Cervical Cancer - Treatment for Cervical Cancer

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Stage 0 and Treatments

Stage 0 is cancer in situ confirmed by biopsy and confined to the first layer of cervical tissue (the epithelium). Treatment Options: Loop electrosurgical excision procedure (LEEP), laser therapy, conization, or cryotherapy.

Stage I (Including Locally Advanced Cancer) and Treatments

Stage I is invasive cancer, but the tumor confined is confined to the cervix. This stage is further categorized as IA and IB.

Stage IA. Five-year survival rates for stage IA can be 95% or more.

• In stage IA1 cancer cells are microscopic, there is minimal invasion (less than 3 mm) into the supportive tissue around the cervix (the stroma), and the horizontal extent of the tumor is less than 7 mm. Treatment Options: Simple hysterectomy. Conization is an alternative that is sometimes possible for women who want to preserve fertility and who have a nonaggressive tumor that has spread less than 3 mm with no lymph or blood vessel involvement. Trachelectomy has been investigated for women who want to preserve fertility.
• In stage IA2 there is deeper invasion (greater than 3 mm but less than 5 mm) and the horizontal extent of the tumor is less than 7 mm. Treatment Options: Radical hysterectomy with surgical lymph node removal (lymphadenectomy) is a common approach.

Note on Stage IA2 through IIA: Postoperative concurrent radiation and platinum-based chemotherapy may be considered for stages IA2 through IIA tumors if the following high risk features are found at the time of primary surgery: lymph node involvement, cancerous cells found in the margins of the tumor, and involvement of the parametrium.

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.