Treatment Options for Cervical Cancer, by Stage
The stage of a cervical cancer is the most important factor in choosing treatment. But other factors can also affect your treatment options, including the exact location of the cancer within the cervix, the type of cancer (squamous cell or adenocarcinoma), your age and overall health, and whether you want to have children.
Stage IA1
Treatment for this stage depends on whether or not you want to be able to have children (maintain fertility) and whether or not the cancer has grown into blood or lymph vessels (called lymphovascular invasion).
Treatment options for women who want to maintain fertility
A cone biopsy is the preferred procedure for women who want to have children after the cancer is treated.
If the edges of the cone don’t contain cancer cells (called negative margins), the woman can be watched closely without further treatment as long as the cancer doesn’t come back.
If the edges of the cone biopsy have cancer cells (called positive margins), then cancer may have been left behind. This can be treated with a repeat cone biopsy or a radical trachelectomy.
If the cancer has grown into blood or lymph vessels, one treatment option is a cone biopsy (with negative margins) with removal of pelvic lymph nodes. Another option is a radical trachelectomy along with removal of the pelvic lymph nodes.
Treatment options for women who don’t want to maintain fertility
A simple hysterectomy may be an option if the cancer shows no lymphovascular invasion and the edges of the biopsy have no cancer cells. If the edges of the biopsy have cancer cells present, a repeat cone biopsy or a radical hysterectomy with removal of the pelvic lymph nodes might be an option.
If the cancer has grown into blood or lymph vessels, you might need a radical hysterectomy along with removal of the pelvic lymph nodes. Sometimes, surgery is not done and external beam radiation to the pelvis followed by brachytherapy is used.
If none of the lymph nodes are found to have cancer, radiation may still be discussed as an option if the tumor is large, if the tumor has grown into blood or lymph vessels, or if the tumor is invading the surrounding connective tissue that supports organs such as the uterus, bladder, vagina (the stroma).
If the cancer has spread to the tissues next to the uterus (called the parametria) or to any lymph nodes, or if the tissue removed has positive margins, radiation (EBRT) with chemotherapy is usually recommended. The doctor may also advise brachytherapy after the combined chemo and radiation are done.
Stage IA2
Treatment for this stage depends in part on whether or not you want to continue to be able to have children (maintain fertility).
Treatment options for women who want to maintain fertility
Cone biopsy with removal of pelvic lymph nodes (pelvic lymph node dissection)
Radical trachelectomy with pelvic lymph node dissection
Treatment options for women who don’t want to maintain fertility
The stage of a cervical cancer is the most important factor in choosing treatment. But other factors can also affect your treatment options, including the exact location of the cancer within the cervix, the type of cancer (squamous cell or adenocarcinoma), your age and overall health, and whether you want to have children.
Stage IA1
Treatment for this stage depends on whether or not you want to be able to have children (maintain fertility) and whether or not the cancer has grown into blood or lymph vessels (called lymphovascular invasion).
Treatment options for women who want to maintain fertility
A cone biopsy is the preferred procedure for women who want to have children after the cancer is treated.
If the edges of the cone don’t contain cancer cells (called negative margins), the woman can be watched closely without further treatment as long as the cancer doesn’t come back.
If the edges of the cone biopsy have cancer cells (called positive margins), then cancer may have been left behind. This can be treated with a repeat cone biopsy or a radical trachelectomy.
If the cancer has grown into blood or lymph vessels, one treatment option is a cone biopsy (with negative margins) with removal of pelvic lymph nodes. Another option is a radical trachelectomy along with removal of the pelvic lymph nodes.
Treatment options for women who don’t want to maintain fertility
A simple hysterectomy may be an option if the cancer shows no lymphovascular invasion and the edges of the biopsy have no cancer cells. If the edges of the biopsy have cancer cells present, a repeat cone biopsy or a radical hysterectomy with removal of the pelvic lymph nodes might be an option.
If the cancer has grown into blood or lymph vessels, you might need a radical hysterectomy along with removal of the pelvic lymph nodes. Sometimes, surgery is not done and external beam radiation to the pelvis followed by brachytherapy is used.
If none of the lymph nodes are found to have cancer, radiation may still be discussed as an option if the tumor is large, if the tumor has grown into blood or lymph vessels, or if the tumor is invading the surrounding connective tissue that supports organs such as the uterus, bladder, vagina (the stroma).
If the cancer has spread to the tissues next to the uterus (called the parametria) or to any lymph nodes, or if the tissue removed has positive margins, radiation (EBRT) with chemotherapy is usually recommended. The doctor may also advise brachytherapy after the combined chemo and radiation are done.
Stage IA2
Treatment for this stage depends in part on whether or not you want to continue to be able to have children (maintain fertility).
Treatment options for women who want to maintain fertility
Cone biopsy with removal of pelvic lymph nodes (pelvic lymph node dissection)
Radical trachelectomy with pelvic lymph node dissection
Treatment options for women who don’t want to maintain fertility
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