Cervical Cancer

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Treatment

Treatment for cervical cancer depends on the stage of the disease. In cases of cervical intraepithelial neoplasia (CIN), abnormal tissue may be removed using loop electrode excision (using wire loops heated by electric current) or cone biopsy.

Carcinoma in situ may be removed using loop electrode excision, cryosurgery, or laser ablation. In cryosurgery, liquid nitrogen is circulated through a probe, which is applied to cancerous tissue. Freezing temperatures destroy the cancer cells. Laser ablation involves using a laser (device that emits intense heat and light at close range) to remove cancerous tissue.

Invasive Cervical Cancer
Invasive cervical cancer and metastatic disease are usually treated with surgery, radiation, and chemotherapy.

Surgical treatment for invasive cervical cancer is radical hysterectomy, which is the removal of the uterus, fallopian tubes, ovaries, adjacent lymph nodes, and part of the vagina. If cancer has spread (metastasized) to lymph nodes in the abdomen, lymphadenectomy (surgical removal of lymph nodes) may also be performed.

Radiation may be used alone, or after surgery, or chemotherapy. Radiation is delivered by a machine outside the body (called external beam radiation) or by radioactive "seeds" implanted in the uterus and vagina (called brachytherapy). After surgery, radiation may be used to decrease the risk for recurrence. Side effects include fatigue, swelling, and skin reddening.

Chemotherapy uses toxic drugs to destroy cancer cells. Cisplatin (Platinol®) and fluorouracil (Adrucil®, Efudex®) are often used in combination and in addition to radiation to treat invasive cervical cancer. Chemotherapy is administered intravenously, through injection, or in pill form. Side effects may be severe and include nausea, vomiting, diarrhea, and leukopenia (low white blood cell count).

Prognosis

Cancer of the cervix often can be cured, if it is detected and treated early. The prognosis depends on the stage of the disease at the time of diagnosis. The 5-year survival rate for all stages of cervical cancer combined is approximately 70%.

Prevention

Avoiding sexual activity that increases the risks for HPV infection, not smoking, and having regular Pap smears can help prevent most cases of cervical cancer. Using condoms and limiting the number of sexual partners may prevent HPV infection.

In June of 2006, the Food and Drug Administration (FDA) approved a cervical cancer vaccine for girls and women between the ages of 9 and 26. This vaccine (Gardasil®) has been shown to protect against the human papillomavirus (HPV).

Electrosurgery, cryosurgery, podophyllum, and trichloroacetic acid are methods used to remove HPV in mucosal tissue. Removal is warranted because of the potential for developing into cancer.

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