Cervical Cancer - Treatment for Cervical Cancer

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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.

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Stage IIA. Cure rates for stage IIA can be as high as 75 - 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 5-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%.

Stage IV and Treatments

In stage IV invasive cancer with tumor spread beyond the pelvis or to the mucosal lining of the bladder or rectum. Five-year survival rates are less than 20%.

Stage IV. In stage IVA the cancer involves the inner lining of the bladder or rectum. Treatment Options: Radiation therapy with concurrent cisplatin-based chemotherapy.

Stage IVB. In stage IVB, the cancer has metastasized beyond the pelvis. Treatment Options: Radiation therapy to relieve symptoms and chemotherapy (usually cisplatin or carboplatin combined with other drugs such as topotecan). Platinum-based chemotherapy yields short-lived response in 20% of patients. Clinical trial participation is reasonable.