Treatments for Cervical Cancer

Cervical Cancer Treatments

There are many ways to treat cervical cancer. Our patients’ treatment plans depend on the stage of the cancer – or, whether it is only in the cervix or if it has spread beyond it. Many patients with early-stage cervical cancer will undergo surgery to remove the cancer. Some patients will also receive chemotherapy and/or radiation therapy to treat cancer cells that have spread to other organs or to reduce the risk of the cancer coming back.

At Siteman Cancer Center, our team of Washington University gynecologic oncologists understand that every patient is unique. They will design a personalized treatment plan for you, taking into account, not only the type, stage, and even genetic profile of your cancer, but also your age, desires for future fertility, and your overall health.

Many patients at Siteman receive treatment through clinical trials, research studies evaluating new drugs and procedures. Trials give patients access to new therapies, some that may even lead to better outcomes than the current standard of care.  Siteman offers more clinical trials than any other facility in the region. Your physicians will have a conversation with you if they think a particular trial could be a good fit.

We understand that you probably have many questions and concerns as you go through treatments for cervical cancer. There is no question too small or simple to ask. Your care team – your physicians, nurse coordinators, and other support personnel – will be with you every step of the way, ready to help.

Surgery

Surgery may be the first course of treatment for patients with cervical cancer. Depending on the stage and spread of the cancer, this might mean a more minor procedure, such as a cone biopsy, or a more extensive procedure, such as a radical hysterectomy.

Certain surgical procedures can impact your future fertility. At Siteman, our team of surgeons will do their best to create a treatment plan that considers your fertility and future.

Click here to read more about surgery for cervical cancer at Siteman.

Radiation therapy

Radiation therapy uses energy beams to eliminate cancer cells. Patients with more advanced cases of cervical cancer may receive radiation therapy to get rid of malignant cells and keep the cancer from coming back.

There are two basic ways of delivering radiation therapy to cervical cancer patients: external and internal. Most patients will receive both forms of radiation as part of their treatment. External radiation therapy uses large machines to transmit radiation beams to the tumor. During internal radiation therapy, a pelvic exam is performed where a radioactive source passes by the tumor staying a short distance away for a few minutes. This process is called brachytherapy.

Learn more about radiation therapy at Siteman.

Chemotherapy

Chemotherapy is a cancer therapy that is infused through an IV to treat cancer cells wherever they may be found in the body. As with radiation therapy, it is used for patients with more advanced cervical cancer. Sometimes, low dose chemotherapy is given with radiation to help the radiation work better.

Most patients tolerate chemotherapy well. If chemotherapy is recommended for you, your oncologist will go over common side effects. These include fatigue, nausea, vomiting, and low blood counts – or reduced numbers of red blood cells and white blood cells in the blood stream.  Low blood counts can make you more susceptible to bleeding, bruising, and infections.

At Siteman, we recognize that starting chemotherapy can be overwhelming. To help you through treatment, you will be assigned a dedicated nurse coordinator, who will spend additional one-on-one time with you and any support persons to make sure all of your questions and concerns are addressed. Your nurse coordinator will provide you with:

• Educational material on common chemotherapy side effects
• Prescriptions for medications that help prevent side effects before they occur
• A schedule of all of your treatments

We will guide you through this process. If you have already started your treatments and have questions, or are starting to notice symptoms that bother you, be sure to speak to your care team. There are ways they can change your care to better support you and to offset negative side effects.

Immunotherapy

Immunotherapy is a new form of cancer treatment that trains the patient’s own immune system to better recognize and attack cancer cells. It can be highly effective against cervical cancer.

At this time, the FDA has approved one immunotherapy drug, pembrolizumab, to treat cervical cancer. Pembrolizumab is a type of medication known as a “checkpoint inhibitor.” Some cervical cancer cells express a signal that allows them to go unnoticed by the body’s immune system. Checkpoint inhibitors “unmask” cancer cells, allowing the immune system to recognize and eliminate them.

Like chemotherapy, immunotherapy for cervical cancer is administered as an IV infusion. It’s currently approved to treat patients with advanced or relapsed disease and who have cancer cells that express the targeted immune signal.

Learn more about immunotherapy at Siteman Cancer Center.

Targeted therapy

Targeted therapies are medications that inhibit the mechanisms inside cancer cells that allow them to grow and multiply. Some patients with cervical cancer will receive targeted therapies as part of their treatment plan.

In monoclonal antibody therapy, antibodies are created in a laboratory. The antibodies attach to specific substances on the cells, leading to effects within the cell to kill the cancer cells, block their growth, or keep them from spreading. They may be used alone or to carry drugs directly in the cancer cells.

One monoclonal antibody, bevacizumab, is used to treat cervical cancer that has metastasized or recurrent cervical cancer. This targeted therapy used to treat cervical cancer prevents the tumors from growing new blood vessels. Tisotumab vedotin is another monoclonal antibody that directly brings a drug into the cancer cell for a more selective effect. This type of treatment is called an antibody-drug conjugate.

Targeted treatments are enhanced by the Washington University Genomics and Pathology Service (GPS), which offers genomic testing and next generation sequencing that can identify optimal patient treatment strategies for your specific cancer type and subtype.