0

This stage of cervical cancer is called carcinoma in situ, meaning the cancer cells are on the surface of the cervix and do not invade deeper cell layers of the cervix. Since this stage is not invasive, there is no risk of the cancer spreading (metastasizing) to other tissues.

(TisN0M0)

Cervical biopsy is done before any treatment to be sure the cancer cells have not spread beyond the surface of the cervix.

For women who wish to preserve the ability to have children:

• Conization
• Loop electrosurgical excision procedure (LEEP)
• Carbon dioxide laser therapy
• Cryotherapy

For women who do not wish to preserve the ability to have children:

• Abdominal or vaginal hysterectomy

IA

(T1a1N0M0, T1a2N0M0)

For women who wish to preserve the ability to have children:

• Conization may be an option for squamous cell cancer that extends less than 3mm into deeper tissues (stromal invasion).

For women who do not wish to preserve the ability to have children:

• Total hysterectomy for cancer that extends less than 3mm into deeper tissues (stromal invasion) and does not involve the blood vessels or lymphatic system
• Radical hysterectomy and pelvic lymph node biopsy for cancer that extends between 3mm and 5mm deep
• Radiation implants in the vaginal cavity for women who cannot have surgery

IB, IIA

(T1b1N0M0, T1b2N0M0, T2aN0M0)

Radiation, using both an external beam of radiation to the pelvis and implants in the vaginal cavity

Radical hysterectomy and bilateral pelvic lymph node removal

Radical hysterectomy and bilateral pelvic lymph node removal followed by radiation and chemotherapy with cisplatin or cisplatin and fluorouracil (chemoradiation)

Radiation and chemotherapy with cisplatin or cisplatin and fluorouracil

IIB, IIIA, IIIB, IVA

(T2bN0M0; T3aN0M0; T1N1M0; T2N1M0; T3aN1M0; T3b, any N, M0; T4, any N, M0)

Radiation, using both an external beam of radiation to the pelvis and implants in the vaginal cavity and chemotherapy with cisplatin or cisplatin and fluorouracil (chemoradiation)

Stage IVA may also be treated with extensive pelvic surgery (pelvic exenteration) if cancer is contained in the pelvis.²

IVB

(any T, any N, M1)

Palliative chemotherapy or radiation therapy

Clinical trials

Recurrent

Radiation and chemotherapy

Palliative chemotherapy or radiation therapy

Clinical trials

Cervical cancer that has come back can sometimes be treated with extensive pelvic surgery (pelvic exenteration) if cancer is contained in the pelvis.³