Cervical cancer treatment can include surgery or radiation and chemotherapy (medication). Your treatment plan will depend on how deeply the tumor has penetrated the tissue, if lymph nodes are involved, and if cancer has spread to other parts of your body. This is called staging.
Your age, general health, and your desire to have children in the future also come into play for your treatment plan. Your care team will work with you and coordinate your care across all specialists to find the best treatment options for you.
Your doctor will send a tumor biopsy to a pathologist, who will look for problems with genes and proteins that are driving tumor growth. The results will tell your care team how you might respond to new therapies and investigational treatments.
If you’re younger and want to have children, doctors might help you keep your fertility. We work with the Columbia University Fertility Center, one of the oldest and largest fertility programs in the country, to help you find the best option for you. We have specialized programs specifically for patients undergoing cancer treatments who are interested in fertility preservation.
Your gynecologic oncologist may be able to remove your cancer surgically, depending on whether it has spread beyond your cervix.
Cryosurgery freezes precancerous cells to kill them.
Laser ablation burns precancerous cells to kill them.
Cervical conization removes the cancerous part of your cervix.
Trachelectomy removes your entire cervix but preserves the uterus allowing you to become pregnant in the future.
These procedures can allow you to preserve your fertility, but they are only available for early-stage cancers.
Simple hysterectomy removes your entire uterus and cervix, but leaves your parametria and uterosacral ligaments, vagina, and pelvic lymph nodes intact. Your doctor will usually leave your ovaries in place unless there’s a medical reason to remove them. We use minimally invasive techniques as often as possible.
Radical hysterectomy removes your entire uterus, cervix, parametria and uterosacral ligaments, and the top part of your vagina. Your doctor will often remove lymph nodes to find out if cancer has spread to them. They’ll often leave your ovaries unless there’s a medical reason to remove them. We use minimally invasive techniques as often as possible.
Radiation therapy uses high-energy X-rays to destroy cancer cells. Radiation therapy may be part of your treatment plan based on the tumor size, extent, and location. If your doctors determine you are not a candidate for surgery, radiation is usually delivered in combination with chemotherapy with the goal to destroy tumor cells while preserving urinary and bowel function. Your radiation oncologist, who is part of your personal care team, will design an optimal treatment plan for you for the best possible results.
Your radiation treatment plan may include one or a combination of the following types of radiation therapy depending on your disease stage:
External Beam Radiation
External beam radiation is used to deliver radiation to the pelvis. We use conformal techniques to help minimize radiation dose to the bladder, bowel, and rectum while focusing the radiation on areas within the pelvis where tumor cells have or may have spread to.
Treatments are delivered daily as an outpatient over a few weeks. Each treatment lasts only a few minutes.
Brachytherapy, or internal radiation, is a treatment where a radioactive source is placed directly inside or very close to the tumor. It is able to deliver very high doses of radiation while sparing surrounding normal tissues. There are many different types of applicators that may be used to deliver brachytherapy in the pelvis. Your radiation oncologist will meet with you to discuss whether brachytherapy should be part of your treatment plan and what type of brachytherapy would be most appropriate.
Chemotherapy is the most commonly known cancer treatment. Chemotherapy uses medications (chemicals) to stop cancer growth and spread, and to prevent cancer from recurring, by causing rapidly dividing cancer cells to become damaged and die.
Chemotherapy is “systemic” medicine—it interferes with all fast-dividing cells in your body. This is why it causes side effects like hair loss.
Chemotherapy is often given through an IV in our infusion center. It’s given in cycles across a few weeks, with each treatment followed by a rest period.
You may have chemotherapy before surgery (neoadjuvant) to shrink the tumor so it can be removed with less extensive surgery. Or, you may have chemotherapy in combination with radiation either after surgery or as the primary treatment for cervical cancer.
We routinely test tumors for biomarkers—proteins and genes—using an unprecedented, broad genetic panel that tells us if you can benefit from new targeted therapies.
You may qualify to participate in a clinical trial, which is a research study to learn more about promising new treatments or supportive care therapies. The hope is to improve the quality of life and survivorship of cervical cancer patients. You can talk to your care team about whether a clinical trial is an option for you.
Gynecologic Oncology Survivorship Program
Once you’re finished with treatment, you’ll enter a period of surveillance to make sure your cancer doesn’t return, and if it does, to catch it early. Our experts in the Gynecologic Oncology Survivorship Program create an individualized survivorship plan for you. This plan is a comprehensive assessment that includes all the treatment you received, possible late side effects to watch for, a blueprint for future cancer screening, a surveillance plan, and a personalized plan for wellness activities to improve your lifestyle.
Surveillance for cervical cancer typically includes ongoing Pap tests and possibly imaging tests. You’ll usually see your gynecologic oncologist instead of your regular gynecologist for these tests.
When cancer comes back after treatment, it’s called recurrence.
Cancer can recur anywhere in your body, including your pelvis or abdominal cavity, or distant areas such as your lungs, liver, or bone.
It’s important to communicate any of these symptoms of recurrence to your gynecologic oncology team:
- Vaginal bleeding
- Pelvic or abdominal pain
- Nausea or vomiting
- Changes in bowel or bladder habits
Treatment depends on what previous treatment you had and the site and extent of the disease. Your individualized care plan can include surgery, radiation, and chemotherapy. Many people also participate in clinical trials to access new and promising drugs that wouldn’t otherwise be available, or that target your cancer’s unique genetic problems.