Treatment

If you have been diagnosed with cervical cancer, then your treatment options will depend on the your stage of cancer, ranging from stage I (cancer is in the cervix or uterus only) to stage IV (the cancer has spread to distant organs, such as the liver). Early stages typically require less treatment. To determine the best treatment plan for you, you will see a specialist.

In general, treatment options are:

  • Surgery
  • Radiation therapy
  • Chemotherapy 
  • A combination of these methods

For more information, please  

For a breakdown of treatment options by stage, please   

I have no health insurance, what programs are there for my treatment?

If you are between the ages 21-64 and meet the following qualifications

  • at or below 200% of the Federal Poverty Line
  • are uninsured or underinsured

then you are eligible for the Texas Breast and Cervical Cancer Services (BCCS) program, which provides free clinical pelvic examinations and Pap tests at no or low-cost.

For more information, please   

If you live in Harris County and meet the eligibility requirements, you can receive treatment through the Harris County Hospital District Financial Assistance Program (HCHD), better know as the Gold Card program, please see our Gold Card page for details

What questions should I ask my doctor before treatment?

  • What is the stage of my disease? Has the cancer spread? If so, where?
  • May I have a copy of the report from the pathologist?
  • What are my treatment choices? Which do you recommend for me? Will I have more than one kind of treatment?
  • What are the expected benefits of each kind of treatment?
  • What are the risks and possible side effects of each treatment? What can we do to control the side effects?
  • What can I do to prepare for treatment?
  • Will I have to stay in the hospital? If so, for how long?
  • What is the treatment likely to cost? Will my insurance cover the cost?
  • How will treatment affect my normal activities?
  • How may treatment affect my sex life?
  • Will I be able to get pregnant and have children after treatment? Should I preserve eggs before treatment starts?
  • What can I do to take care of myself during treatment?
  • What is my chance of a full recovery?
  • How often will I need checkups after treatment?
  • Would a research study (clinical trial) be right for me?

What are my options?

Surgery

This option is for Stage I and II of cancer, the various types are listed below:

  • cervical conization: removal of only the cancerous part of the cervix; this is effective for the earliest stage, stage 1A, of cervical cancer
  • radical trachelectomy: removal of the cervix, part of the vagina, and the lymph nodes in the pelvis. Again, this is for women with the earliest stages of cancer
  • radical hysterectomy: the surgical removal of the cervix and uterus, due to the spreading of the cancer to nearby tissue. This may also be called complete hysterectomy.

 

After Surgery:

After surgery, you will most likely feel tired or weak. You will stay in the hospital for a few days, and can typically return to normal daily life within 4-8 weeks after the surgery.

For the first few days after surgery, you may experience pain or discomfort–your health care team will discuss pain relief options with you.

After trachelectomy: you may need a tube inserted in your bladder to drain urine. This is temporary, and can usually be removed a few days after your surgery.

After hysterectomy: you may have constipation, nausea and vomiting. Also, some women may experience bladder complications, which will usually go away in time. You will also no longer have menstrual periods, and will not be able to become pregnant.

After ovary removal: you will undergo menopause, which may cause hot flashes, vaginal dryness, and night sweats. This is because you have lost female hormone production. Your health care team will work with you to develop a treatment plan.

After lymph node removal: swelling, known as lymphedema, may occur in one or both legs.

Some questions for your doctor before surgery:

  • Do you recommend surgery for me? If so, which kind? Will my ovaries be removed? Do I need to have lymph nodes removed?
  • What is the goal of surgery?  
  • What are the risks of surgery?
  • How will I feel after surgery? If I have pain, how will it be controlled?
  • How long will I have to be in the hospital?
  • Will I have any lasting side effects?
  • When will I be able to resume normal activities?

Radiation Therapy

This treatment is available for any stage of cervical cancer. Radiation therapy is the use of high-energy rays to kill cancer cells. If you have an early stage of cancer, you may choose radiation therapy instead of surgery. This treatment may also be used after surgery to ensure all cancer cells are destroyed. For more information, please   

There are two types of radiation therapy:

External radiation therapy: A large machine directs radiation at your pelvis or other areas with cancer. The treatment usually is given in a hospital or clinic. You may receive external radiation therapy 5 days a week for several weeks. Each treatment takes only a few minutes.

Internal radiation therapy: A narrow cylinder is placed inside your vagina, and a radioactive substance is loaded into the cylinder. Usually, a session of internal radiation therapy lasts only a few minutes. The cylinder and substance are removed, and you can go home. The short session may be repeated two or more times over several weeks. When the radioactive substance is removed, no radioactivity is left in your body. With a less common method of internal radiation therapy, you may stay in the hospital for several days during treatment. This is also known as brachytherapy.

Side Effects:

During radiation therapy, you should not experience any pain. However, you may have side effects depending on how much radiation you received and the part of your body it was delivered to. Some common side effects are listed below:

  • nausea
  • vomiting
  • diarrhea
  • urinary problems
  • hair loss in genital area
  • red, dry, tender abdominal or pelvic skin
  • dryness, itching, burning in vagina
  • fatigue

These side effects can usually be managed or treated. Be sure to talk with your doctor or nurse.

There are also potential long-term side effects:

  • Narrowed vagina: this may complicate sex or follow-up exams. Prevention is possible, but methods exist to expand the vagina.
  • Ovary damage: you may experience hot flashes and vaginal dryness. Menstrual periods will most likely stop, but may return, especially for younger women. If you are considering becoming pregnant after treatment, consult your doctor about methods of egg preservation before treatment.

Some questions for your doctor before radiation therapy:

  • What is the goal of this treatment?
  • How will the radiation be given?
  • Will I need to stay in the hospital? If so, for how long?
  • When will the treatments begin?
  • How often will I have them? When will they end?
  • How will I feel during treatment? Are there side effects?
  • How will we know if the radiation therapy is working?
  • Will I be able to continue my normal activities during treatment?
  • How will radiation therapy affect my sex life?
  • Are there lasting side effects?

Chemotherapy

This treatment uses drugs to kill fast-growing cancer cells. Typically this is used in combination with radiation therapy. For late stages of cancer, which has spread to other organs, chemotherapy may be used by itself. The drugs are given into a vein using a thin needle. Some may be taken by mouth, or orally. Most women receive chemotherapy in a clinic or at the doctor’s office. Drugs that are swallowed may be taken at home instead. Some women need to stay in the hospital during treatment. For more information, please  

Side Effects:

This will depend on the amount and type of drug used. Since chemotherapy kills fast-growing cells, normal cells that grow quickly may be affected, some of which are described  below:

  •  Reduced blood cells: you may bruise and bleed more easily, as well as more likely to get infections. You may also feel tired and weak. Medication is available to help your body produce more blood cells.
  • Reduced cells in hair roots:  This essentially means hair loss. While your hair will grow back, its texture and color may change
  • Reduce digestive tract lining cells: You may experience a loss of appetite, nausea, vomiting, diarrhea, or mouth and lip sores. Treatment is available.

Other side effects are listed below. Most will go away once treatment ends, and treatment is available.

  • skin rash
  • tingling or numbness in hands and feet
  • hearing problems
  • loss of balance
  • joint pain
  • swollen legs and feet

Some questions for your doctor before chemotherapy:

  • Why do I need this treatment?
  • Which drug or drugs will I have? 
  • How do the drugs work?
  • What are the expected benefits of the treatment?
  • What are the risks and possible side effects of treatment? What can we do about them?
  • When will treatment start? When will it end?
  • How will treatment affect my normal activities?

Combination

An alternative is chemoradiotherapy, which simply means a combination of chemotherapy and radiation therapy. This is recommended if you have cancer beyond the cervix.