Cervical Cancer - Treatment for Cervical Cancer

Stage IB and Locally Advanced Cancer. Five-year survival rates for stage IB can be 80% to 90% with either radiation or surgery. Survival rates are lower if lymph nodes are involved.

In stage IB1 the tumor is typically visible (not usually microscopic) and diameter may be up to 4 cm. Treatment Options: Radical hysterectomy with pelvic lymph node removal (lymphadenectomy). Primary radiation can be used instead of surgery in patients who are poor surgical candidates or who do not plan on being sexually active.
In stage IB2 the tumor is more than 4 cm and considered "bulky." Treatment Options: Relapse rates after surgery are higher than in stage 1B1. Primary treatment with radiation therapy with concurrent platinum-based chemotherapy is reasonable. Some women in stage IB may be given combinations of radiation and surgery, although the benefits of such combinations are unclear for most women, particularly given a higher risk for severe side effects.

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Note on Locally Advanced Cervical Cancer: Stages IB2 through IVA are often referred to collectively as locally advanced cancer and are frequently treated similarly. In addition to standard treatments, notably radiotherapy with concurrent platinum-based chemotherapy, experimental approaches for some women with locally advanced cervical cancer employ radiation therapy with hyperthermia (high heat often provided by ultrasound) and neoadjuvant (preoperative) chemotherapy and radical surgery.

Stage II and Treatments

Stage II invasive cancer extends beyond the cervix, but not does not involve the pelvic side wall. This stage is further categorized as IIA and IIB.

Stage IIA. Cure rates for stage IIA can be as high as 75% to 80% with either radiation or radical hysterectomy. Survival rates are lower if lymph nodes are involved. In stage IIA the upper two thirds of the vagina are involved but not the parametrium (the connective tissue between the pelvic floor and upper part of the cervix). Treatment Options: Same as stage IB1 above unless tumor is bulky. In this latter case, treatment is the same as stage IB2.

Stage IIB. For stage IIB five-year survival rates are about 60%. In stage IIB the cancer has spread to the parametrium. Treatment Options: Radiation therapy with concurrent cisplatin-based chemotherapy.

Stage III and Treatments

In stage III invasive cancer with tumor extending to the lower third of the vagina (stage IIIA) or to the side walls of the pelvis (stage IIIB). The kidney may be affected. Treatment Options: Radiation therapy with concurrent cisplatin-based chemotherapy. Five-year survival rates are about 40%.