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Treatment decisions

Find out how your doctor decides which treatment you need, and about the types of treatment you might have.

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

The treatment you have depends on:

  • where your cancer is
  • how far it has grown or spread (the stage)
  • the type of cancer
  • how abnormal the cells look under a microscope (the grade)
  • your general health and level of fitness

Your doctor will discuss your treatment, its benefits and the possible side effects with you.

Types of treatment

You might have one or more of the following treatments depending on the stage of your cancer: 

  • surgery
  • chemotherapy and radiotherapy together (chemoradiotherapy)
  • radiotherapy
  • chemotherapy

If you have abnormal cervical cells which were picked up through screening, this isn’t the right section for you.

Treatment for early cervical cancer

Early cervical cancer means cancer that is only in the neck of the womb (stage 1A or 1B) or has started to grow into the top of the vagina (stage 2A). It can usually be cured with surgery or a combination of chemotherapy and radiotherapy (chemoradiotherapy).

For some very early cervical cancers (stage 1A1), it might be possible to remove all of the cancer with a large loop excision of the transformation zone (LLETZ) or cone biopsy. Doctors usually use these treatments for women with abnormal cervical cells that are picked up through cervical screening.

Surgery

Surgery usually means that you have your womb and cervix completely removed (hysterectomy).

If you have a stage 1 cervical cancer and want to have children, it may be possible to have an operation called a radical trachelectomy. This removes most of the cervix, but leaves enough behind so that you might be able to become pregnant and carry a baby afterwards.

You need to talk to your doctor to find out if you can have this type of operation. It’s not possible to do it in everyone with early cervical cancer. If you do have a trachelectomy, your doctor still can’t guarantee that you will be able to have children afterwards.

If the cancer has started to grow further into the tissues of the cervix (stage 1A2 and above), your doctor will also remove the lymph nodes in your pelvis (lymphadenectomy). This is because there is a risk the cancer may have spread from the cervix to nearby lymph nodes.

Diagram of the lymph nodes in the pelvis

If you have surgery and your doctor is not sure that all the cancer cells have been removed, they may recommend that you have a course of chemoradiotherapy afterwards. This lowers the risk of the cancer coming back.

Chemoradiotherapy

For some larger early stage cancers (stage 1B or stage 2A), your doctor may suggest chemoradiotherapy instead of surgery. 

You have daily external radiotherapy for 5 days every week, for around 5 weeks. You also have a boost of internal radiotherapy (brachytherapy) at the end of your course.

During your course of radiotherapy, you also have chemotherapy once a week or once every 2 or 3 weeks. This depends on the chemotherapy drugs you have.

Treatment for advanced cervical cancer

Advanced cervical cancer means cancer that has grown into the tissues around the cervix or has spread further.

For stages 2B, 3 and 4A (locally advanced) cervical cancer, you are most likely to have chemoradiotherapy.

For cervical cancer that has spread further away in the body, such as the lungs (stage 4B or metastatic cancer), you might have:

  • chemotherapy
  • radiotherapy
  • other medicines to help with symptoms (symptom control)

If you can't have surgery

Health problems might mean you can’t have surgery, or you could decide you don’t want it. You have tests to check how fit you are before you have any treatment including heart and lung tests.

When surgery isn’t possible, you might have one or more of these treatments:

  • chemoradiotherapy
  • radiotherapy
  • chemotherapy
  • symptom control

Clinical trials to improve treatment

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.

Information and help

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About Cancer generously supported by Dangoor Education since 2010.