Treatment options for cervical cancer can include surgery, radiation, and chemotherapy. Your individualized treatment plan is based on the stage of your cancer, your medical history, and your future family plans.
With treatment, cervical cancer is typically curable if it’s diagnosed in the early stages. Survival rates are very high.
Pap smears have led to increased detection and treatment of precancerous cellular changes. This has reduced the incidence of cervical cancer in the Western world.
The type of treatment used for cervical cancer depends on the stage at diagnosis. More advanced cancers usually require a combination of treatments. Standard treatment options include:
- surgery
- radiation therapy
- chemotherapy
- other medications
If precancerous cells are found in your cervix, these treatment options are available to help prevent the progression to cervical cancer.
Cryotherapy
Cryotherapy involves the destruction of abnormal cervical tissue through freezing. The procedure only takes a few minutes and is performed using local anesthesia.
Loop electrosurgical excision procedure (LEEP)
LEEP uses electricity that’s run through a wire loop to remove abnormal cervical tissue. Like cryotherapy, LEEP only takes a few minutes and can be performed at a doctor’s office with local anesthesia.
Laser ablation
Lasers may also be used to destroy abnormal or precancerous cells. Laser therapy uses heat to destroy the cells. This procedure is performed in a hospital, and local or general anesthesia may be needed, depending on the circumstances.
Cold knife conization
This procedure uses a scalpel to remove abnormal cervical tissue. Like laser ablation, it’s performed in a hospital setting, and general anesthesia may be required.
If you’re diagnosed with cervical cancer, surgery is an option that aims to remove all of the visible cancer tissue. Sometimes, nearby lymph nodes or other tissues are also removed, where the cancer has spread from the cervix.
Your doctor may recommend surgery based on several factors, such as:
- how advanced the cancer is
- your overall health
- whether you want to have children
Cone biopsy
During a cone biopsy, a cone-shaped section of your cervix is removed. It’s also called cone excision or cervical conization. It can be used to remove precancerous or cancerous cells.
The cone shape of the biopsy maximizes the amount of tissue that’s removed at the surface. Less tissue is removed from below the surface.
Cone biopsies can be performed using multiple techniques, including:
- LEEP
- laser surgery
- cold knife conization
After a cone biopsy, the abnormal cells are sent to a pathologist. This specialist examines the biopsy specimen under a microscope to detect cancerous cells. They also check the margins of the biopsied tissue to ensure that all of the precancerous or cancerous tissue was removed.
The procedure can be both a diagnostic technique and a treatment. When there’s no cancer at the edge of the cone-shaped section that was removed, further treatment may not be necessary.
Hysterectomy
Hysterectomy is the surgical removal of your uterus and cervix. It greatly reduces the risk of cancer recurrence when compared to more localized surgery. You can’t have children after a hysterectomy.
There are a few different ways to perform a hysterectomy:
- Abdominal hysterectomy removes the uterus through an abdominal incision.
- Vaginal hysterectomy removes the uterus through your vagina.
- Laparoscopic hysterectomy uses specialized instruments to remove the uterus through several small incisions in either your abdomen or vagina.
- Robotic surgery uses a robotic arm guided by a doctor to remove the uterus through small incisions in your abdomen.
A radical hysterectomy is sometimes needed. It’s more extensive than a standard hysterectomy. It removes the uterus, cervix, and upper part of the vagina.
In some cases, the fallopian tubes and the ovaries may also be removed along with the uterus. This is called a total abdominal hysterectomy and bilateral salpingo-oophorectomy. The pelvic lymph nodes may be removed as well, which is known as a pelvic lymph node dissection.
Trachelectomy
This surgery is an alternative to a hysterectomy. The cervix and upper part of the vagina are removed. The uterus and ovaries are left in place. An artificial opening is used to connect the uterus to the vagina.
Trachelectomies allow you to maintain the ability to have children. However, pregnancies after trachelectomy are classified as high-risk, because there’s an
Pelvic exenteration
This surgery is only used if cancer has spread within your pelvis. It’s usually reserved for more advanced cases. Exenteration removes your:
Surgery is usually preferred over radiation therapy for early stage cervical cancer. However, radiation therapy is an alternative to surgery if surgery can’t be performed. This may be the case for someone who has multiple medical conditions or has a poor functional health status.
Radiation uses high-energy beams to destroy cancer cells. Traditional radiation treatment employs a machine outside your body to deliver an external beam that’s aimed at the cancerous site.
Radiation can also be delivered internally using a procedure called brachytherapy. An implant containing radioactive material is placed in your uterus or vagina. It’s left in place for a set amount of time before being removed. The amount of time it’s left in can depend on the radiation dose.
Radiation can have significant side effects. Most of these go away once treatment is completed, but vaginal narrowing and damage to the ovaries can be permanent.
Chemotherapy uses medication to kill cancer cells. Medication may be administered before surgery to shrink tumors. It can also be used after surgery to get rid of remaining microscopic cancerous cells.
In some cases, chemotherapy is combined with radiation, since chemotherapy kills cancer cells and sensitizes the tumor to the radiation. This is called concurrent chemoradiation.
Chemotherapy can be used to treat advanced cervical cancer, or cancer that has spread from the cervix to other organs and tissues. Sometimes, a combination of chemotherapy drugs is given. Chemotherapy drugs can cause significant side effects, but these usually go away once treatment is over.
According to the
- cisplatin (Platinol)
- carboplatin (Paraplatin)
- paclitaxel (Taxol)
- topotecan (Hycamtin)
In addition to chemotherapy drugs, newer medications are increasingly becoming available to treat cervical cancer. These drugs fall under two different types of therapy: targeted therapy and immunotherapy.
Targeted therapy
Targeted therapy drugs are able to specifically identify and attack cancer cells. Often, targeted therapy drugs are antibodies that are made in a laboratory.
Bevacizumab (Avastin, Mvasi) is an antibody that’s Food and Drug (FDA)–approved to treat cervical cancer. It works by interfering with the blood vessels that help cancerous cells to develop. Bevacizumab is used to treat recurring or metastatic cervical cancer.
Immunotherapy
Immunotherapy drugs use your immune system to help combat cancer cells. A common type of immunotherapy is called an immune checkpoint inhibitor. These drugs attach to a specific protein on cancer cells, allowing immune cells to find and kill them.
Pembrolizumab (Keytruda) is an immune checkpoint inhibitor that’s been FDA-approved to treat advanced or metastatic cervical cancer. It’s used when cervical cancer continues to progress either during or after chemotherapy.
Many cervical cancer treatment options can make it difficult or even impossible for you to get pregnant after treatment is over. Researchers are developing new options for people who have had treatment for cervical cancer to preserve fertility and sexual functioning.
Oocytes, or eggs, are at risk of damage from radiation therapy or chemotherapy. However, they can be harvested and frozen before treatment. This provides an option for getting pregnant after treatment using your own eggs.
In vitro fertilization is also an option. Your eggs are harvested and fertilized with sperm before treatment begins, and then the embryos can be frozen and used for pregnancy after the treatment is over.
One option that’s still being studied is something called a
Taking certain steps can help prevent cervical cancer. Start with these strategies.
Minimize risk factors
Most cases of cervical cancer are human papillomavirus (HPV)-related. Risk factors for contracting HPV include:
- starting to have sex at a young age
- having multiple sexual partners
- having high-risk sexual partners
- having a previous history of contracting a sexually transmitted infection (STI)
Taking steps to avoid these risk factors can help prevent HPV and cervical cancer.
Other cervical cancer risk factors to avoid that aren’t related to HPV include smoking cigarettes and using oral contraceptives.
Talk with a doctor about your risk factors to help you understand what steps you can take to minimize them.
Get regular cervical cancer screenings
Start by getting regular cervical cancer screenings. Screenings can either identify changes in the cells of your cervix (Pap smear) or find the HPV virus, an important risk factor for cervical cancer.
In 2018, the U.S. Preventive Services Task Force released
Under age 21: Cervical cancer screenings aren’t recommended.
Between ages 21 and 29: Cervical cancer screening via Pap smear should be performed every 3 years.
Between ages 30 and 65: There are three options for cervical cancer screening within this age bracket. They include:
- Pap smear every 3 years
- high-risk HPV (hrHPV) testing every 5 years
- both Pap smear and hrHPV testing every 5 years
Over age 65: Cervical cancer screenings aren’t recommended as long as you’ve received adequate prior screenings.
Get vaccinated
A vaccine is also available to prevent infection with the types of HPV most likely to cause cancer. Currently, it’s
Using condoms or other barrier methods when having sex can also reduce your risk of developing HPV.
The outlook for people with cervical cancer depends on the stage at the time it’s diagnosed. The 5-year survival rates for people with cancer that was diagnosed early are excellent.
According to the
If you’re diagnosed with cervical cancer, your individualized treatment plan will depend on:
- the stage of your cancer
- your medical history
- if you want to get pregnant after treatment
Work with your doctor to determine the treatment approach that’s best for you.