Following a Pap test or HPV test to diagnosis the presence of abnormal cervical cells, you may need additional tests or possibly imaging to detect the presence of cervical cancer.

Once we have determined the nature of your abnormal cervical tissue, your gynecologic oncologist will design a treatment plan for you. Together, you and your doctor will decide how and when to start treatment. This is the time to ask about fertility preservation if giving birth at some point is important to you.

The main forms of treatment for cervical cancer are surgery, radiation therapy, and chemotherapy as well as some newer treatments such as targeted therapy and immunotherapy.

Surgical Treatments for Cervical Cancer

Your gynecologic oncologist will determine if your cervical cancer requires surgery. There are various types of surgery, and your doctor will advise about which will give you the best result.

Some types of surgery used to treat cervical conditions include:

• Fertility-conserving procedure to remove the cervix. This is used to treat early cervical cancer in which the uterus and ovaries are kept to enable future childbearing (radical cervical trachelectomy) 
• Freezing and destroying abnormal cervical tissue (cryotherapy or cryosurgery)
• Using a narrow beam of intense light as a knife to make bloodless cuts in tissue to remove a cervical tumor (laser surgery)
• Passing an electrical current through a thin wire loop as a knife to remove abnormal cervical tissue or cervical cancer (loop electrosurgical excision procedure or LEEP)
• Removing a cone-shaped piece of tissue from the cervix and cervical canal to either examine the tissue for cancer or precancerous cells (cone biopsy) or to treat a cervical condition (conization)
• Removing the lower colon, rectum, and bladder along with the cervix, vagina, ovaries, and nearby lymph nodes (pelvic exenteration), requiring follow-up reconstructive procedures.

Your treatment may require a hysterectomy—a type of surgery that involves removing the uterus and the cervix, and possibly the ovaries, fallopian tubes and surrounding structures. We perform several types of hysterectomies, depending on your individual situation. The most common approaches are:

• Modified radical hysterectomy—removes the uterus, cervix, the upper part of the vagina, and ligaments and tissues that closely surround these organs and lymph nodes
• Radical hysterectomy—removes the uterus, cervix, part of the vagina, and a wide area of ligaments and tissues around these organs including lymph nodes and possibly the ovaries and fallopian tubes
• Total hysterectomy—removes the uterus including the cervix

Your gynecologic oncologist will explain your options and best form of surgery for you. 

Nonsurgical Treatments for Cervical Cancer

We may use nonsurgical treatments in addition to—or instead of—surgery. These include:

• Radiation therapy—uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
  • External radiation therapy—uses machine outside the body to send radiation toward the cancer.
  • Internal radiation therapy—uses a radioactive substance sealed inside a device that goes directly into your body, in or near the cancer. Internal radiation places the radiation inside the body in a cylinder-shaped container that stays in the vagina for one or two days (LDR brachytherapy) during a hospital stay. Another type of internal radiation treatment is three or four outpatient treatments done weekly or biweekly.
• Chemotherapy, also known as infusion therapy—uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

Your gynecologic oncologist will explain the procedure to treat your cervical cancer that will give you best possible outcome.