Finding out You Have Cervical Cancer: Making Treatment Decisions

The cervix is the lower, narrow end of the uterus. The uterus is where the fetus grows when a woman is pregnant. Babies pass from the uterus through the cervix and into the birth canal when they are born.

Before cervical cancer appears, the cells of the cervix begin to change. This is called dysplasia. As time goes on, the cells become cancer, or malignant, and they spread more deeply into the tissue of the cervix and the area surrounding it.

The most common cause of cervical cancer is being infected with the human papilloma virus, or HPV. But not all women with HPV develop cervical cancer. HPV is spread through sexual activity. Some people are able to fight the HPV infection, and it goes away. But if you’re not able to fight HPV, the virus remains in your body and can cause some of the cells in your cervix to become pre-cancerous.

Most women experience no symptoms of early cervical cancer. The best chance at early detection is to have an annual Pap smear. This test can detect abnormal cells before they become cancerous.

Even if you have pre-cancerous cells, that doesn’t mean you have cancer. Often, pre-cancerous cells return to normal on their own. That’s why doctors often recommend an additional Pap test if a woman has a Pap smear that shows an abnormality

Remember—cancer of the cervix is rare among women who have regular PAP smears and who get treatment if their results are abnormal. But if cancer does develop, there are treatments available.

Staging and Treatment
If you’ve been diagnosed with cervical cancer, your treatment option will depend upon several factors:

• The stage the cancer is in
• The size of the tumor
• Your desire to have children
• Your age

The stages of cervical cancer range from I to IV:

Stage I:       The cancer cells are in the cervix only.

Stage II:     The cancer has spread beyond the pelvis, but not to the pelvic wall.

Stage III:    The cancer has spread to the lower part of the vagina and possibly to the pelvic wall and lymph nodes.

Stage IV:    The cancer has spread to the bladder, rectum or other parts of the body.           

Surgery
There are several types of surgery for cervical cancer. The more complex and involved the surgery, the more advanced the cancer is. Surgical options include:

Conization: The surgeon removes a cone-shaped piece of tissue from the cervix. This allows cells to be examined under a microscope. This procedure can be used to diagnose a cervical condition. It’s also called a cone biopsy.

Total hysterectomy: This removes the uterus and cervix. Surgeons perform the procedure in several ways—removal through the vagina, through one long incision in the abdomen, or through a small incision in the abdomen.

Bilateral salpingo-oophorectomy: Removal of ovaries and fallopian tubes.

Radical hysterectomy: Removal of uterus, cervix and part of the vagina. The ovaries, fallopian tubes and lymph nodes in the area may also be removed.

Pelvic exenteration: Removal of lower colon, rectum and bladder, and as well as the cervix, vagina, ovaries and nearby lymph nodes. Surgery may be needed to create openings for your urine and stool to pass through your body, and to make an artificial vagina.

Cryosurgery: This freezes abnormal tissue. It’s also called “cryotherapy.”

Laser surgery: Using a laser beam to remove cancerous tissue or tumor.

Loop electrosurgical excision procedure: This uses electrical current passed through a thin wire loop as a knife to remove abnormal tissue or cancer.

Chemotherapy and radiation
Other possible treatments for cervical cancer include radiation and chemotherapy. Radiation uses high-energy x-rays or other type of radiation to kill cancer cells. It can be given externally, by a machine that’s outside the body, or internally, by placing radioactive substances inside the body.

Chemotherapy uses drugs to stop cancer growth. It can be given through a vein, by mouth or sometimes injected directly into a body cavity, such as the abdomen.

Talking with your doctor
When your doctor talks with you about your treatment options, be sure to ask the following questions:

• What are the goals of each treatment?
• What are the side effects of these treatments?
• What are the risks?
• What do you think my chances for survival are?

Source:
The American Cancer Society; The National Cancer Institute.