Treatment for Cervical Cancer
Treatment for cervical cancer depends on several factors, including the stage of the disease. In cases of cervical intraepithelial neoplasia (CIN), abnormal tissue may be removed using loop electrode excision (using wire loops heated by electric current) or cone biopsy.
Carcinoma in situ may be removed using loop electrode excision, cryosurgery, or laser ablation. In cryosurgery, liquid nitrogen is circulated through a probe, which is applied to cancerous tissue. Freezing temperatures destroy the cancer cells. Laser ablation involves using a laser (device that emits intense heat and light at close range) to remove cancerous tissue.
Invasive Cervical Cancer Treatment
Invasive cervical cancer and metastatic disease are usually treated with surgery, radiation, and chemotherapy.
Surgical treatment for invasive cervical cancer is radical hysterectomy, which is the removal of the uterus, fallopian tubes, ovaries, adjacent lymph nodes, and part of the vagina. If cancer has spread (metastasized) to lymph nodes in the abdomen, lymphadenectomy (surgical removal of lymph nodes) may also be performed.
Radiation therapy may be used alone, or after surgery, or chemotherapy. In this treatment, radiation is delivered by a machine outside the body (called external beam radiation) or by radioactive "seeds" implanted in the uterus and vagina (called brachytherapy). After surgery, radiation may be used to decrease the risk for recurrence. Side effects of radiation therapy include fatigue, swelling, and skin reddening.
Chemotherapy uses toxic drugs to destroy cancer cells. Cisplatin (Platinol) and fluorouracil (Adrucil, Efudex) are often used in combination and in addition to radiation to treat invasive cervical cancer. Chemotherapy is administered intravenously, through injection, or in pill form. Side effects may be severe and include nausea, vomiting, diarrhea, and leukopenia (low white blood cell count).
In August 2014, the U.S. Food and Drug Administration (FDA) approved bevacizumab (Avastin) to treat persistent, recurrent, or late-stage cervical cancer. This drug is approved for use in combination with other chemotherapy drugs such as paclitaxel and cisplatin or paclitaxel and topotecan (approved as a treatment in 2006).
Avastin also is used to treat other types of cancer. Common side effects of this biologic agent include fatigue, loss of appetite, high blood pressure, and others. In clinical trials, the drug increased survival (from 12.9 months to 16.8 months) in women with advanced cervical cancer over treatment with chemotherapy alone.
Prognosis for Women with Cervical Cancer
Cancer of the cervix often can be cured, if it is detected and treated early. The prognosis depends on the stage of the disease at the time of diagnosis. The 5-year survival rate for all stages of cervical cancer combined is approximately 70 percent.