Once cervical cancer is diagnosed, the choice of treatment typically depends on the clinical stage of the disease. Lymph nodes are usually examined to determine if the cancer has spread away from the cervix. Most precancerous low-grade cells typically detected with a Pap Test tend to revert to normal cells without treatment, whereas high-grade precancerous cells usually require treatments to remove the precancerous cells. Such treatments include one or more of the following methods:
- Cold knife cone biopsy
- Loop electrosurgical excision procedure (LEEP)-- a cone biopsy using a heated electrical wire
- Cauterization or diathermy
- Laser surgery
These procedures may also be used in conjunction with other treatments. For the treatment of other stages of cervical cancers and recurrent cervical cancer, the following may also be used:
A simple hysterectomy may be performed with only the uterus removed. In some cases, the fallopian tubes and ovaries may also be removed. In some patients, a radical hysterectomy may be performed and involves the removal of the uterus and adjoining tissues including the ovaries, the upper region of the vagina near the cervix, and pelvic lymph nodes. If the tissue indicates that the cancer has spread, additional treatment may be required after a hysterectomy.
Radiation treatment uses high-dosage x-rays or other high-energy waves to destroy the cancer cells and is typically performed for the treatment of stages IB, IIA, and IIB cervical cancers, or may be used in combination with surgery. Radiation can be performed outside the body with rays focused on the pelvic area or from within the body using implant or internal radiation with pellets of radioactive material placed near the tumor.
Chemotherapy with specific drugs to destroy cancer cells is typically used to treat cervical cancers that have spread beyond the cervix. Chemotherapy may also be used following surgery or radiation treatment. A combination of external and internal radiation and chemotherapy may be used for patients with stage IIB, III, or IV cervical cancer or patients with recurrent cervical cancer. Common drugs used to treat cervical cancers are cisplatin, ifosfamide, and fluorouracil, which can be injected or taken orally. The National Cancer Institute (NCI) recommends that chemotherapy with cisplatin be considered for all women receiving radiation therapy for cervical cancer.
Biological therapy may be performed to treat cervical cancers, either in combination with chemotherapy or alone. In addition, Interferon may be used to boost the immune system's response to help in the treatment of cervical cancer.
The five-year survival rate is nearly 100% for patients with cervical cancer that is diagnosed in the pre-invasive stage. If cancers are detected in the early invasive stages, the five-year survival rate is approximately 90%. Cervical cancer in stage IVB is not considered to be curable. For all cervical cancers combined, the five-year-survival rate is approximately 70%. The death rate from cervical cancer continues to decline by about 2% each year with women over the age of 65 accounting for 40-50% of all deaths from cervical cancer.