Questions About Cervical Cancer Treatment

How is it treated?

There are 2 types of cervical cancer: squamous cell cancer (the more common type) and adenocancer. (Again, no need to focus on these medical terms.) They are treated the same way. The cancer may be treated with surgery, radiation therapy, chemotherapy, or a combination of these therapies.

Surgery

Surgery to remove the cervix and uterus is called a hysterectomy. In some cases part of the vagina, the fallopian tubes, and ovaries may be removed as well (a procedure called a radical hysterectomy).

The surgeon may remove lymph nodes in the pelvic area to see if they contain cancer. Lymph (pronounced limf) nodes filter out microorganisms and other particles from lymph which reduces the risk of infection. If cancer cells have reached the lymph nodes, it means the disease may have spread to other parts of the body. This is called metastases. (This means the spread of cancer from the original tumor, to other parts of the body by means of tiny clumps of cells transported by the blood or lymph).

I know this is a little complicated but just be aware that the lymph nodes have a very important function in your body. The lymph system is like a protective army in your body to prevent the “bad guys” from harming your vital organs. These bad guys are cancer, bacteria and viruses. They cause infection in your body. If your uterus is removed, you will no longer be able to have children.

For very early cervical cancer, other methods may be used to remove cancerous tissue and keep your ability to have children. For example, a surgical procedure called conization may be done to remove a cone-shaped piece of tissue from the cervix and cervical canal.

The earlier cervical cancer is found and treated, the greater the chances are that you will keep your ability to have children.

Let's discuss the next type of cervical cancer treatment...

Radiation Therapy

Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. It affects cells only in the treated area. If surgery is not a possible treatment for you, your healthcare provider may suggest radiation therapy instead.

Doctors use 2 types of radiation therapy to treat cervical cancer: internal and external radiation.

• External radiation comes from a large machine outside your body. The treatment is usually given in an outpatient clinic 5 days a week for several weeks.

• For internal radiation, also called intracavitary radiation, thin tubes containing a radioactive substance are left in the vagina for a few hours or up to 3 days. You may stay in the hospital during this time. To protect others from the radiation, you may not be able to have visitors or may have visitors for only a short period of time while the tubes are in place. Once the tubes are removed, no radioactivity is left in the body. This type of cervical cancer treatment may be repeated 2 or more times over several weeks.

Please see the American Cancer Society document, Understanding Radiation Therapy: A Guide for Patients and Families for additional suggestions on managing side effects.

Chemotherapy

Chemotherapy uses anti-cancer drugs to kill cancer cells. It can affect cells all over the body. Anticancer drugs for cervical cancer are usually given through a vein. (This means starting an IV in your arm with a needle and attaching tubing and a bag containing the medication in fluid).

This treatment is usually given in an outpatient part of the hospital, at your provider's office, or at home. Chemotherapy is used more often when the cancer has spread to other parts of your body.

If you are diagnosed with cervical cancer during pregnancy, your provider will discuss with you the risks of treatment and the risks of not getting treatment.

Find out more about managing side effects of chemotherapy.

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How long will the effects last?

When it is found early and treated, cervical cancer is highly curable. If it is not treated, the cancer may spread to surrounding areas such as lymph nodes and nearby pelvic tissues.

As the tumor gets bigger or spreads beyond the cervix, the chance of cure is less. However, combined cervical cancer treatment with surgery, radiation, and chemotherapy does improve the survival rate.

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How can I take care of myself?

If you have been diagnosed with cervical cancer:

• Discuss your cancer and treatment choices with your healthcare provider so that you understand them. You may want to get a second opinion. Do not hesitate to do this. Your doctor will understand.

• Tell your provider if your treatment causes discomfort. Usually there are ways to relieve the discomfort. Speak up. Every one of us has a different tolerance for pain or discomfort.

• Ask your provider for instructions regarding intercourse, douching, or using tampons. If discussing this with the doctor is embarrassing for you, perhaps the nurse can help you. Usually, printed information on this is given to you as well.

• After your treatment, be sure to follow your provider's schedule for checkups. Your provider will monitor your recovery and check for signs the cancer has returned. Checkups may include a physical exam as well as Pap tests and chest X-rays. Between scheduled visits, you should contact your provider right away if you have any health problems. Please keep all appointments! Follow all instructions given. You are not completely safe. Cancer is one of those “bad guys” who will try to come back. Do not let your guard down.

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