At Siteman Cancer Center, our team of WashU Medicine gynecologic oncologists understands that every patient is unique. They will design a personalized treatment plan for you. Their goal has two parts: 1.) to treat your cancer and 2.) to help you thrive as a person. As they make your plan, they will keep in mind your age, your hopes for your family, and your overall health.
We understand that you probably have many questions and concerns as you go through treatments for cervical cancer. There is no question too small or simple to ask. Your care team – your physicians, nurse coordinators, and others – are always ready to listen.
What treatment could I have for my cervical cancer?
There are many ways to treat cervical cancer. Your treatment plan will depend on how far the cancer has spread. Many patients with early-stage cervical cancer will have surgery to remove the cancer. Some patients will also receive chemotherapy and/or radiation therapy to treat cancer cells that have spread to other organs or to reduce the risk of the cancer coming back.
Surgery for Cervical Cancer
Some patients with early-stage cervical cancer may need surgery. Siteman surgeons excel at several surgical options and procedures. Surgery might be the only treatment you need. You may have one of the following procedures:
- Conization: This procedure is also called a cone biopsy. Your surgeons will remove the cancer from the cervix by cutting out a segment of tissue shaped like a cone. You may be eligible for a conization if cancer is limited to a small area of your cervix.
- Radical Trachelectomy: This procedure is done when cancer has spread throughout the cervix but has not traveled to other parts of the body. The surgeon will remove the cervix and then connect the uterus directly to the vagina. It is a complex surgery that is not offered at all cancer centers.
- Total Hysterectomy: A total hysterectomy is done when cancer has spread beyond the cervix. Your surgeon will remove your cervix, uterus, and fallopian tubes.
- Radical Hysterectomy: A radical hysterectomy is more extensive than a total hysterectomy. In addition to the cervix, uterus and fallopian tubes, the surgeon also removes some of the surrounding tissues that touch the cervix, including the upper vagina and lymph nodes. The ovaries may be removed as well.
How does surgery for cervical cancer affect fertility?
Some procedures used to treat cervical cancer can protect a patient’s future fertility. These are:
- Conization
- Radical trachelectomy
We call these procedures “fertility-sparing.” The uterus stays in the body and can function normally. This means that it’s still possible to get pregnant and carry a child. Your WashU Medicine physicians may recommend a fertility-sparing procedure if your cancer is at an early stage and if you hope to have children in the future.
Sometimes, surgery for cervical cancer involves removing the uterus. That happens during the following procedures:
- Total hysterectomy
- Radical hysterectomy
If the uterus is removed, then it is no longer possible to become pregnant and carry a child. This is significant. Sometimes these options are necessary to remove cervical cancer. Your doctors may recommend this level of treatment if your cancer is more advanced.
We understand that the potential loss of fertility is a sensitive, challenging issue. Siteman offers a range of services to help patients expand their families even after a fertility-ending treatment. And every patient can work with trained psychologists to process the impact treatment has on you.
When do patients with cervical cancer receive radiation therapy?
Most patients with cervical cancer have radiation therapy. Radiation therapy kills cancer cells that might be left behind after surgery and helps prevent the cancer from coming back (recurrence). For some patients, radiation therapy is their primary treatment.
There are two main types of radiation therapy used to treat cervical cancer at Siteman. Patients often receive a combination of both types. We are the only cancer center in the region that specializes in this combined, highly-effective approach.
- Intensity-modulated radiation therapy (IMRT): IMRT is an extra-precise form of radiation therapy. During IMRT, your doctors will shape the radiation to the exact 3-D shape of your tumor. This means that your tumor will get a high dose of radiation therapy but the tissues around it will be protected.
- Brachytherapy: During brachytherapy, your doctors will deliver radiation therapy directly to the cancer cells in your cervix. To do this, they will place a device called an applicator in your cervix. Then, they will connect the applicator to an external source of radiation for a few minutes. This allows radiation therapy to flow through the applicator and into your cervix, where it can kill the cancer cells.
Siteman has one of the largest and most comprehensive brachytherapy centers in the United States. We are national leaders in this form of treatment.
Drug therapy for cervical cancer
Some patients with cervical cancer will take medications as part of their treatment. These drugs all work differently, but they help kill cancer cells and prevent the cancer from spreading. Patients with more advanced cervical cancer are likely to need medications.
You may take one or more of these types of drugs:
- Chemotherapy: Chemotherapy is a type of medication that kills cancer cells wherever they are found in the body. You’ll receive chemotherapy through an IV.
- Targeted therapy: Targeted therapies are medications that stop cancer cells from growing and multiplying. Some targeted therapies are used to bring additional drugs directly into cancer cells. Because targeted therapies focus on specific features of cancer cells instead of killing them directly, they can have fewer side effects than chemotherapies. You might receive targeted therapy if your cervical cancer is more advanced. At Siteman, we will sequence the genes of your tumor to help choose the most effective targeted therapy for you.
- Immunotherapy: Immunotherapy is a new form of cancer treatment that trains your own immune system to recognize and attack cancer cells. It can be highly effective against cervical cancer. If your cervical cancer has started to spread, you may receive immunotherapy as part of your treatment plan.