Stephen J. Schueler, M.D.

Cancer of the Cervix Treatment

Treatment for cervical cancer depends on whether the cancer has spread to surrounding tissues. A number of procedures are used to destroy cancer cells that are confined to the tip of the cervix. Once the cancer has spread beyond the cervix, treatment includes a combination of surgery, radiation therapy, and chemotherapy. Surgery may include a hysterectomy, which removes the cervix and entire uterus (womb). Chemotherapy drugs kill rapidly growing cancer cells, while radiation therapy uses x-ray beams to destroy cancer cells.

Treatment for cervical cancer that is confined to the tip of the cervix may include:

  • Loop electrosurgical excision for cervical cancer:
    • Electricity is used to destroy the cells
  • Laser surgery for cervical cancer:
    • Powerful light beam is used to destroy the cells
  • Conization for cervical cancer:
    • A cone-shaped piece of tissue is removed form the cervix
  • Cryosurgery for cervical cancer:
    • Freezing destroys the cells

Treatment for cervical cancer that has spread beyond the cervix may include:

Cancer of the Cervix Hysterectomy

The treatment of cervical cancer may require hysterectomy.

What is a hysterectomy?
Hysterectomy means the surgical removal of the uterus. There are several different ways a hysterectomy can be performed.

For the most part, they differ in regard to:

  • How much of the uterus is removed
  • How the uterus is removed
  • What other nearby organs might be removed along with the uterus
  • The size of the incision:
    • A larger conventional incision
    • A smaller incision using laparoscopy

The surgery may be performed through an incision that is made in the lower abdomen. It is also performed through the vagina. This is called a vaginal hysterectomy. During this surgery, only the uterus can be removed. Sometimes a flexible tube with a light on it is placed into the abdomen to assist with this surgery.

What happens after the uterus is removed?
After this procedure most women feel no different. The removal of the uterus makes future pregnancy impossible. It also removes the source of a woman's menstrual period. If the ovaries are removed, then menopause will occur. This is due to the lack of estrogen hormones. In many cases this will need to be corrected with hormone medicines.

Who needs a hysterectomy?
Your doctor may recommend a hysterectomy to correct a number of different medical problems. A hysterectomy is not recommended for women who are still interested in childbearing and just wish to avoid their menstrual periods.

Problems that may be treated with hysterectomy include the following:

How is a hysterectomy performed?
This operation is usually performed in a hospital operating room under general anesthesia. This means you are totally asleep during the procedure. You can have nothing to eat or drink for at least 12 hours prior to the operation. You may need an enema and a vaginal douche to help keep the surgical area clean. Pre-medication is usually given to make you sleepy. An intravenous line is started, and a bladder catheter is usually inserted to drain urine during and after surgery.

A standard abdominal hysterectomy is done through an incision in the lower abdomen. The uterus and ovaries are found and removed. Some doctors recommend removing your appendix at this time.

A vaginal hysterectomy removes the cervix and uterus through the vagina. The end of the vagina is closed with sutures. The ovaries and very large uterine fibroids cannot be removed using this procedure. Vaginal hysterectomy is a good option for women who just need the uterus removed.

Fiberoptic instruments allow many abdominal operations to be performed laparoscopically. This surgery uses small puncture-like incisions and long, thin instruments. This allows the surgeon to see and operate inside the abdomen.

What happens after surgery?
Most women do very well after either type of hysterectomy. Most report complete relief of their symptoms and enhanced quality of life.

With abdominal hysterectomy, there will be several days of pain control and convalescence required in the hospital. The incision needs to be kept clean and watched for signs of infection. Since incisions are made through the abdominal wall, activity must be slowly increased and heavy activity limited for 3-6 weeks while healing occurs. Sexual intercourse is usually not recommended for 6 weeks.

Vaginal hysterectomy usually requires a shorter period of recuperation since a large abdominal incision is not necessary. A very short hospitalization or even an overnight stay (after surgery) in an outpatient facility is an option with this approach.

Are there any other changes after surgery?
Although the majority of women recover uneventfully, some women have problems after surgery. A few complain of weakness and fatigue for a period of time. Bladder control problems affect a few women. Menopause will result when the ovaries are removed. From one quarter to one half of women will have some change in their sexual drive.

What are the risks associated with surgery?
Any surgery that requires general anesthesia carries some risk. Complications are more common in women with serious medical conditions. Women who smoke will have a much higher risk of complications than nonsmokers.

Other risks of hysterectomy include:

The organs most likely to be damaged during this procedure are the ureters. It is rare to have a serious complication from a hysterectomy if you are an otherwise healthy person.

After hysterectomy, you should call your doctor if you develop:

Are there alternatives to hysterectomy?
Abnormal uterine bleeding often responds to hormonal therapy. Sometimes a simple D and C procedure will help. This is a surgical procedure that removes only the inner lining of the uterus.

Many small cancers of the cervix can be treated without the complete removal of the uterus. Benign fibroid tumors may be treated with a number of procedures. Talk with your OB-GYN physician about which options might be best for you.

Cancer of the Cervix Options Stage 0

Treatment of stage 0 cervical cancer may include the following:

Cancer of the Cervix Options Stage 1a

Treatment of stage 1A cervical cancer may include the following:

Cancer of the Cervix Options Stage 1b

Treatment of stage 1B cervical cancer may include the following:

Cancer of the Cervix Options Stage 2a

Treatment of stage 2A cervical cancer may include the following:

Cancer of the Cervix Options Stage 2b

Treatment of stage 2B cervical cancer may include both:

Cancer of the Cervix Options Stage 3

Treatment of stage 3 cervical cancer may include both:

Cancer of the Cervix Options Stage 4a

Treatment of stage 4A cervical cancer may include both:

Cancer of the Cervix Options Stage 4b

Treatment of stage 4B cervical cancer may include the following:

Cancer of the Cervix Questions For Doctor

The following are some important questions to ask before and after the treatment of cervical cancer.

Questions to ask before treatment:

  • What are my treatment options?
    • Is surgery an option for me?
  • What are the risks associated with treatment?
  • Do I need to stay in the hospital?
    • How long will I be in the hospital?
  • What are the complications I should watch for?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • Do I need to change my diet?
  • Are there any medications or supplements I should avoid?
  • When can I resume my normal activities?
  • When can I return to work?
  • Do I need a special exercise program?
  • Will I need physical therapy?
  • Will I need occupational therapy?
  • What else can I do to reduce my risk for having this problem again?
  • Are my children at risk for this condition?
  • How often will I need to see my doctor for checkups?
  • What local support and other resources are available?

Cancer of the Cervix Specialist

Physicians from the following specialties evaluate and treat cervical cancer:

Continue to Cancer of the Cervix Home Care

Last Updated: May 24, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
Copyright DSHI Systems, Inc. Powered by: FreeMD - Your Virtual Doctor

PubMed Cancer of the Cervix References
  1. Eddy DM: Screening for cervical cancer. Ann Intern Med 1990 Aug 1; 113(3): 214-26. [2115753]
  2. Ellenson LH, Wu TC. Focus on endometrial and cervical cancer. Cancer Cell. 2004 Jun;5(6):533-8. [15193256]
  3. Schiffman MH, Bauer HM, Hoover RN: Epidemiologic evidence showing that human papillomavirus infection causes most cervical intraepithelial neoplasia. J Natl Cancer Inst 1993 Jun 16; 85(12): 958-64. [8388478]
  4. Sundar S, Horne A, Kehoe S. Cervical cancer. Clin Evid. 2005 Jun;(13):2285-92. [16135328]
  5. Waxman AG. Guidelines for cervical cancer screening: history and scientific rationale. Clin Obstet Gynecol. 2005 Mar;48(1):77-97. [15725861]
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