Cervical Cancer Treatment

The treatment of cervical cancer depends on several factors, including the type and stage of cancer, possible side effects, and the woman’s preferences and overall health. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care.

Women with cervical cancer may have concerns about if or how their treatment may affect their sexual function and fertility (ability to have children), and these topics should be discussed with the health care team before treatment begins. A woman who is pregnant should talk with her doctor about how treatments could affect both her and the unborn child. Treatment may be able to be delayed until after the baby is born.

Surgery for Cervical Cancer

Surgery is the removal of the tumor and surrounding tissue during an operation. A surgical oncologist is a doctor who specializes in treating cancer using surgery. For cervical cancer that has not spread beyond the cervix, these procedures are often used:

• Conization is the use of the same procedure as a cone biopsy (see Diagnosis) to remove all of the abnormal tissue. It can be used to remove microinvasive cervical cancer.
• LEEP is the use of an electrical current passed through a thin wire hook. The hook removes the tissue. It can be used to remove microinvasive cervical cancer.
• A hysterectomy is the removal of the uterus and cervix. Hysterectomy can be either a simple hysterectomy, which is the removal of the uterus and cervix, or a radical hysterectomy which is the 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, which means the removal of the lymph nodes.
• If needed, a bilateral salpingo-oophorectomy. This is the removal of both fallopian tubes and both ovaries and is done at the same time as the hysterectomy.
• Radical trachelectomy is surgery to remove the cervix that leaves the uterus intact with pelvic lymph node dissection. It may be used for young patients who want to preserve their fertility. This procedure has gained acceptance as an alternative to a hysterectomy.

For cervical cancer that has spread beyond the cervix, this procedure may be used:

• Exenteration is the removal of the uterus, vagina, lower colon, rectum, or bladder if cervical cancer has spread to these organs following radiation therapy (see below). Exenteration is typically done after radiation treatment if the cancer has come back.

Complications or side effects from surgery vary depending on the extent of the procedure. Occasionally, patients experience significant bleeding, infection, or damage to the urinary and intestinal systems.

If extensive surgical procedures have affected sexual function, other surgical procedures can be used to make an artificial vagina. Because these surgical procedures affect a woman′s sexual health, women should talk with their doctor about their symptoms and concerns in detail before the surgery.