Cervical cancer originates in the cells of the cervix, the lower part of the uterus that connects to the vagina. Modern medicine provides several effective treatments for this disease, but the specific course of action is highly personalized. A treatment plan depends on many individual factors, making it important to understand the available options.
How Treatment Plans Are Determined
A healthcare team considers many factors before recommending a course of action. The most significant is the cancer’s stage, which describes how far it has spread from its origin. Staging ranges from Stage I to IV and is a primary guide for treatment decisions.
The specific characteristics of the tumor also play a large part in planning treatment. This includes the tumor’s size and the type of cancer cells involved, most commonly squamous cell carcinoma or adenocarcinoma. These details help predict how the cancer might behave and respond to different therapies.
A person’s age, overall health, and personal preferences are also integral to the decision-making process. For some, the desire to have children is a major consideration, and fertility-preserving options can be explored with the medical team before any treatment begins.
Local Treatments for Cervical Cancer
Local treatments target the cancer at its source and in the immediate surrounding area. Surgery is a common treatment, particularly for cancers detected in the early stages.
For very small, early-stage cancers, a cone biopsy may be sufficient. This procedure involves removing a cone-shaped piece of tissue from the cervix, which includes the cancerous cells and a margin of healthy tissue. For younger individuals who wish to preserve their ability to have children, a radical trachelectomy might be an option. This surgery removes the cervix and the upper part of the vagina but leaves the uterus intact. In other cases, a hysterectomy, the removal of the uterus and cervix, may be necessary.
Radiation therapy is another local treatment that uses high-energy rays to destroy cancer cells. It can be used as a primary treatment or after surgery to eliminate any remaining cancer cells. There are two main types of radiation therapy used for cervical cancer. External beam radiation therapy (EBRT) delivers radiation from a machine outside the body, targeting the pelvic region over several weeks.
The other form is brachytherapy, also known as internal radiation. This method involves placing a radioactive source directly inside or near the cancer for a specific amount of time. Brachytherapy delivers a high dose of radiation directly to the tumor, which minimizes exposure to nearby healthy organs like the bladder and bowel, and is often used in combination with EBRT.
Systemic Treatments for Cervical Cancer
Systemic treatments are therapies that circulate throughout the body to find and destroy cancer cells. These approaches are used for cervical cancers that are more advanced or have returned after initial treatment. They can be used alone or in combination with other treatments like radiation.
Chemotherapy uses powerful drugs to kill cancer cells. For locally advanced cancers, chemotherapy is often administered with radiation therapy, a combination known as chemoradiation. This is because chemotherapy can make cancer cells more sensitive to the effects of radiation. For cancers that have spread to other parts of the body, chemotherapy may be the main form of treatment.
Targeted therapy is a newer class of treatment that uses drugs designed to attack specific parts of cancer cells. For instance, some targeted drugs block the growth of new blood vessels that tumors need to survive. This type of therapy is often considered when chemotherapy is no longer effective.
Immunotherapy works by helping the body’s own immune system recognize and fight cancer. Certain immunotherapy drugs, known as checkpoint inhibitors, can block proteins that cancer cells use to hide from the immune system. This treatment is used for advanced or recurrent cervical cancer, and biomarker tests may be used to predict whether a person’s cancer is likely to respond.
Palliative and Supportive Care
Palliative care is specialized medical care focused on providing relief from the symptoms and stress of a serious illness like cervical cancer. Its primary goal is to improve the quality of life for both the patient and their family. This type of care can be provided at any stage of the illness and is often given alongside curative treatments.
This supportive care addresses the physical symptoms of the cancer and the side effects of treatment, such as pain, nausea, and fatigue. A palliative care team, which can include doctors, nurses, and social workers, works with the patient’s other doctors to provide an additional layer of support.
It is important to understand that palliative care is not just for end-of-life situations; it is about managing symptoms to live as well as possible. This care also extends to providing emotional, social, and spiritual support, helping patients and their families cope with the challenges of the illness.