Treatment for cervical cancer depends on how far the cancer has spread.
As cancer treatments are often complex, hospitals use multidisciplinary teams (MDTs) to treat cervical cancer and tailor the treatment programme to the individual.
MDTs are made up of a number of different specialists (see below) who work together to make decisions about the best way to proceed with your treatment.
Your cancer team will recommend what they thinkthe best treatment options are, but the final decision will be yours. In most cases, the recommendations will be:
The prospect of a complete cure is good for cervical cancer diagnosed at an early stage, although the chances of a complete cure decrease the further the cancer has spread.
In cases where cervical cancer isn't curable, it's often possible to slow its progression, prolong lifespan and relieve any associated symptoms, such as pain and vaginal bleeding. This is known as palliative care .
The different treatment options are discussed in more detail below.
If your screening results show that you don't have cervical cancer, but there are biological changes that could turn cancerous in the future, a number of treatment options are available. These include:
A radical trachelectomy is usually only suitable if cervical cancer is diagnosed at avery early stage. It's usually offered to women who want to preserve their child-bearing potential.
During the procedure, the surgeon will make a number of small incisions (cuts)in your abdomen. Specially designed instruments will be passed through the incisions and used to remove your cervix and the upper section of your vagina. Lymph nodes from your pelvis may also be removed. Your womb will then be reattached to the lower section of your vagina.
Comparedwith a hysterectomy or pelvic exenteration,the advantage of this type of surgeryis that your womb remains intact, which means that you maystill be able to have children. However, it's important to be aware that the surgeons carrying out this operation can't guarantee you'll still be able to have children.
If you do have children after the operation, your child would have to be delivered by caesarean section . It's also usually recommended that you wait 6 to 12 months after having surgery before trying for a baby, so that your womb and vagina have time to heal.
Radical trachelectomy is a highly skilled procedure. It's only available at a number of specialist centres in the UK, so it may not be available in your area and you may have to travel to another city to be treated.
A hysterectomy is usually recommended for early cervical cancer. This may be followed by a course of radiotherapy to help prevent the cancer coming back.
Two types of hysterectomiesare used to treat cervical cancer. They are:
Short-term complications of a hysterectomy include infection, bleeding, blood clots and accidental injury to your ureter, bladderor rectum.
The risk of long-term complications issmall, but they can be troublesome. They include:
As your womb is removed during a hysterectomy, you'll no longer be able to have children.
If your ovaries are removed, it will also trigger the menopause if you haven't already experienced it. See complications of cervical cancer for more information about the menopause.
A pelvic exenteration is a major operation that's usually only recommended when cervical cancer returns after what was thought to be a previously successful course of treatment. It's offered if the cancer returns to the pelvis, but hasn't spread beyond this area.
A pelvic exenteration involves two phases of treatment:
Following a pelvic exenteration, your vagina can be reconstructed using skin and tissue taken from other parts of your body. This means you'll be able to have sex after the procedure, although it may be several months until you feel well enough to do so.
Radiotherapy may beused on its own or combined with surgeryfor early stagecervical cancer. It may be combined with chemotherapy for advanced cervical cancer, where it can be used to control bleeding and pain.
There are two ways that radiotherapy can be delivered. These are:
In most cases, a combination of internal and external radiotherapy will be used. A course of radiotherapy usually lasts for around five to eight weeks.
As well as destroying cancerous cells, radiotherapy can sometimes also harm healthy tissue.This means it can cause significant side effects many months, and even years, after treatment.
However,the benefits of radiotherapy often tend to outweigh the risks. For some people, radiotherapy offers the only hope of getting rid of the cancer.
Side effects of radiotherapy are common and can include:
Most of these side effects will resolve within about eight weeks of finishing treatment, although in some cases they can be permanent. It's also possible to develop side effects several months, or even years, after treatment has finished.
If infertility is a concern for you, it may be possible to surgically remove eggs from your ovaries before you have radiotherapy, so that they can be implanted in your womb at a later date. However, you may have to pay for this.
It may also be possible to prevent an early menopause by surgically removing your ovaries and replanting them outsidethe area of your pelvis that will be affected by radiation. This is known as an ovarian transposition.
Your MDT can provide more information about the possible options for treating infertility and whether you're suitable for an ovarian transposition.
Chemotherapy can be combined with radiotherapy to tryto cure cervical cancer, or it can be used as a sole treatment for advanced cancer to slowits progression and relieve symptoms (palliative chemotherapy).
Chemotherapy involves using either a single chemotherapy medication called cisplatin or a combination of different chemotherapy medications to kill thecancerous cells.
Chemotherapy is usually given using an intravenous drip on an outpatient basis, so you'll be able to go home once you've received your dose.
As with radiotherapy, these medications can also damage healthy tissue. Side effects are thereforecommon and caninclude:
Some types of chemotherapy medication can damage your kidneys, so you may need to have regular blood tests to assess the health of your kidneys.
After your treatment has been completed and the cancer has been removed, you'll need to attend regular appointments for testing. This will usually involve a physical examination of your vagina and cervix (if it hasn't been removed).
As there's a risk of cervical cancer returning, these examinations will be used to look for signs of this. If anything suspicious is found,a further biopsy can be carried out.
If cervical cancer does return, it usually returns around 18 months after a course of treatment has been completed.
Follow-up appointments are usually recommended every four months after treatment has been completed for the first two years, and then every six to 12 months for a further three years.
Cancer of the cervix often has no symptoms in its early stages. If you do have symptoms, the most common is unusual vaginal bleeding, which can occur after sex, in between periods or after the menopause.
Read more about the symptoms of cervical cancer including unusual vaginal bleeding, pain or discomfort during sex and an unpleasant smelling vaginal discharge.
In almost all cases, cervical cancer is the result of a change in cell DNA caused by the human papilloma virus (HPV).
Early diagnosis of cervical cancer is crucial. Read about the tests you'll have to discover whether you have cancer and the tests used to find out whether your cancer has spread.
Treatment for cervical cancer depends on how far the cancer has spread. As cancer treatments are often complex, hospitals use multidisciplinary teams (MDTs) to treat cervical cancer and tailor the treatment programme to the individual.
Read about the complications of cervical cancer, includingpossible side effects of treatment, such as early menopause, narrowing of the vagina and lymphoedema.