Cervical Cancer

Treatment

Mayo Clinic gynecologic oncologists, medical oncologists and radiation oncologists work together to tailor treatment to your needs. For most Stage I and II cancers of the cervix, you'll have a choice of surgery or combined chemotherapy and radiation therapy. If your cancer is more advanced, your doctor may recommend a combination of treatments that could include surgery, chemotherapy and radiation therapy.

Types of surgery

Mayo Clinic surgeons perform many procedures based on the stage of disease and the needs of the patient. Your surgeon may recommend:

• Cervical cone biopsy (conization). Using a scalpel, your surgeon removes a cone-shaped piece of cervical tissue where the abnormality is found.
• Laser surgery. A narrow beam of intense light is used to kill abnormal cells. Surgeons usually perform this surgery to remove precancerous cells.
• Loop electrosurgical excision procedure (LEEP). In this procedure, your surgeon uses a wire loop to pass electrical current, which cuts diseased tissue from the cervix.
• Cryosurgery. Your doctor kills cancerous and precancerous cells by freezing them.
• Simple hysterectomy. In this procedure, your surgeon removes your cervix and uterus.
• Radical hysterectomy. In this procedure, your surgeon removes your cervix, uterus and surrounding tissue.
• Lymphadenectomy. In a lymphadenectomy, your surgeon removes the lymph nodes that drain the cervix.
• Exenteration. Your surgeon may recommend exenteration if you have an advanced cancer that has spread to organs next to the cervix but not to distant parts of your body, or when following previous treatment. This surgery involves removal of your uterus, cervix, lymph nodes and possibly your bladder, vagina, rectum and part of your colon.
• Reconstructive surgery. Often used to treat advanced cases of cervical cancer, reconstruction may be necessary for your vagina, bladder, pelvic floor and parts of your pelvis.

Radiation therapy

Radiation therapy is often the most effective treatment for cervical cancer at any stage of development. At Mayo Clinic, state-of-the-art radiation therapy includes:

• Intensity-modulated radiation therapy (IMRT). This form of external radiation minimizes the high-dose radiation applied to healthy tissue around the tumor. Doctors also aim external beam radiation at lymph node tissue in the pelvis that your cancer has invaded.
• Brachytherapy. Brachytherapy is internal radiation directed into your vagina and uterus. You can receive brachytherapy in the outpatient setting.

Chemotherapy

Chemotherapy uses anti-cancer drugs given intravenously or by mouth to destroy cancerous cells. Doctors prescribe higher doses of chemotherapy when your cancer has spread beyond the tumor or if your cancer returns after initial treatment. Studies show that low-dose chemotherapy, when combined with radiation therapy, improves survival rates in women who have advanced cervical cancer. Studies also show an advantage for chemotherapy in some early-stage tumors. Mayo Clinic doctors often use this combination.

Reconstructive surgery

At Mayo Clinic, a gynecologic oncologist and a plastic surgeon work together to restore as much anatomy and function as possible through reconstructive surgery. This teamwork is especially important in radical cancer surgery that includes surgical reconstruction as part of your treatment plan. Reconstructive surgical procedures include:

• Rebuilding your vagina. Surgeons may rebuild your vagina after radical cancer treatment.
• Skin grafts. Your doctor may recommend skin grafts to cover large treated areas after radiation therapy or radical surgery for recurrent cancer in your vulva or groin.
• Rebuilding vital organs. Your surgeon may rebuild vital organs (such as a urinary bladder, vagina or pelvic floor) that were removed to treat advanced cancer or were damaged during radiation therapy. In the case of bladder reconstruction, for example, your surgeon may be able to create a pouch that holds your urine internally, eliminating the need for an external collection bag.
• Pelvic floor reconstruction. Reconstruction of the pelvic floor can correct pelvic prolapse and urinary or rectal incontinence.

Mayo Clinic physicians will discuss your concerns and expectations as well as possible approaches to treatment and reconstruction and work with you to determine the most appropriate treatment. Reconstructive surgery techniques can produce cosmetically pleasing and functional results that improve your quality of life.

Prevention

Two new vaccines are available in the United States that offer protection from the most dangerous types of human papillomavirus (HPV), the virus that causes most cervical cancers. Although the vaccines could prevent up to 70 percent of cervical cancer cases, they can't prevent infection from every virus that causes cervical cancer. Routine Pap tests to screen for cervical cancer remain important.