Treatment for cervical cancer is highly individualized and may involve surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy or a combination of approaches. At Saint John’s Cancer Institute, specialists work together to develop a treatment plan based on the stage and characteristics of the cancer, your overall health, and individual considerations such as fertility and quality of life.
Choosing the appropriate treatment begins with understanding how far the cancer has progressed and whether it has spread beyond the cervix. Your care team may also consider tumor characteristics, previous treatments, other health conditions and your personal goals when recommending a treatment approach. For some patients, preserving fertility is an important part of these discussions and should be considered before treatment begins.
How Is Cervical Cancer Treated?
Different stages of cervical cancer can require very different approaches to treatment. Early-stage cancers may be treated with surgery in appropriately selected patients, while radiation therapy combined with chemotherapy is an important treatment for many locally advanced cancers. Targeted therapy, immunotherapy and chemotherapy may also be used in certain locally advanced, recurrent or metastatic cancers.
Treatment decisions are made with both cancer control and quality of life in mind. Gynecologic oncologists, radiation oncologists, medical oncologists and other specialists may participate in planning care so that the different treatment options can be considered together rather than independently.
For information about cervical cancer causes, symptoms, diagnosis and stages, visit Cervical Cancer.
Surgery for Cervical Cancer
Surgery may be an option for some patients with early-stage cervical cancer. The type and extent of surgery depend on factors such as the size and location of the cancer, whether it has spread, and whether preserving fertility is an important consideration.
Hysterectomy
A hysterectomy removes the uterus and cervix. Depending on the extent of the cancer, a radical hysterectomy may be recommended, which also removes tissue surrounding the cervix and part of the upper vagina. Nearby lymph nodes may also be evaluated or removed to determine whether cancer has spread.
Fertility-Sparing Surgery
For carefully selected patients with certain early-stage cervical cancers who wish to preserve the possibility of pregnancy, fertility-sparing surgery may be considered. A radical trachelectomy removes the cervix and nearby tissue while preserving the uterus. Whether this approach is appropriate depends on characteristics of the cancer and should be discussed before treatment begins.
Ovarian Considerations
Removal of the ovaries is not required for every patient undergoing surgery for cervical cancer. Whether the ovaries can be preserved depends on factors including age, menopausal status, the type and extent of cancer and the planned treatment. Your surgeon can discuss how the proposed operation may affect fertility, hormone function and long-term health.
Radiation Therapy for Cervical Cancer
Radiation therapy is an important treatment for cervical cancer and may be used as the primary treatment or, in certain situations, following surgery. For many patients with locally advanced cervical cancer, radiation is given together with chemotherapy, an approach known as concurrent chemoradiation. Treatment commonly combines external beam radiation therapy with brachytherapy to treat the cancer from outside and inside the body.
External Beam Radiation Therapy (EBRT)
External beam radiation therapy delivers radiation to the cervix and other areas at risk using a machine outside the body. Modern techniques such as intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT) help the radiation oncology team shape and position treatment while limiting radiation exposure to surrounding healthy tissues and organs.
Brachytherapy
Brachytherapy delivers radiation from a source placed inside or close to the area being treated. In cervical cancer, it is commonly used with external beam radiation therapy and allows a concentrated dose of radiation to reach the cervix and tumor while reducing exposure to surrounding structures. The radiation oncology team determines the technique and treatment schedule according to the individual treatment plan.
Radiation therapy can cause side effects such as fatigue, bowel or bladder changes, nausea and irritation of tissues within the treatment area. The type and severity of side effects vary, and the care team can provide medications, supportive care and other strategies to help manage them during and after treatment.
Learn more about Vasek Polak Radiation Oncology at Saint John’s Health Center.
Chemotherapy and Chemoradiation for Cervical Cancer
Chemotherapy uses medications that travel through the bloodstream to treat cancer cells. In cervical cancer, chemotherapy can serve different purposes depending on the stage and treatment plan. It may be given with radiation therapy, used as part of treatment for recurrent or metastatic disease, or incorporated into other individualized treatment strategies.
Concurrent Chemoradiation
For many patients with locally advanced cervical cancer, chemotherapy is given during radiation therapy. Cisplatin is commonly used because it can make cancer cells more sensitive to radiation, helping the two treatments work together. The exact regimen and radiation schedule are determined by the treatment team.
Chemotherapy for Recurrent or Metastatic Cervical Cancer
When cervical cancer has returned after treatment or spread to distant parts of the body, chemotherapy may be used to control the cancer, relieve symptoms and help patients live longer. Depending on the individual cancer, chemotherapy may also be combined with targeted therapy or immunotherapy.
Chemotherapy can affect healthy cells as well as cancer cells and may cause side effects such as fatigue, nausea, changes in blood counts and increased risk of infection. Treatment is monitored closely so that side effects can be addressed and the treatment plan adjusted when necessary.
Targeted Therapy for Cervical Cancer
Targeted therapies are medications designed to interfere with particular processes that cancer cells use to grow, survive or spread. They differ from traditional chemotherapy in how they act on cancer and may be used for certain patients with persistent, recurrent or metastatic cervical cancer.
The appropriate targeted therapy depends on the clinical situation and, for some treatments, characteristics identified through testing of the cancer. These therapies may be given alone or in combination with chemotherapy, immunotherapy or other treatments. Your oncology team can explain whether targeted therapy has a role in your individual treatment plan.
Immunotherapy for Cervical Cancer
Immunotherapy helps the immune system recognize and attack cancer cells and has become an important treatment option for some patients with cervical cancer. Depending on the stage, previous treatment and characteristics of the cancer, immunotherapy may be used with other treatments or as part of therapy for persistent, recurrent or metastatic disease.
Testing for biomarkers may help determine whether certain immunotherapies are appropriate, although eligibility depends on the specific treatment and clinical circumstances. Because cervical cancer treatment continues to evolve, your oncology team can explain how current immunotherapy options may apply to your diagnosis.
Clinical Trials for Cervical Cancer
Clinical trials help evaluate new treatments and new ways of using existing therapies for cervical cancer. Depending on your diagnosis and previous treatment, participation in a clinical trial may provide access to an investigational approach while helping researchers improve treatment for future patients.
Saint John’s Cancer Institute participates in cancer research and clinical trials as part of its commitment to advancing cancer care. Your care team can discuss whether an appropriate clinical trial may be available and how participation could fit within your overall treatment plan.
Common Questions About Cervical Cancer Treatment
Treatment decisions can raise questions about what happens next, how treatment may affect your body and whether choices made now could affect fertility or future health. Your care team can help you understand these considerations in the context of your diagnosis and treatment plan.
What happens after I am diagnosed with cervical cancer?
After cervical cancer is diagnosed, the next step is to determine the extent of the cancer and gather the information needed to plan treatment. This may involve imaging, examination and other testing to determine the stage of the cancer and whether it has spread to nearby tissues, lymph nodes or other parts of the body.
Your treatment plan can then be developed based on the stage and characteristics of the cancer, your overall health and your individual priorities. Because cervical cancer treatment may involve surgery, radiation therapy and systemic treatments, specialists from several areas of cancer care may participate in determining the appropriate approach.
Can cervical cancer treatment affect fertility?
Yes. Some treatments for cervical cancer can affect the ability to become pregnant or carry a pregnancy. The impact depends on the treatment you receive and may be affected by surgery involving the cervix or uterus, radiation to the pelvis, chemotherapy and other individual factors.
For carefully selected patients with certain early-stage cervical cancers, fertility-sparing treatment may be possible. If future pregnancy is important to you, discuss this with your care team before treatment begins so that appropriate options can be considered as part of treatment planning.
What happens if my cervix is removed?
The effects of removing the cervix depend on the type of surgery performed. A radical trachelectomy removes the cervix and nearby tissue while preserving the uterus and may allow some patients to pursue pregnancy in the future. A hysterectomy removes both the cervix and uterus, which means pregnancy is no longer possible and menstrual periods will stop.
The ovaries are separate from the cervix and uterus and may sometimes be preserved during cervical cancer surgery. If both ovaries are removed or their function is affected by treatment, menopause can occur. Your surgeon can explain exactly which organs and tissues are expected to be removed and how the operation may affect fertility, sexual health and hormone function.
Does removing the cervix get rid of HPV?
No. Removing the cervix treats cervical disease but does not necessarily eliminate human papillomavirus (HPV) from the body. HPV can also affect tissues elsewhere in the genital area, and whether an infection persists depends in part on how the immune system responds to the virus.
Patients who have been treated for cervical cancer or significant precancerous changes may need continued surveillance even after the cervix has been removed. Your care team will recommend follow-up based on your medical history, previous test results and the treatment you received.
Moving Forward After Cervical Cancer Treatment
Cervical cancer treatment does not end with the final procedure, radiation treatment or medication. Follow-up care provides an opportunity to monitor recovery, evaluate new symptoms, manage treatment-related effects and address concerns involving sexual health, fertility, menopause, emotional well-being and quality of life.
Your follow-up schedule will depend on your diagnosis and treatment. Staying connected with your cancer care team can help ensure that changes in your health are evaluated appropriately and that supportive services are available as your needs change during recovery and survivorship.
If you have been diagnosed with cervical cancer, our multidisciplinary team can help you understand your treatment options and determine the next steps in your care.
If you have questions regarding cervical cancer or would like an expert second opinion, please call today or click here to schedule an appointment.
