Treatments and Side Effects
Talk to your gynecologic oncologist about the treatment options available for your type and stage of cervical cancer. Your doctor can explain the risks and benefits of each treatment and their side effects. Side effects are how your body reacts to drugs or other treatments.
Cervical cancer is treated in several ways. It depends on the kind of cervical cancer and how far it has spread. Treatments include surgery, chemotherapy, and/or radiation.
Understanding the goals of treatment
As you begin your treatment, make sure that you understand what to expect. Is this for a cure? What are the chances of a cure? If there is no cure, will the treatment make me live better or longer? It is very important to understand the truth about what to expect from the treatment—and what are the potential costs of side effects, expenses, etc.—so that you can make the best decisions for yourself and the life you want to lead.
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Side Effects of treatment
All treatments for cervical cancer have side effects, but most side effects can be managed or avoided. Treatment may affect various aspects of your life, including your function at work, home, intimate relationships, and deeply personal thoughts and feelings.
Before beginning treatment, it is important to learn about the possible side effects and talk with your treatment team members about your feelings or concerns. They can prepare you for what to expect and tell you which side effects should be reported to them immediately. They can also help you find ways to manage the side effects that you experience.
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The National Comprehensive Cancer Network (NCCN) establishes guidelines for treatment of many cancers, including cervical cancer. You can find a patient guide to standardized treatment of cervical cancer HERE.
Learn more about NCCN HERE.
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Surgery
Several types of surgery can be performed, but the final choice for you will depend on several factors that your gynecologic oncologist will consider, especially the stage and size of your cancer as well as your general health.
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Cervical conization: the surgical removal of just the cancerous (or precancerous in many cases) part of the cervix. Conization is an option only for the earliest cancers, the ones that are microscopic. This is the preferred treatment for birthing people with very small cancers who wish to preserve fertility.
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Abdominal hysterectomy: the uterus and cervix are removed through an incision on the abdomen. In the less common vaginal hysterectomy, these organs are removed through the vagina.
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Laparoscopic hysterectomy: this involves the removal of the uterus and cervix in a procedure that is performed through several (3 to 5) very small incisions on your abdomen, and the uterus and cervix are brought out through the vagina. This procedure allows for quicker recovery than abdominal hysterectomy.
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Robotic hysterectomy: this procedure is essentially the same as a laparoscopic hysterectomy using several small incisions, but in this procedure your surgeon uses the assistance of a robotic technology (robot) that s/he is in control of at all times.
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Radical hysterectomy: this procedure can be performed abdominally (with an incision), laparoscopically, or robotically. Open surgery is often recommended for radical hysterectomy, as cancer outcomes have been shown to be better with this approach. The word radical means that the uterus and the tissue between the uterus and pelvic wall, as well as part of the upper vagina, are removed. Lymph nodes in the pelvis are also removed and examined to determine if the cancer has spread (radical pelvic lymphadenectomy). In some cases, both ovaries and both fallopian tubes must be removed. This procedure is called a bilateral salpingo-oophorectomy.
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Radical trachelectomy: in this surgery, your cervix and surrounding tissues are removed, but the upper uterus is preserved for future pregnancy. This operation is only available for carefully selected people and is dependent on several factors.
Chemotherapy
Chemotherapy for cervical cancer is usually given intravenously (injected into a vein). You may be treated in the doctor’s office or the outpatient part of a hospital. The drugs travel through the bloodstream to reach all parts of the body. This is why chemotherapy can be effective in treating cervical cancer that has spread beyond the cervix. However, the same drugs that kill cancer cells may also damage healthy cells. To limit the damage to healthy cells, chemotherapy is usually given in cycles. Periods of chemotherapy are alternated with rest periods, during which no chemotherapy is given. Side effects usually still occur, but are manageable.
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Managing Chemo Side Effects
Each person responds to chemotherapy differently. Some people may have very few side effects, while others experience several. Most side effects are temporary. They include:
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Nausea
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Loss of appetite
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Mouth sores
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Increased chance of infection
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Bleeding or bruising easily
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Hair loss
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Fatigue
Radiation
Radiation therapy can be an effective treatment for early-stage cervical cancers. However, in early cervical cancer, it is more commonly used as extra treatment after surgery for patients at highest risk for recurrence of their cancer—such as when the tumor might have spread beyond the cervix. Radiation is also used to treat larger or higher-stage cancers where it actually works better than surgery. Your need for radiation therapy will be determined using information from your staging tests, examinations and surgery if an operation was performed based on findings at the time of your evaluation.
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Two types of radiation therapy are used to treat cervical cancer. Radiation therapy for cervical cancer is most often given in combination with chemotherapy.
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External radiation therapy: uses a machine that directs the radiation toward a precise region of the body. The therapy is usually given daily, Monday through Friday, for about six weeks. Radiation does not hurt during the treatment and only takes a few minutes each day. You can be treated at a clinic, hospital, or radiation oncology office, and typically you return home each day after treatment.
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Internal radiation therapy (also called brachytherapy): involves placing a small capsule of radioactive material inside the vagina or near the cervix. This procedure can sometimes be performed on an outpatient basis and other times requires hospitalization for a night or two. Medication is given to alleviate the discomfort from these procedures. During the time the radiation capsules are in, your family may be allowed only limited time next to you, but the radiation capsules are removed prior to going home.
Side effects of radiation
The side effects of radiation therapy depend on the dose used and the part of the body being treated. Common side effects include:
Dry, reddened skin in the treated area
Fatigue
Diarrhea
Discomfort when urinating
Narrowing of the vagina
Anemia
Most of these side effects are temporary. Be sure to talk with your treatment team members about any side effects that you experience. They can help you find ways to manage them.
You may find it helpful to track any side effects you experience and then talk to your doctor about the ones that cause you concern. Often, your doctor will have a solution or suggestions for helping combat side effects. They won’t know unless you tell them!
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