Our Treatment Approach
At the Susan F. Smith Center for Women's Cancers Gynecologic Oncology Program, our gynecologic experts make your cervical cancer their priority. You can feel confident in the treatment at Dana-Farber Brigham Cancer Center, as our specialists in surgery, chemotherapy, and radiation focus exclusively on gynecologic cancers.
Our multidisciplinary team includes experienced surgical, medical, and radiation oncologists, radiologists, pathologists, researchers, nurses, physician assistants, nutritionists, and social workers who care for each patient with dedication and compassion.
Beginning with your first appointment, our team will walk you through the entire treatment process, making sure you know what to expect and where to find helpful resources, such as counseling, nutrition advice, or palliative care.
Each patient has access to a social worker for extra support and guidance if needed. Your medical team will work together to ensure you receive the best care available. We create a unique, personalized plan for every patient, and we consider all aspects of your health when making our recommendations.
Hysterectomy. The uterus is surgically removed with or without other organs or tissues. In a total hysterectomy, the uterus and cervix are removed. In a total hysterectomy with salpingo-oophorectomy, (a) the uterus plus one (unilateral) ovary and fallopian tube are removed; or (b) the uterus plus both (bilateral) ovaries and fallopian tubes are removed. In a radical hysterectomy, the uterus, cervix, both ovaries, both fallopian tubes, and nearby tissue are removed. These procedures are done using a low transverse incision or a vertical incision.
Cervical Cancer Treatment by Stage
Depending on how much the cancer has grown, you may have one treatment or a combination of treatments. Treatment depends on:
- The stage of the disease
- Your age
- Your desire to preserve fertility
- Your overall health
More than 90 percent of early-stage cancers are treated successfully with surgical procedures and do not require any further treatment.
If you are a diagnosed with early-stage cervical cancer (stage I) and would still like to have children, there are surgical options that can preserve your fertility without compromising treatment or survival. If you are diagnosed with advanced-stage cervical cancer, we will carefully review your treatment and surgery options to ensure good pregnancy outcomes. Our dedicated fertility and reproductive specialists can discuss all fertility concerns, as well as options for you to consider, such as embryo (egg) freezing or harvesting.
- If you are diagnosed with cervical dysplasia or precancerous cells are found (carcinoma in situ, or stage 0 cervical cancer), surgery is generally the only treatment necessary to remove precancerous areas on the cervix. A biopsy to remove areas on your cervix will be performed, either by using the loop electrosurgical excision procedure (LEEP) or the cold-knife cone biopsy procedure. A minor fertility-sparing surgery may be the only treatment necessary to remove precancerous areas on the cervix, or a simple hysterectomy is often suggested if you are no longer interested in having children. In certain younger patients with moderate dysplasia, close observation may be another option.
- If you are diagnosed with Stage I (Stage IA or IB) cervical cancer, your treatment may include surgeries and therapies beyond a biopsy to remove the cancerous cells. Radiation may also be suggested. However, surgery is generally recommended for younger patients, and radiation is generally recommended for older patients. In some cases, or when fertility is not a concern, surgery to remove the uterus and cervix (hysterectomy or radical hysterectomy) may be the preferred course of treatment.
- If you are diagnosed with Stage II (Stage IIA or IIB) cervical cancer, radiation therapy (external and internal radiation) and chemotherapy are generally the first suggested lines of treatment. In stage II cases, your doctor will generally review clinical trials as an option to supplement treatment. In rare stage II cases, removal of the uterus, cervix, and adjacent lymph nodes may be performed.
- If you are diagnosed with Stage III cervical cancer, your doctor will start a customized treatment plan of radiation (external and internal radiation) combined with chemotherapy. In advanced stage III cases, surgery to remove the uterus and/or cervix is not necessary, as the cancer has spread throughout the pelvis and, in some cases, to the ureter. Instead, your doctor may recommend a clinical trial as a supplemental treatment option.
- If you are diagnosed with Stage IV (Stage IVA or IVB) cervical cancer, your treatment plan will be tailored to your specific needs. Extensive radiation therapy (external and internal radiation) is generally administered and combined with chemotherapy to control the spread of the cancer, relieve any symptoms, and improve your quality of life. In advanced cases like these, your doctor will encourage you to participate in a clinical trial of new anticancer drugs or drug combinations. Surgery is only a palliative care option at this stage of the disease.