Cervical Cancer: Primary Therapy

Treatment for cervical cancer depends on many factors, and may involve surgery, radiation, and/or chemotherapy. The main factor that determines treatment is the stage of the cervical cancer. Other factors include the woman’s age and general health, as well as whether she desires to have children in the future.

Surgery

Early stage cervical cancer is usually treated with surgery. There are different kinds of surgery used to treat cervical cancer, such as:

  • Cold knife conization – this is a minor surgery that entails removing a cone-shaped portion of the cervix with a scalpel. It is performed for very early stages of cervical cancer, especially in women who desire to have children in the future.

  • Simple hysterectomy – this surgery is also used in very early stages of cervical cancer in which only the uterus and cervix are removed.

  • Radical hysterectomy – this surgery is used for cervical cancers that are still considered early stage, but have grown into the cervix a little further, or grown to be a little bigger. This surgery involves removal of the uterus and cervix, but also the tissue surrounding the uterus and cervix (known as the parametrium), a small portion of the upper vagina, and the lymph nodes in the pelvis.

Radiation

Radiation therapy uses strong beams of energy to kill cancer cells. Radiation therapy may be used alone, in combination with chemotherapy, or after surgery. It can be given either externally and/or internally. When given externally, the beams of radiation energy are directed to the areas affected by the cancer. When given internally, a device filled with radioactive material is placed inside the vagina, directly next to the cervix.

Chemotherapy

Chemotherapy involves using medications to kill cancer cells. It is injected into veins and travels through the bloodstream of the entire body. It may be used in combination with radiation therapy in order to enhance the effects of the radiation. Or, two or three different types of chemotherapy may be used together to treat cancers that have spread to areas of the body that are far away from where the cancer started in the cervix.

Fertility-sparing options

Cervical cancer often develops in young women who would like to have children. For women with early stage cervical cancer who would like to have children in the future, possible surgical options include either a cold knife conization or a radical trachelectomy. With a cold knife conization, only a portion of the cervix is removed. This is an option for only the earliest stage of cervical cancer. With a radical trachelectomy, the entire cervix is removed, along with the tissue surrounding the cervix and the lymph nodes in the pelvis. For women who need radiation or chemotherapy for treatment of their cervical cancer, it may be possible to preserve their eggs before treatment.