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Cervical Cancer Treatment Surgery Cervical cancer in its early stages, has upwards of a 95% cure rate with either surgery or radiation therapy. Surgery is often recommended if the woman has no other medical problems, in order to spare her some of the possible long term effects of radiation therapy. This surgery is called a "radical hysterectomy and pelvic lymph node dissection". It is different from a regular hysterectomy (removal of the uterus), in that extra tissue around the uterus and vagina are removed. This is done to try and make sure that all tissues involved with cancer are removed. The lymph nodes in the pelvis are also examined and removed to tell if any cancer has spread there. Lymph nodes are glands that are scattered along on either side of large blood vessels within the body. They work to help sift out and filter bacteria and other things that are not needed. Unfortunately, cancer cells can also end up here, and their presence many indicate a need for more therapy than just surgery alone. A woman's ovaries may or may not be removed, depending on her age and medical history. Recovery from a radical hysterectomy takes longer than a regular hysterectomy. The extra tissue removed and how it is removed often causes the bladder to take longer to heal. Woman may not be able to tell their bladder is full or be able to empty completely when they do urinate. Often the woman is taught how to empty her bladder herself, with a soft rubber tube (catheterization), until the bladder recovers. This may take as long as 4 - 8 weeks. Usually a woman can expect a hospital stay of 4 - 7 days and full recovery usually takes 6 - 8 weeks. Radiation Therapy Radiation therapy for cervical cancer is used in different ways. In woman with more advanced cervical cancer (that which has spread beyond the cervix) radiation therapy is the treatment of choice, because all the cancer cannot be removed with surgery. It may also be used in women with early disease but who, for medical reasons, cannot tolerate major surgery. If a woman is found to have spread of the cancer to her lymph nodes or other areas, after a radical hysterectomy, radiation may also be recommended in that case as well. Radiation therapy is designed to kill cancer cells; unfortunately, other tissues that are in the area are affected and react to the radiation. This is where most of the radiation side effects come from. There are also two ways to give radiation therapy for women with cervical cancer. External or teletherapy is given with a radiation source that is outside the body and is then directed to a certain area. Internal or brachytherapy is given with a radiation source that is temporarily inserted into the body to target a smaller, very specific area. External radiation is usually given daily Monday through Friday and takes 15 - 20 minutes. The radiation doctor, called a radiation oncologist, usually recommends about 5 weeks of therapy. After this is finished, and for women who still have their uterus, internal radiation completes the treatment. This can be done with the patient in the hospital for 2 - 4 days with one long implant or two short implants a week apart. Sometimes, the internal radiation is given in a special center as a weekly treatment over several weeks, and the woman does not have to stay overnight in the hospital. Chemotherapy Very recently (since 1999), clinical trials have shown a benefit for woman with cervical cancer who need radiation therapy, to also have chemotherapy at the same time. The term for this type of chemotherapy is called "chemosensitization". Wherein just enough chemotherapy is given to help the radiation therapy work better. Often the chemotherapy is given once a week before the radiation and continues every week during the time of external radiation. Other types of schedules of different drugs may also be recommended. Women who have recurrent cervical cancer (cancer which has come back after their first treatment with radiation therapy or surgery), may be offered chemotherapy alone. The goal of chemotherapy given this way is to treat the whole body where the cancer cells may be. It is frequently given as an outpatient and may be given on an every 3 - 4 week schedule. |
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