Cervical cancer treatment depends on several factors, including the stage and type of cancer, the overall health of the patient, possible side effects of the treatment, whether or not future pregnancy is contemplated, and the personal preference of the patient. Of all of these factors, the stage of the disease is the most important that decides the treatment plan. In this blog, we will discuss the initial treatment options for cervical cancer.
Treatment of cervical cancer
The initial treatment of cervical cancer (especially for the earlier stages) is surgery. Other treatment options include radiation therapy, chemotherapy, targeted therapy, and immunotherapy.
Initial treatment options for cervical cancer stage IA1
The treatment for this stage is decided by whether or not the patient wants to retain her chances of conceiving and whether the cancer has metastasised to the nearby lymph or blood vessels. Following are the treatment options for those who want to preserve their reproductive function:
Cone biopsy: During this procedure, the cancerous cervical cells are resected. If some malignant cells have been left behind, those are further removed by radical trachelectomy or repeat cone biopsy.
Following are the treatment options for those who don’t want to preserve their reproductive function:
- A simple hysterectomy may be an option if cancer doesn’t reveal lymphovascular invasion.
- If cancer cells are present in the edges of the biopsy, a repeat cone biopsy or radical hysterectomy along with pelvic lymph node removal might be recommended.
- If cancer has spread to the lymphatic vessels or blood vessels, a radical hysterectomy with pelvic lymph node removal will be performed. Sometimes, surgery is avoided and replaced by external beam radiation to the pelvic area.
- Even if cancer hasn’t spread to the lymph nodes, radiation might still be recommended if the tumor is large and has spread to the blood vessels or the surrounding tissues.
- If cancer has metastasized to the surrounding tissues, or if the margins of the excised tissue are positive for cancer, radiation with chemotherapy might be a good treatment option. After the combined chemotherapy and radiation therapy are complete, the doctor may also recommend brachytherapy.
Initial treatment of cervical cancer stage IA2
For those who want to preserve fertility:
- Cone biopsy with pelvic lymph node dissection
- Radical trachelectomy with the removal of pelvic lymph nodes
For those who don’t want to preserve fertility:
- Brachytherapy, along with external beam radiation therapy (EBRT) to the pelvis.
- If none of the lymph nodes contains cancer cells, a radical hysterectomy with removal of pelvic lymph nodes may be performed.
- If cancer has metastasised to the surrounding structures, chemotherapy with external beam radiation therapy may be performed, followed by brachytherapy.
Cervical cancer in pregnancy
Cervical cancers can also be diagnosed during pregnancy. Most of these cancers are at an initial stage, stage I. The treatment plan for cervical cancer during pregnancy depends on the gestational age, tumor size, whether or not the nearby lymph nodes have been involved, and the specific type of cervical cancer.
It is usually safe to continue the pregnancy to term for early-stage cancers and get cervical cancer treatment several weeks post-delivery. Post-delivery treatment of early-stage cervical cancer includes a hysterectomy, cone biopsy, or radical trachelectomy.
The treatment options mentioned here have been suggested keeping the common cases in mind. Your healthcare provider will formulate a tailored treatment plan for you after carefully assessing all the factors related to your health. So, the actual treatment may vary from one case to another.
Nevertheless, it is imperative to know about all the treatment options, including their side effects and benefits, and discuss those with your doctor so that you can decide what best suits your needs and personal preferences. It is also helpful to ask questions whenever you don’t understand something. Discuss the goals of each treatment plan with your doctor, along with what to expect while receiving the treatment. You may ask questions regarding your symptoms, investigation reports, the number of appointments required, and the prognosis. This shared-decision making will help you feel more confident about your treatment and its prognosis.
Coping and support
A cancer diagnosis can be challenging for anyone. However, you can take several steps to manage the shock and fear:
- Try to learn as much about the disease as possible. It will help you make informed decisions about your care.
- Talk with a friend or a family member and vent out your fears.
- Cancer treatment can be exhausting, so let people help.
- Set reasonable goals so that you get a sense of purpose and feel in control of your situation.
- Practice self-care by eating well-balanced meals, taking time off from work and relaxing, and getting enough sleep to help alleviate stress and anxiety.
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