Cervical Cancer Treatment Options - OmniMedicalSearch.com

Conditions & Diseases: Cancers

Cervical Cancer

Treatment

The treatment approach can vary from patient to patient and depends mainly on the cancer stage. The treatment options for cervical cancer are: surgery, radiation therapy, and chemotherapy.

Surgery
There are eight types of surgery performed in patients with cervical cancer:

1. Cryosurgery: Is a type of surgery that kills cancerous cells by freezing them. This procedure uses the advantages provided by the freezing temperature on the cells. The cells, when exposed to low temperatures, form ice crystals inside that tear apart the cell’s body. The most common substance used as a cooling agent is liquid nitrogen. The nitrogen can be administrated (1) by spraying it on the tissue, (2) through a tube (cryoprobe) inserted into the tissue, or (3) swabbed directly on the tissue. Cryosurgery is a minimally invasive procedure that substantially reduces the patient's recovery time by minimizing the pain and bleeding. This type of surgery is used only in patients with preinvasive forms of cervical cancer.

2. Laser surgery: This is a type of surgery that uses a laser beam (a narrow beam of intense light) to remove the tumor. This laser beam is used as a knife, only that the cut is bloodless. The laser removes the tumor by burning off the tissue. This surgery is also performed only in patients with preinvasive forms of cervical cancer.

3. Loop electrosurgical excision procedure (LEEP): This is a type of surgery where the tumor is removed with a thin wire loop passed by a low intensity electric current.

4. Conization: This is a type of surgery where a cone-shape tissue is removed from the cervix. This surgery can be performed through two procedures: (1) the tissue is removed with the laser, procedure called core knife cone biopsy, and (2) the tissue is removed with a loop heated by electricity, procedure called LEEP or LEETZ. This type of surgery is rarely performed and is effective only in women with cervical precancerous changes.

5. Simple hysterectomy: This is a type of surgery where only the uterus is removed without adjacent tissues. The uterus is removed through an incision performed in the front of the abdomen or through vagina. During this procedure, the patient receives epidural or general anesthesia. A simple hysterectomy is performed in patients with stage 0 (when the abnormal cells are at the edge of the cone biopsy) or stage IA.

6. Total hysterectomy: This is a type of surgery where the uterus is removed together with adjacent structures or organs such as parametria and uterosacral ligaments, the upper part of the vagina located next to the cervix, the lymph node (procedure called pelvic lymph node dissection) and sometimes, the fallopian tubes and ovaries. This surgery can be performed through an abdominal incision or through vagina in combination with laparoscopic node dissection (a minimally invasive surgery where the lymph nodes are removed through small incisions - less than 1.5 cm). The main side effect is infertility. The most common complications that can follow this surgery include: excessive bleeding, womb infection, and damage of the urinary tract or intestinal system. This surgery is performed in patients with cancer in the stage IA2, stage IB, and stage IIA, and especially in young women.

7. Trachelectomy: This is a type of surgery where the surgeon tries to remove as little of the healthy tissue as possible by removing the cervix and the upper part of the vagina, and placing a so called “purse-string” stitch, which will act as an artificial opening of the cervix. During this operation, the lymph nodes are also removed through a laparoscopy procedure. This type of surgery is still tested in clinical trials. Early clinical trials suggest that few of the cervical cancers treated with this surgery had relapsed. Women that undergo this type of surgery have a higher risk of miscarriages, but some women were able to carry the pregnancy to the term and delivered healthy babies by cesarean section.

8. Pelvic exenteration: This is a type of surgery where the uterus is removed together with adjacent structures or organs such as parametria and uterosacral ligaments, the upper part of the vagina located next to the cervix, the lymph node, fallopian tubes and ovaries, the rectum, part of the colon, vagina, and urine bladder. During this operation, the doctor also creates artificial openings called stoma which allow the urine and the stool to collect in special bags. Also the vagina might be reconstructed surgically using skin, intestinal tissue, or skin and muscles grafts. This type of surgery is performed in patients with recurrent cervical cancer (the cancer that relapsed after was treated).

Radiation therapy
Radiation therapy or radiotherapy uses high-energy rays or particles to destroy cancerous cells. Radiation therapy can be administrated in two ways to the cervical cancer patients:

External radiation therapy: This form of radiation therapy uses a device called a linear accelerator that generates an external beam that is concentrated on the tumor area and breaks it up into smaller pieces. Sessions last a few minutes and are administered every day for 6 to 7 weeks.
Internal radiation therapy or brachytherapy: The radiation is administrated from radioactive materials such as seeds, capsule inserted into the vagina near the tumor or through thin tubes or wires inserted into the tumor.

Radiation therapy side effects include:

Skin irritation (the skin becomes red or fades into a tanned color, becomes dry, or tender in the area where the body is irradiated).
Tiredness.
Upset stomach.
Loose bowls.
Vagina stenosis (the vagina narrows because of the scar tissue).
Vaginal dryness.
Premature menopause.
Urination problems.
Pelvic fracture (hip fracture are common in women that undergo radiation therapy).

Chemotherapy
Chemotherapy is a systemic treatment (affects cells throughout the entire body) that uses drugs either to stop the abnormal growth and dividing process of the cancerous cells, or to kill them. This type of treatment involves either a single drug, or a combination of several drugs, and is usually administered in cycles where a treatment period is followed by a recovery period. Chemotherapy can be administrated (1) as pills, (2) intravenous as an IV, or (3) as injections.

The most common drugs used in the treatment of cervical cancer are:

Cisplatin
Paclitaxel
Topotecan
Ifosfamide
Fluorouracil

Chemotherapy can be used 1) as a primary treatment in advanced stages of cancer, 2) in addition to surgery (as an adjuvant treatment - to enhance the results of the surgery by destroying possible cancerous cells that could have been left behind, and reducing the risk of cancer relapse) or radiation therapy, 3) before surgery (as a neoadjuvant treatment - to reduce the size of the tumor), 4) to reduce the cancer-related symptoms which cause a high level of discomfort for the patient and to improve the patient’s life (in patients with advanced stages or recurrent cancer), or (5) to prolong patient survival (in patient with advanced stages or recurrent cancer).

Like every medicated treatment, chemotherapy causes side effects. The complexity and extent of the side effects depend on the chemotherapy drug and its dosage. The most common side effects include:

Severe nausea with or without vomiting
Temporary hair loss
Fatigue
Mouth and lips sore
Diarrhea
Loss of appetite
Tiredness
Weakness
Fatigue
Vulnerability to infections (caused by a reduced number of white blood cells)
Easy bleeding and brushing due to minor injuries (caused by a reduced number of blood platelets)
Shortness of breathing (caused by a reduced number of red blood cells)
Premature menopause

Most of these side effect can be controlled with medication.

Article by Alina Morrow, MS
Medical Writer
OmniMedicalSearch.com