The primary treatment options for cervical cancer include surgery, radiation therapy and chemotherapy. The type of treatment you receive will depend on a number of different considerations, such as the type of cervical cancer you have, its stage, your overall health and your treatment preferences. This page aims to give you a holistic overview of how cervical cancer treatment works in the private health system.
Understanding treatment for cervical cancer and how it is delivered
What are the treatment options for cervical cancer?
Types of cervical cancer treatment
- Radiation therapy
- Targeted therapy
Surgery is usually recommended for women who have a tumour that is confined to the cervix. The type of surgery you have will depend on how far within the cervix the cancer has spread2 and whether you want to be able to have children. Surgical options for patients who wish to maintain their fertility include:
- Biopsy – A cone biopsy is used to diagnose cervical cancer and can be used to treat very early and small tumours. The procedure involves removing a cone shaped section of the cervix where the cancer has been detected
- Trachelectomy – A trachelectomy refers to the surgical removal of the cervix. This type of surgery is often used to treat small cancers in young women who wish to remain fertile.
- Lymphadenectomy – For some women, lymph nodes in your pelvic region may be removed as a staging procedure to see if cancer cells have spread. This procedure is referred to as a lymphadenectomy
If remaining fertile is not a priority to you, surgical options include:
- Wertheim’s Hysterectomy – This refers to the surgical removal of the entire uterus, connective tissue, upper part of the vagina and lymph nodes
- Pelvic exenteration – A pelvic exenteration involves removing all or part of the cancerous tissue and is more commonly used in cases where cancer has returned and has not spread
Most women who have radiation therapy for cervical cancer will receive both external and internal radiation therapy.
External beam radiation therapy
External beam radiation therapy is used to treat cervical cancer by delivering radiation therapy beams to the cervix, lymph nodes and adjacent tissues where cancerous cells may have spread. Most patients will receive EBRT five days per week for five to six weeks.
Internal radiation therapy
Internal radiation therapy is also known as brachytherapy. For cervical cancer, a radiation source is placed inside the body next to the cancer in the cervix. This reduces the effect radiation has on nearby organs such as the bowel and bladder.
Chemotherapy uses a range of drugs to kill and slow the growth of cervical cancer cells. Typically, cervical cancer patients will receive low dose weekly chemotherapy alongside radiation therapy, which helps the radiation therapy to treat your cancer more effectively. This treatment method is known as concurrent chemoradiation and is the preferred treatment method for stage IB3, II and III and IVA cervical cancers.
Chemotherapy treatment for cervical cancer takes place over several sessions, known as a cycle. Your care team will walk you through how many cycles you may need for your course of treatment, with most people completing chemotherapy in a period of five to six weeks.
Common chemotherapy medicines
There are a number of different chemotherapy drugs that are used to treat cervical cancer. These drugs are typically combined based on factors such as the type of cervical cancer you have, your cancer’s stage and how much it has spread. Some of the drugs used include:
- Cisplatin – This is a drug that is used together with radiation therapy to treat cervical cancer. It is used as a radiosensitiser to help the radiation therapy work more effectively
- Carboplatin – This is a type of chemotherapy drug that contains platinum. It is usually given in combination with other drugs such as bevacizumab and paclitaxel to treat advanced cervical cancer
- Paclitaxel – This chemotherapy drug is usually given in combination with other chemotherapy drugs (for example, bevacizumab and cisplatin) to treat advanced and recurrent cervical cancer
- 5-fluorouracil – Belonging to a class of chemotherapy drugs known as antimetabolites, 5-fluorouracil may be used together with cisplatin as part of chemoradiation treatment to sensitise the cancer cells to radiation therapy
Targeted therapies use specialised drugs to destroy specific proteins in cervical cancer cells and are commonly used to treat advanced cervical cancer and cervical cancer that has returned (recurrent cancer).
- Bevacizumab – This is a targeted therapy drug used to treat advanced cervical cancer. It is usually given together with other chemotherapy drugs as an intravenous infusion every three weeks
Immunotherapy may be used to treat select advanced or metastatic cervical cancers with positive PD-L1. This treatment option uses your own immune system to slow the growth of cervical cancer cells and to destroy existing ones.
When you are diagnosed with cervical cancer, your oncologist will develop your treatment plan as part of a multidisciplinary team based on the stage of your cancer and whether you would like to have children.
Common treatment options for each stage of cervical cancer include:
When cervical cancer is classified as stage I, there are treatment options available to help maintain your fertility. Most of these most treatment plans begin with a biopsy, and in some cases may be followed by a radical trachelectomy if there are cancer cells present in the edges of the biopsy. Some women may also receive a sentinel node biopsy or lymphadenectomy to remove surrounding lymph nodes.
If maintaining fertility is not a concern for you, your treatment plan will likely start with a hysterectomy, removing both the cervix, uterus, connective tissue as well as lymph node staging.
Stages II and III
For patients with stage II or III cervical cancer, the majority will receive radiation therapy treatment. Chemotherapy is also used to help increase the effectiveness of the radiation therapy treatment. Occasionally, some early stage IIA cervical cancer patients may be treated with a radical hysterectomy and lymphadenectomy.
Stage IVA cervical cancer is commonly treated through concurrent chemoradiation. However, if the cancer has spread to distant sites and is classified as stage IVB, it is no longer considered curable in most cases and treatment will focus on palliative care. Treatment options will typically include radiation therapy and may be given alongside chemotherapy and targeted therapies to relieve your symptoms.
- Cancer Australia (2019, December 18). Cervical Cancer; Treatment options. Cancer Australia. Retrieved November 22, 2021, from https://www.canceraustralia.gov.au/cancer-types/cervical-cancer/treatment
- Cancer Council Victoria (2019). Cervical Cancer; Treatment of cervical cancer. Retrieved on 01 October 2019 from https://www.cancervic.org.au/cancer-information/types-of-cancer/cervical_cancer/treatment_for_cervical_cancer.html
- American Cancer Society (2021, January 3). Cervical cancer chemotherapy: Chemo for cervical. American Cancer Society. Retrieved November 22, 2021, from https://www.cancer.org/cancer/cervical-cancer/treating/chemotherapy.html
- American Cancer Society. (2021, January 3). Cervical cancer treatment options: Treatment choices by stag American Cancer Society. Retrieved November 22, 2021, from https://www.cancer.org/cancer/cervical-cancer/treating/by-stage.html
- Cervical cancer. Retrieved November 29,2021 from https://www.eviq.org.au/medical-oncology/gynaecological/cervical