Your treatment depends on where in the cervix your cancer is, how big it is, whether it has spread anywhere else in your body and your general health.
You usually have surgery or a combination of chemotherapy and radiotherapy (chemo radiotherapy).
Treatment decisions
Find out how your doctor decides which treatment you need, and about the types of treatment you might have.
Chemotherapy uses drugs to destroy cancer cells anywhere in the body. It can be given through a vein or taken in pill form. Sometimes both methods are used.
For locally advanced cervical cancer, low doses of chemotherapy are often combined with radiation therapy, since chemotherapy may enhance the effects of the radiation. This is known as chemoradiation and typically takes 5-6 weeks to complete. Higher doses of chemotherapy might be recommended to help control symptoms of very advanced cancer.
Targeted drug treatments focus on specific weaknesses present within cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die. Targeted drug therapy is usually combined with chemotherapy. It might be an option for advanced cervical cancer.
Immunotherapy is a drug treatment that helps your immune system to fight cancer. Your body’s disease-fighting immune system might not attack cancer because the cancer cells produce proteins that make them undetectable by the immune system cells. Immunotherapy works by interfering with that process.
For cervical cancer, immunotherapy might be considered when the cancer is advanced and other treatments aren’t working. These are under trials.
Surgery is one of the main treatments for cervical cancer. Find out about radical hysterectomy and radical trachelectomy, and what to expect before and after your operation.
Radical trachelectomy A fertility-sparing operation to remove early-stage cervical cancer.
Radical Hysterectomy (nerve-sparing) and Pelvic Node Dissection for Cervical Cancer
Cervical cancer is still the second most common malignancy and the second most common cause of cancer-related death in women worldwide. A radical hysterectomy and pelvic node dissection are performed for cancer of the cervix (neck of the womb). The surgery aims to remove all of cancer and make sure there has been no spread.
Patients with early stage cervical cancer have the choice of undergoing either surgery or radiotherapy. Some patients who undergo surgery may require to undergo radiotherapy after the operation; this happens when certain high risk features are noted on pathological examination of the tissue removed during surgery.
Patients with locally advanced cervical cancer are treated primarily with radiation along with concurrent chemotherapy.
The treatment of cervical cancer is a combination of external beam radiotherapy and vaginal brachytherapy.
When treating cervical cancers, the aim of modern radiotherapy techniques is to ensure that the uterus, its adjacent pelvic structures and the pelvic lymph node bearing region receive the correct dose. An additional and equally important aim is to ensure that the normal organs in the vicinity i.e., the urinary bladder, rectum, small and large bowel, and bone marrow, receive the least possible dose. This is done to ensure that the toxicity of radiation is kept at the minimum possible.
Irradiation of these of the above mentioned structures leads to short term and long term consequences such as inflammation of the bladder, diarrhoea, narrowing of the gut, bleeding in the urine and stool and risk of insufficiency fractures.
The side effects can be minimised by reducing the doors to all these structures.
At Apollo Proton Cancer Center, the options for delivering safe and accurate radiotherapy are theRadixact Helical Tomotherapy Unit and Proteus Plus proton therapy unit.
The Radixact helical tomotherapy machine is a sophisticated linear accelerator which has inbuilt features that ensure that patient undergoes imaging I,e a CT scan prior to delivery of treatment every day. The radiation is delivered in successive narrow segments as the patient moves through the machine which allows the treating team to spare normal organs very effectively.
Proton therapy has a unique characteristic in that protons, which are positively charged particles, deposit their entire energy at a predefined target and tissues distal to the target receive no radiation. This allows better sparing of the normal organs. In endometrial cancer patients, this results in smaller doses to the small bowel, large bowel, bone marrow and urinary bladder. The expected outcome of this is reduction in the risk of diarrhea, narrowing of the bowel and inflammation of the bladder. In addition, since the pelvic bone marrow is being spared, there is better tolerance of treatment delivered along with or after chemotherapy. This is especially relevant in the elderly. In young patients, there is the additional benefit of reduction in the risk of radiation induced second cancers because of decrease in low dose radiation being received by normal structures.
The target for this patient suffering from cancer cervix is outlined in green.
The lavender colourwash represents 50% of the prescribed dose. The green colourwash represents 30% of the prescribed dose.
The 50% and 30 % dose clouds spare the bone marrow (white arrow) and the intestines (red arrow).
In this plan, with proton therapy the average dose received by the bladder is and bone marrow are
approximately 55-60% of the dose received in the Tomotherapy plan.
Similarly, the average dose received by the intestines in proton therapy is half of that received during photon based treatment.
Since the risk of side effects like severe diarrhoea, cramps, cystitis and low blood counts is dose linked, this reduces the probability of these side effects.
All patients receive treatment with diligent attention to ensuring least possible dose to normal organs by following daily bladder filling protocols; a filled urinary bladder displaces bowel for the region being treated, thus protecting it.
At present, Vaginal brachytherapy services are not available at Apollo Proton Cancer Centre.
The treatment of cancer of the vagina is similar to that of cancer cervix.
Find out from your specialist what happens if you’re diagnosed with cervical cancer when you’re pregnant.
The team will let you know about follow up appointments and tests after treatment for cervical cancer. Usually every 3-4 months in the first two years and then every six months.
Survival depends on many different factors. It depends on your individual condition, type of cancer, treatment and level of fitness. It is difficult to tell you exactly how long you will live.
These are general statistics based on large groups of patients. Remember, they can’t tell you what will happen in your individual case.
Your doctor can give you more information about your own outlook (prognosis).
Survival for cervical cancer is related to the stage of the cancer at diagnosis. Most patients are diagnosed at stage 1 or 2.
Stage 1
Around 95 out of 100 women (around 95%) will survive their cancer for 5 years or more after diagnosis.
Stage 2
More than 60-70 out of 100 women (more than 50%) will survive their cancer for 5 years or more after diagnosis.
Stage 3
Almost 40-50 out of 100 women (almost 50%) will survive their cancer for 5 years or more after diagnosis.
Stage 4
Around 5 out of 100 women (around 5%) will survive their cancer for 5 years or more after being diagnosed.
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