The treatment for cervical cancer is determined by the stage of the cancer, the patient’s age, and whether the patient wants to have children. If a woman who is pregnant is diagnosed with cervical cancer, treatment may be postponed until after the birth.
Treatments for cervical cancer include surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy.
Surgery – The type of surgery used for cervical cancer depends on the stage of the cancer and includes conization (removal of cone-shaped portion of the cervix; cone biopsy) for early stage cervical cancer, using a scalpel, electrosurgical current, or laser; total hysterectomy (removal of the uterus) either through the abdomen, the vagina, or with a laparoscope; radical hysterectomy (removal of the uterus, cervix, part of the vagina, and the ligaments and tissues surrounding these organ, and which often includes removal of the ovaries, fallopian tubes, or nearby lymph nodes) for advanced stage cervical cancer; modified radical hysterectomy (removal of the uterus, cervix, upper part of the vagina, and ligaments and tissues surrounding these organs and some lymph nodes); radical trachelectomy (removal of the cervix, nearby tissue and lymph nodes, and upper part of the vagina); bilateral salpingo-oophorectomy (removal of the fallopian tubes and both ovaries); and pelvic exenteration (removal of the cervix, vagina, ovaries, and nearby lymph nodes, lower colon, rectum, and bladder, with the placement of artificial urine and stool openings with collection bags); and artificial vagina construction.
Radiation therapy – Radiation therapy uses high-energy X-rays, protons, or other types of radiation to kill cancer cells. Types of radiation therapy used for cervical cancer include external radiation therapy (intensity-modulated radiation therapy; IMRT), which directs radiation at the cancer, and internal radiation therapy, in which radioactive needles, seeds, wires, or catheters are placed directly in the cancer. In addition to treatment, radiation therapy can be used to help alleviate the symptoms of cervical cancer.
Patients with cervical cancer who have not yet had children should speak with their doctor about egg preservation before undergoing radiation therapy.
Chemotherapy – Chemotherapy uses drugs that kill cancer cells or prevent them from growing and can be administered orally (pill), intravenously (IV), intraabdominally (directly into the abdomen), or intrathecally (into the spinal canal) and may be combined with other treatments.
Targeted therapy – Targeted therapy uses drugs that target specific proteins on cancer cells to prevent them from growing or to kill cancer cells and include monoclonal antibodies (bevacizumab), which can be given by infusion and is used to treat cervical cancer that has spread (metastasized) and recurrent cervical cancer.
Immunotherapy (Biotherapy or Biologic therapy) – Immunotherapy uses a patient’s immune system to kill cancer cells and uses the immune checkpoint inhibitor, pembrolizumab, for the treatment of recurrent cervical cancer.
Palliative (Supportive) care – Palliative care for cervical cancer focuses on relief of pain and other symptoms while undergoing cancer treatment and may also be used to help improve patient quality of life.