Our Treatment Approach
MD Anderson’s experts have at their fingertips the most-advanced technologies and therapies available today, and they use them with extraordinary expertise to give you personalized care for cervical cancer. We also offer treatment for pre-cancerous changes of the cervix.
Your therapy is customized to fit your unique situation, taking into account a number of factors. The cervical cancer therapies available to you may include:
- Fertility-sparing techniques, including radical trachelectomy, a highly specialized procedure that may help some women keep the ability to have children
- Laparoscopic retroperitoneal lymph node dissection in locally advanced cervical cancer
- Robotic and laparoscopic hysterectomy
- Radical hysterectomy
- Specialized advanced radiation techniques
Remarkable Skill, Experience
Surgery is part of treatment for many cases of cervical cancer. Like all surgeries, it is most successful when performed by a specialist with a great deal of experience in the particular procedure.
MD Anderson surgeons are among the most skilled and recognized in the world. They perform a large number of surgeries for cervical cancer each year, using the least-invasive and most-advanced techniques.
Our Cervical Cancer Treatments
If you are diagnosed with cervical cancer, your doctor will discuss the best options to treat it. This depends on several factors, including:
- Stage of the cancer
- Whether cancer has spread to other parts of the body
- Size of the tumor
- Your desire to have children in the future
- Your age and overall health
If you are pregnant, your therapy for cervical cancer depends on the stage of pregnancy and the stage of cervical cancer. Treatment may be delayed until the baby is born if you are in your third trimester of pregnancy or if the cancer is in the early stages and has not spread.
At MD Anderson, your treatment for cervical cancer will be customized to your particular needs. One or more of the following therapies may be recommended to treat the cancer or help relieve symptoms.
Small Precancerous Lesions
These types of surgery may be used for precancerous lesions or cervical cancer that has not spread beyond the cervix:
Cryosurgery (cryotherapy): A instrument freezes and destroys precancerous tissue.
Laser surgery: A narrow laser beam destroys precancerous cells. A benefit of laser treatment is its precision; it destroys only diseased tissue and does not harm healthy tissue.
LEEP (loop electrosurgical excision procedure): Electrical current is passed through a thin wire hook to remove precancerous lesions.
Cone: This procedure is the same as a cone biopsy that removes all the cancerous tissue. It may be used when the cancer is small and the woman wants to be able to have children.
Hysterectomy: This operation removes the uterus and the cervix, but not the tissue next to the uterus. The vagina and nearby lymph nodes are not removed. The surgery may be done through the vagina or an incision (cut) in the abdomen. Minimally invasive laparoscopic surgery, sometimes with a robotic device, may be an option for some women with cervical cancer.
Bilateral salpingo-oophorectomy: The fallopian tubes and ovaries are removed at the same time as the hysterectomy. If a woman is close to the age of menopause, her doctor may discuss removing her ovaries and fallopian tubes to reduce the chance the cervical cancer will come back in one of those organs.
Large Cervical Cancer Lesions
These surgeries may be used for larger cervical cancer lesions (usually up to 4 to 5 centimeters in width) if the cancer is only in the cervix. If the cancer has spread, doctors usually will recommend chemotherapy and radiation therapy.
Trachelectomy: The cervix and surrounding tissue are surgically removed but not the uterus. This procedure sometimes is used for young women who have larger cancer (usually up to 2 centimeters) but wish to keep the ability to have children.
Lymph nodes may be removed during surgery too. A cerclage or stitch is used to help support the base of the uterus. If more cancer is found during the surgery, a hysterectomy probably will be done.
This is a highly specialized procedure that requires a great deal of skill on the part of the surgeon to be successful. If you are considering this surgery, be sure the doctor performing it has a high level of experience in this procedure.
Radical hysterectomy: The cervix, uterus, part of the vagina, the tissues surrounding the cervix (parametria) and nearby lymph nodes are removed, either through the vagina or a cut on the abdomen. Depending on your age and the size of the tumor, you also may have a bilateral salpingo-oophorectomy (removal of the ovaries and fallopian tubes).
The surgery can be done with a laparoscope, using robotic equipment or through a larger incision (cut) in the abdomen.
Other surgery types include:
Pelvic exenteration: If cervical cancer returns after treatment, this complex surgery may be performed. As well as the organs and tissues removed in a radical hysterectomy, the bladder, vagina, rectum and part of the colon are removed.
- If the bladder is removed, a piece of intestine may be used to make a new bladder. Then urine may be drained through a catheter (tube) into a urostomy, which is a small opening on the abdomen, or into a small plastic bag worn on the outside of the body.
- If the rectum and part of the colon are removed, you may have a colostomy, which is an opening on the abdomen that allows solid waste (stool) to pass into a small bag worn on the outside of the body. Sometimes the colon may be reconnected so that a colostomy is not needed.
- If the vagina is removed, the surgeon may be able to form a new one from skin or other tissue.
To learn more about the surgery, watch Total Pelvic Exenteration: What You Need to Know.
Laparoscopic retroperitoneal lymph node dissection: an advanced procedure that helps surgeons plan your surgery and determine how far the cancer has spread.
Radiation therapy usually is used to treat cervical cancers that have spread beyond the cervix or very large lesions (larger than 4 centimeters). New radiation therapy techniques and remarkable skill allow MD Anderson doctors to target tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.
Radiation therapy may be used instead of surgery. Sometimes it is necessary after surgery to treat cancer that has spread or to reduce the risk that a cancer will come back.
Three types of radiation therapy may be used to treat cervical cancer:
- External radiation therapy uses a machine outside the body to send radiation toward the cervical cancer.
- Internal radiation therapy implants (brachytherapy) are inserted through the vagina into the cervix, where they are placed next to the tumor. The implants stay in place for a few days while you stay in the hospital. High-dose treatment, which involves leaving the radioactive material in place for a few minutes each time, may be done on an outpatient basis.
- Intensity-modulated radiotherapy (IMRT), which tailors treatment to the specific shape of the tumor or enlarged lymph nodes.
MD Anderson offers the most up-to-date and advanced chemotherapy options for cervical cancer. We also work with you to provide supportive care for side effects of treatment, including nausea and constipation.
Our Cervical Cancer Clinical Trials
Since MD Anderson is one of the nation’s leading research centers, we’re able to offer clinical trials (research studies) of new treatments for cervical cancer. We constantly strive to improve treatment outcomes, which includes tumor response and quality of life. Our cervical cancer research is designed to help us continue this mission.