internal radiation therapy uses radioactive materials placed directly into the body.
Chemotherapy uses drugs to kill cancer cells. Because these drugs travel through the whole body in the bloodstream, chemotherapy is often used when cancer has spread beyond the cervix.
Chemotherapy drugs can be taken by mouth or injected directly into a vein. Two or more drugs may be given at once.
Targeted therapy uses drugs or other substances to attack cancer cells without harming normal cells.
The right combination
The best treatment for any case of cervical cancer or precancer depends on several factors, according to the American Cancer Society. These factors include:
- The woman's age.
- The type and stage of the cancer.
- The woman's general health.
- The woman's plans, if any, for future pregnancies.
Some women prefer to get a second opinion before starting treatment of any kind. Some insurance companies require this.
Before any treatment, a woman may want to ask about:
- The goal of the treatment.
- Other treatment options.
- How long the treatment will take.
- What side effects to expect.
- The cost of treatment.
- The chances that the treatment will be successful.
- Whether she is a good candidate for a clinical trial.
Regular follow-up exams after treatment for cervical cancer or precancer are essential to make sure the disease doesn't come back. Regular follow-ups may need to be done for several years.
Some treatments can also cause side effects that show up years later. Regular checkups offer a woman the chance to report any problems that arise.