Surgery and radiation are the most common treatments for cervical cancer. Chemotherapy may also be used to treat cervical cancer.

Surgery

Many different treatments are available for dysplasia and cancer of the cervix. The choice of treatment depends on the type and degree of abnormal cells present, and the woman's desire to preserve her fertility. Surgery is only recommended for early-stage small cancers that are confined to the cervix.

The procedures most commonly used to treat early-stage cervical cancer include:

• LEEP surgery
  A small, low-voltage wire loop is used with cautery to remove a piece of the cervix.

• Laser surgery
  A laser beam is used to burn off cells or to remove a small piece of tissue.

• Cone biopsy
  A cone biopsy can be used for more extensive lesions or for those lesions that extend further into the cervical canal. A cone-shaped piece of tissue is removed from the cervix for examination.

LEEP surgery, laser treatments and cone biopsies are usually performed for dysplasia and not invasive cancer of the cervix. Women with early-stage, minimally invasive cancer who wish to preserve their fertility may be considered for cone biopsy. All of these procedures are performed on an outpatient basis.

Other procedures used to treat cervical cancer include:

• Simple hysterectomy
  The uterus is removed, but not the tissue next to the uterus. A simple hysterectomy is used only after a cone biopsy has been done to ensure that the cancer is only minimally invasive.

• Radical hysterectomy and pelvic lymph node dissection
  The uterus and the tissues next to it, including the upper part of the vagina and the lymph nodes from the pelvis are removed. This is the most common surgical procedure for cervical cancer. However, it is only appropriate when the cancer has not spread to the walls of the pelvis.

• Radical trachelectomy
  In early-stage cancer, it may be possible to remove the pelvic lymph nodes and the cervix and retain the uterus for future pregnancy, using this procedure. Only a few gynecological cancer surgeons perform radical trachelectomies.

• Pelvic exenteration
  When the cancer has returned after radiation treatment, this operation is used to remove the uterus, fallopian tubes, lymph nodes, ovaries, either the bladder or the rectum (in rare cases, both) and part or all of the vagina.

Radiation

Radiation therapy is used to treat invasive cervical cancers. Two forms of radiation therapy are used to cure cervical cancer: external beam radiation and brachytherapy.

• External beam radiation therapy focuses radiation from outside the body to treat the cancer cells and the pelvic lymph nodes.

• Brachytherapy (also called internal radiation therapy) involves the insertion of radioactive material into the uterus and vagina, to treat the cervical cancer directly.

Women treated with radiation therapy for cervical cancer often get chemotherapy at the same time.

There can be side effects from radiation treatment. Most will go away. The skin in the treated area may get red and then look slightly tanned later, but will return to normal within 6 to 12 months.

Other side effects include:

• fatigue
• skin irritation
• diarrhea
• urge to urinate frequently
• burning sensation when urinating
• vaginal stenosis (narrowing of the vagina by scar tissue)
• premature menopause

Treatment to the pelvic area may cause the vagina to become narrower because of scar tissue, which can make having sex painful. Early menopause and problems with urination can also occur. However, all of these effects can be minimized and avoided altogether by taking certain precautions and appropriate hormone therapy. Talk to your doctor about any side effects and the treatments or medications that can help alleviate them.

Chemotherapy

Chemotherapy (drugs used to kill cancer) is used to treat invasive cervical cancers. It is commonly given at the same time as radiation. Chemotherapy drugs are usually injected into a vein. They then travel through the bloodstream to reach all areas of the body. If this treatment is chosen, you may receive one or several drugs at one time.

Side effects from chemotherapy will depend on the type of drugs you are taking, your dosage and the length of time you are on the medication. Side effects may include:

• Upset stomach and vomiting (you will be given anti-nausea drugs)
• Diarrhea
• Change in appetite
• Fatigue
• Temporary loss of hair
• Mouth or vaginal sores
• Increased chance of infection
• Tiredness
• Changes in the menstrual cycle
• Premature menopause
• Infertility

Most of the side effects (except for menopause and infertility) will go away when the treatment is over.