Cervical cancer

Alternative Names

Treatment

Treatment of cervical cancer depends on the stage of the cancer, the size and shape of the tumor, the age and general health of the woman, and her desire to have children in the future.

Early cervical cancer can be cured by removing or destroying the pre-cancerous or cancerous tissue. There are various surgical ways to do this without removing the uterus or damaging the cervix, so that a woman can still have children in the future.

Types of surgery for early cervical cancer include:

• LEEP (Loop Electrosurgical Excision Procedure) - uses electricity to remove abnormal tissue
• Cryotherapy - freezes abnormal cells
• Laser therapy  - uses light to burn abnormal tissue

A hysterectomy (removal of the uterus but not the ovaries) is not often performed for cervical cancer that has not spread. It may be done in women who have repeated LEEP procedures. However, in more advanced disease, a radical hysterectomy may be performed. This type of hysterectomy removes the uterus and much of the surrounding tissues, including internal lymph nodes and upper part of the vagina. In the most extreme surgery, called a pelvic exenteration, all of the organs of the pelvis, including the bladder and rectum, are removed.

Radiation may be used to treat cancer that has spread beyond the pelvis, or cancer that has returned. Radiation therapy is either external or internal. Internal radiation therapy uses a device filled with radioactive material, which is placed inside the woman's vagina next to the cervical cancer. The device is removed when she goes home. External radiation therapy beams radiation from a large machine onto the body where the cancer is located. It is similar to an x-ray.

Chemotherapy uses drugs to kill cancer. Some of the drugs used for chemotherapy for cervical cancer include 5-FU, Cisplatin, Carboplatin, Ifosfamide, Paclitaxel, and Cyclophosphamide. Sometimes radiation and chemotherapy are used before or after surgery.

Support Groups

National Cervical Cancer Coalition - http://www.nccc-online.org/

Outlook (Prognosis)

Many factors influence the outcome of cervical cancer. These include: 

• The type of cancer
• The stage of the disease
• The age and general physical condition of the woman

Pre-cancer conditions are completely curable when followed up and treated properly. The chance of being alive in 5 years (5-year survival rate) for cancer that has spread to the inside of the cervix walls but not outside the cervix area is 92%.

However, the 5-year survival rate falls steadily as the cancer spreads into other areas.

Possible Complications

• Some types of cervical cancer do not respond well to treatment.
• The cancer may come back (recur) after treatment.
• Women who have treatment to save the uterus have a high risk of the cancer coming back (recurrence). 
• Surgery and radiation can cause problems with sexual, bowel, and bladder function.

When to Contact a Medical Professional

Call your health care provider if you:

• Are a sexually active woman who has not had a Pap smear in the past year
• Are at least 20 years old and have never had a pelvic examination and Pap smear
• Think your mother may have taken DES when she was pregnant with you
• Have not had regular Pap smears (ask your health care provider how often you should have one performed)

References

Lowy DR, Schiller JT. Prophylactic human papillomavirus vaccines. J Clin Invest. 2006 May;116(5):1167-73.

Villa LL, Ault KA, Giuliano AR, et al.  Immunologic responses following administration of a vaccine targeting human papillomavirus Types 6, 11, 16, and 18. Vaccine. 2006 May 15 [Epub ahead of print].

US Food and Drug Administration. FDA Licenses New Vaccine for Prevention of Cervical Cancer and Other Diseases in Females Caused by Human Papillomavirus. Rockville, MD: National Press Office; June 8, 2006. P06-77.