Cervical Cancer Cervical Cancer Treatment by Stage

The cancer stage (the extent of cancer in the body) is an important factor in deciding the best treatment for cervical cancer. Other factors, such as your preferences and overall health, are also important.

An important factor for some patients is fertility preservation. If you would like to retain the ability to become pregnant, ask your doctor about fertility-sparing treatment options (treatments for cervical cancer that preserve the uterus and ovaries). Such treatments may be an option for some small cancers that are only in the cervix. If your cancer is more advanced or has a high chance of coming back, you are more likely to have treatments that will prevent you from becoming pregnant. A reproductive endocrinologist can help you understand your options for becoming a parent, such as freezing eggs. To learn more about fertility preservation options and ways to find support, visit Fertility Issues in Girls and Women with Cancer.

For some people, taking part in a clinical trial may be an option. Clinical trials of new cancer drugs or treatment combinations may be available. Learn more about clinical trials, including how to find and join a trial at Clinical Trials Information for Patients and Caregivers.

Treatment of stage IA cervical cancer

Stage IA cervical cancer is separated into stage IA1 and IA2.

Treatment of stage IA1 cervical cancer may include:

• cold knife conization, a fertility-sparing procedure, for some small cancers
• total hysterectomy with or without bilateral salpingo-oophorectomy, for patients whose cancer has a high risk of coming back

Treatment of stage IA2 cervical cancer may include:

• modified radical hysterectomy and removal of lymph nodes
• radical trachelectomy, a fertility-sparing surgery, and removal of lymph nodes
• internal radiation therapy, for patients who cannot have surgery

To learn more about these treatments, visit Cervical Cancer Treatment.

Treatment of stages IB and IIA cervical cancer

Treatment of stage IB and stage IIA cervical cancer may include:

• radiation therapy given at the same time as chemotherapy
• radical hysterectomy and removal of pelvic lymph nodes with or without radiation therapy to the pelvis, plus chemotherapy
• radical trachelectomy, a fertility-sparing surgery
• radiation therapy alone

When radiation is used, it may be given as external radiation therapy only or as a combination of external and internal radiation therapy. Chemotherapy drugs, such as or , may be given at the same time as radiation therapy. Giving chemotherapy at the same time as radiation therapy helps the radiation therapy work better.

To learn more about these treatments, visit Cervical Cancer Treatment.

Treatment of stages IIB, III, and IVA cervical cancer

Treatment of stage IIB, stage III, and stage IVA cervical cancer may include:

• radiation therapy given at the same time as chemotherapy
• surgery to remove pelvic lymph nodes followed by radiation therapy with or without chemotherapy

Most people with stage IIB, III, or IVA cervical cancer will receive a combination of external and internal radiation therapy. Chemotherapy drugs, such as or , may be given at the same time as radiation therapy. Giving chemotherapy at the same time as radiation therapy helps the radiation therapy work better.

Learn more about these treatments at Cervical Cancer Treatment.

Treatment of stage IVB and recurrent cervical cancer

Treatment of stage IVB and cervical cancer that has recurred (come back) may include:

• The immunotherapy drug given alone or with other treatments, such as chemotherapy and the targeted therapy drug .
• Radiation therapy and chemotherapy given at the same time, for cancer that has come back in the pelvis. Radiation may be given as external radiation therapy only or as a combination of external and internal radiation therapy. Many different chemotherapy drugs are used to treat recurrent cervical cancer, including , , , , , , , and . These drugs may be given alone or in combination. Giving chemotherapy at the same time as radiation therapy helps the radiation therapy work better.
• Chemotherapy and bevacizumab as palliative therapy. Many different chemotherapy drugs are used as palliative therapy for recurrent cervical cancer, including cisplatin, carboplatin, ifosfamide, irinotecan, gemcitabine, paclitaxel, topotecan, and vinorelbine. These drugs may be given alone or in combination.

  Palliative therapy is treatment meant to improve the quality of life of people who have a serious or life-threatening disease, such as cancer. Many of the same treatments for cancer, such as chemotherapy or other kinds of drugs and radiation therapy, can also be used for palliative therapy to help a patient feel more comfortable. Learn more about Palliative Care in Cancer.

• Pelvic exenteration, for certain people who cannot have radiation therapy. The goal of pelvic exenteration is to cure the cancer by removing it from all the organs to which it has spread.

To learn more about these treatments, visit Cervical Cancer Treatment.