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Treatment decisions

Find out how your doctor decides which treatment you need and 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.

Treatment overview

The main treatments depend on what stage your cervical cancer is. 

You might have treatment for abnormal cells. This includes treatment to remove or destroy the abnormal cells. 

For stages 1 to 4 cervical cancer you might have one or more of the following treatments depending on the stage of your cancer: 

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

Treatment by stage

Carcinoma in situ (CIS)

The cells are either removed or destroyed. Treatments include:

  • laser therapy
  • cryotherapy
  • cone biopsy
  • hysterectomy

Early cervical cancer

Early cervical cancer is only in the neck of the womb (stage 1A or 1B) or cancer that has started to grow into the top of the vagina (stage 2A).

The main treatments

For some early cervical cancers, it may be possible to treat the cancer with a cone biopsy or to have just the cervix removed. This operation is called a radical trachelectomy.

You will need to talk to your specialist to find out if you can have this type of treatment. It is not possible to do this operation in everyone. But, if it is very important for you to be able to have children, your specialist will do it if they can. If you do have a trachelectomy, your doctor still cannot guarantee that you will be able to have children afterwards.

Early cervical cancer can usually be cured with surgery or radiotherapy or both. Surgery usually means that you have your womb and cervix completely removed (hysterectomy). If the cancer has started to grow further into the tissues of the cervix (stage 1A2 and above), you will also have the lymph nodes in your pelvis taken out (lymphadenectomy). This is because there is a risk the cancer may have spread from the cervix to nearby lymph nodes.

Radiotherapy involves having treatment to the womb, cervix and surrounding tissues. If you have surgery and your specialist is not sure that all the cancer cells have been removed, they will recommend that you have a course of radiotherapy afterwards. This lowers the risk of the cancer coming back.

For larger early stage cancers (stage 1B or stage 2A), your specialist may suggest combined chemotherapy and radiotherapy. This may be better for you if the cancer cells cover a fairly wide area of your cervix.

Advanced cervical cancer

Advanced cervical cancer means cancer that has grown into tissues around the cervix (stage 2B), or that has spread further.

Choosing between treatments

Radiotherapy and surgery

Early cervical cancer can usually be cured with surgery or radiotherapy or both. If you have to choose between hysterectomy and radiotherapy, it can be hard to decide which treatment to have.

There are benefits and drawbacks to both types of treatment. It may just depend on which suits you best. But your doctor might prefer you to have radiotherapy if:

  • you are not fit enough to have a big operation
  • your surgeon thinks surgery may not remove all the cancer cells and you may need radiotherapy afterwards anyway

If your doctor thinks you will need radiotherapy after surgery, it may be better for you to have radiotherapy straight away, rather than having surgery first. Having both treatments increases your risk of long term side effects.

You may have reasons of your own to choose one treatment over another. Some women feel they want:

  • surgery because they want all the cancer physically removed
  • radiotherapy because they don't want to have their womb removed

There is no right or wrong way to feel about this. You may not feel strongly either way. If so, you will need to look at the pros and cons of both treatments to make up your mind.

If you're not having 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:

  • chemotherapy
  • radiotherapy
  • chemoradiotherapy
  • 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:

  • improve treatment
  • make existing treatments better
  • develop new treatments
Last reviewed: 
17 Jun 2014
  • Cervical Cancer: ESMO Clinical Practice Guidelines
    N. Colombo and others
    Annals of Oncology 2012; 23 (Suppl 7): vii27-vii32

  • American Joint Committee on Cancer (AJCC) manual (7th edition)
    S Edge and others
    Springer, 2010

  • Management of locally advanced cervical cancer
    UpToDate, June 2014

  • Invasive cervical cancer: Staging and evaluation of lymph nodes
    UpToDate, June 2014

Information and help

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