The most common treatments for cervical cancer are surgery, radiation therapy and chemotherapy. Radiation therapy or surgery is generally used for small tumors. Chemoradiation (a combination of chemotherapy and radiation therapy) is generally used for women with invasive cervical cancer. Surgery and radiation therapy are both called local therapies because they affect only the area around the cancer site. Chemotherapy is a systemic therapy because it affects the entire body.
In surgery, the doctor operates on the patient to remove the cancerous tissue. For cervical cancer that has not spread beyond the cervix, these procedures are often used:
- Conization This procedure uses the same technique as a cone biopsy to remove all of the abnormal tissue. Conization can be used to remove microinvasive cervical cancer.
- Loop Electrosurgical Excision Procedure (LEEP) An electrical current is passed through a thin wire hood. The hook removes the tissue. LEEP can be used to remove microinvasive cervical cancer.
- Hysterectomy This surgery involves removal of the uterus and cervix. Hysterectomies can be either a simple hysterectomy, which involves removal of the uterus and cervix, or a radical hysterectomy, which involves removal of the uterus, cervix, upper vagina and the tissue around the cervix. In addition, a radical hysterectomy includes an extensive pelvic lymph node dissection (removal of the lymph nodes). If needed, bilateral salpingo-oophorectomy (the removal of both fallopian tubes and both ovaries) is done at the same time as the hysterectomy.
This surgery removes the cervix and leaves the uterus intact. This procedure, along with a pelvic lymph node dissection, may be used for young patients who desire fertility preservation (to have children in the future).
Surgery that removes the cervix, uterus, part of the vagina and the nearby lymph nodes. This surgery can be performed in patients with disease confined to the cervix.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy travels through the bloodstream to tumor cells throughout the body. The goal of chemotherapy can be to destroy cancer remaining after surgery, slow the tumor’s growth or reduce side effects.
Although chemotherapy can be given orally (by mouth), most drugs used to treat cervical cancer are given intravenously (through an IV). IV chemotherapy is either injected directly into a vein or through a thin tube called a catheter, a tube temporarily put into a large vein to make injections easier.
Because chemotherapy affects normal cells as well as cancer cells, many people experience side effects from treatment.
Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. Radiation therapy may be given alone or before surgery to shrink the tumor. Some women may be treated with a combination of radiation therapy and chemotherapy.