Medical Treatment for Cervical Cancer continued...
If a biopsy shows that cancerous cells have invaded through a layer called the basement membrane, which separates the surface layers of the cervix from other underlying layers, surgery is usually required. The extent of the surgery varies, depending on the stage of the cancer.
In cervical cancer, surgery removes cancerous tissue in or near the cervix.
If the cancer is only on the surface of the cervix, the cancerous cells may be removed or destroyed by using methods similar to those used to treat precancerous lesions, such as the LEEP or a cold knife conization.
If the disease has invaded deeper layers of the cervix but has not spread beyond the cervix, an operation may remove the tumor but leave the uterus and the ovaries.
If the disease has spread into the uterus, hysterectomy -- removal of the uterus and cervix -- is usually necessary. Sometimes, the ovaries and fallopian tubes also are removed. In addition, lymph nodes near the uterus may be removed to check for spread of the cancer. Hysterectomy is also sometimes done to prevent spread of the cancer.
Radiation therapy (or radiotherapy) is also used to treat cervical cancer at some stages. Radiation therapy uses high-energy rays to damage cancer cells and stop their growth. Like surgery, radiation therapy is local therapy; the radiation affects cancer cells only in the treated area. Radiation may be applied externally or internally. Some women receive both kinds.
External radiation comes from a large machine, which aims a beam of radiation at your pelvis. Treatments, which take only a few minutes, usually are given five days a week for five to six weeks. At the end of that time, an extra dose of radiation called a "boost" may be applied to the tumor site.
Because of safety concerns and expense of equipment, radiation therapy generally is offered only at certain large medical centers or hospitals.
Internal or implant radiation comes from a capsule containing radioactive material which is placed directly in the cervix. The implant puts cancer-killing rays close to the tumor while sparing most of the healthy tissue around it. It is usually left in place for one to three days, and the treatment may be repeated several times over the course of one to two weeks. You stay in the hospital while the implants are in place.
Chemotherapy is the use of powerful drugs to kill cancer cells. In cervical cancer, it is used most often when the cancer is locally advanced or has spread to other parts of the body. Just one drug or a combination of drugs may be given. Anticancer drugs used to treat cervical cancer may be given via an IV line or by mouth. Either way, chemotherapy is systemic treatment, meaning that the drugs flow through the body in the bloodstream. They can kill cancer cells anywhere in the body.
Chemotherapy is given in cycles: each cycle comprises a period of intensive treatment followed by a recovery period. Treatment usually consists of several cycles. Most patients have chemotherapy as an outpatient (in an outpatient clinic at the hospital, at the doctor's office, or at home). Depending on which drugs are given and your general health, however, you may need to stay in the hospital during treatment.
Treatment for invasive cervical cancer usually involves a team of specialists. The team generally includes a gynecologic, oncologist and a radiation oncologist. These doctors may decide to use one treatment method or a combination of methods.You may choose to take part in a clinical trial (research study) to evaluate new treatment methods. Such studies are designed to improve cancer treatment. Participating in a clinical trial has both benefits and risks.