We treat many cases of cervical cancer with surgery alone. However, there are women with disease that has started to spread, or who have tumors with high-risk features, for which we recommend additional measures such as radiation therapy and/or chemotherapy, a systemic treatment that kills cancer cells nearly everywhere in the body.
Treatment for Newly Diagnosed Disease
If your cancer has spread beyond the cervix and into surrounding pelvic tissues, our doctors may recommend that instead of undergoing surgery, you receive radiation therapy combined with chemotherapy. We may also recommend this combination if you have certain high-risk disease features at the time of your surgery that suggest an increased risk of the cancer returning, such as cancer cells in your lymph nodes or in parts of the tissue that is being surgically removed.
When radiation and chemotherapy are recommended in place of surgery, our doctors typically combine external-beam radiation therapy with internal radiation therapy. External-beam radiation therapy consists of x-ray treatments given daily for about five weeks. Low doses of chemotherapy drugs such as cisplatin (Platinol®) are used during this treatment to sensitize the cancer cells to radiation therapy.
Internal radiation is then given using high-dose brachytherapy, in which high doses of radioactive material are applied through a specialized applicator directly to the tumor. Studies have shown that this combined action can dramatically lengthen life in women with advanced cervical cancer. (1), (2), (3)
Specialized approaches to external-beam radiation therapy may include the use of intensity-modulated radiation therapy (IMRT) as well. IMRT is a type of external-beam radiation that enables the doctor to customize the intensity of each radiation beam to conform to specific tumor shapes and sizes. IMRT not only reduces the dosage of radiation to healthy tissues but may also lessen your risk for side effects.
Treatment for Advanced or Recurrent Cancer
If your cancer has spread beyond the pelvis and into organs such as the lungs or liver, or you have recurrent disease, we will work with you to reduce your cancer-related symptoms and help you maintain your quality of life.
We primarily recommend chemotherapy for women with advanced or recurrent disease. Several drugs, such as cisplatin (Platinol®) and paclitaxel (Taxol®), are available. Memorial Sloan Kettering investigators are researching additional chemotherapy strategies that may be effective for patients.
Some women with recurrent cervical cancer choose to undergo an involved surgery known as pelvic exenteration. With this approach, surgeons remove cancerous tissue and reconstruct the remaining organs to preserve as much function as possible. Brachytherapy can be done at the same time. We reserve this radical procedure for women who have otherwise limited treatment options.