Treatment for cervical cancer
Cancer of the cervix can be treated with either surgery, radiotherapy, chemotherapy or a combination of these treatments.
Your doctor will advise you on the best plan of treatment for you, taking into account a number of factors. These include your age and general health, and the type and stage of the cancer.
Surgery is often the main treatment for women with early-stage cancer of the cervix.
Radiotherapy is as effective as surgery for early-stage cancer and may be used as an alternative to surgery.
Sometimes radiotherapy may also be given after surgery if there’s a risk that cancer cells may have been left behind. This helps reduce the risk of the cancer coming back.
Radiotherapy rather than surgery is usually used to treat larger tumours in the cervix (tumours over 4cm). This is because it’s often not possible to completely remove a larger tumour with surgery alone, whereas radiotherapy treatment can be very effective.
Radiotherapy is often given in combination with chemotherapy treatment for larger tumours. This is known as chemoradiation.
It’s thought that the chemotherapy makes cervical cancer more sensitive to the effects of the radiotherapy, so that the treatment is more effective.
Locally advanced cancer
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This is the main treatment for locally advanced cancer.
Very occasionally, an operation known as a pelvic exenteration may be carried out if the cancer has spread to nearby organs in the pelvis (such as the bladder or bowel), but not to distant organs (such as the lungs). This type of surgery involves a major operation and is only suitable for a small number of women.
This may be used to treat cancer that has spread to more distant parts of the body, such as the liver and lungs.
Chemotherapy can help to shrink and control the cancer and relieve symptoms, to prolong a good quality of life. This is known as palliative treatment.
Planning your treatment
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In most hospitals, a team of specialists will work together to decide which treatment is best for you. This multidisciplinary team (MDT) will include:
a gynaecological oncologist (a surgeon who specialises in gynaecological cancers)
a clinical oncologist (a doctor who specialises in treating cancer with radiotherapy and chemotherapy)
a medical oncologist (a doctor who specialises in treating cancer with chemotherapy)
a specialist nurse, who will be your main contact and will make sure you get help and support throughout your treatment.
The MDT may also include other healthcare professionals, such as a radiographer (a person who operates the machine that gives radiotherapy treatment), dietitian, physiotherapist, occupational therapist, psychologist or counsellor.
The MDT will take a number of factors into account when advising you on the best course of action. These factors include your age, general health, the type and size of the tumour, and whether the cancer has begun to spread.
If two treatments are equally effective for your type and stage of cancer, your doctors may offer you a choice of treatments. Sometimes people find it hard to make a decision. If you’re asked to make a choice, make sure you have enough information about the different options, what’s involved and the possible side effects, so that you can decide on the right treatment for you.
Remember to ask questions about any aspects that you don’t understand or feel worried about. It may help to discuss the benefits and disadvantages of each option with your cancer specialist, your nurse specialist or our cancer support specialists.
If you have any questions about your treatment, don’t be afraid to ask your doctor or nurse. It often helps to make a list of questions and to take a relative or close friend with you.
Before you have any treatment, your doctor will explain its aims. They will usually ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent and before you’re asked to sign the form you should be given full information about:
the type and extent of the treatment
its advantages and disadvantages
any significant risks or side effects
any other treatments that may be available.
If you don’t understand what you’ve been told, let the staff know straight away so they can explain again. Some cancer treatments are complex, so it’s not unusual for people to need explanations repeated.
It’s a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion. You may also find it useful to write a list of questions before your appointment.
People sometimes feel that hospital staff are too busy to answer their questions but it’s important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.
You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.
You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment but it can help to let the staff know your concerns so they can give you the best advice.
The benefits and disadvantages of treatment
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Many people are frightened at the idea of having cancer treatments, particularly because of the possible side effects. However, these can usually be controlled with medicines.
Treatment can be given for different reasons, and the potential benefits will vary depending upon the individual situation.
In women with early-stage cervical cancer, treatment is given with the aim of curing the cancer.
With advanced cancer (cancer that has spread to distant organs), treatment is usually given to control the cancer rather than to cure it. The aim is to improve symptoms and give a better quality of life. However, for some women the treatment will have little effect on the cancer and they will have the side effects without a great deal of benefit.
If you’ve been offered treatment that aims to cure your cancer, deciding whether to accept it may not be difficult. However, if a cure is not possible and the purpose of treatment is to control the cancer for a period of time, it may be more difficult to decide whether to go ahead.
Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your doctor whether you wish to have treatment. If you choose not to have it, you can still be given supportive (palliative) care, with medicines to control any symptoms.
Your multidisciplinary team uses national treatment guidelines to decide the most suitable treatment for you. Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information.
If you do go for a second opinion, it may be a good idea to take a relative or friend with you and have a list of questions ready, so that you can make sure your concerns are covered during the discussion.
Our video discusses the benefits and disadvantages of getting a second opinion.