Treatment for cervical cancer
Treatment of cervical cancer
Treatment recommendations for cervical cancer depend on many factors:
Tumor size, grade and type
Whether the tumor is pressing on important parts of the brainIf the tumor grows into the CNS or other parts of the body
Possible side effects
Patient preferences and overall healthCommon types of treatment used for cervical cancer are detailed below:
Surgery
Surgery is the surgical removal of a tumor and nearby healthy tissue 1.A doctor who specializes in treating gynecologic cancer using surgery is called a gynecologic oncologist. The following procedures are used for cervical cancer that has not spread beyond the cervix:
Conization: Using the same procedure as a cone biopsy to remove all abnormal tissue. It can remove cervical cancer that can only be seen with a microscope, called micro-invasive cancer.
LEEP: Application of electric current through a thin wire hook. The hook removes the tissue. It is used to remove micro-invasive cervical cancer.
Hysterectomy: Removal of uterus and cervix is called hysterectomy. Hysterectomy can be simple or radical. A simple hysterectomy removes the uterus and cervix, while a radical hysterectomy removes the uterus, uterus and tissue around the uterus and upper vagina 2. A radical hysterectomy also includes an extensive pelvic lymph node dissection, which means the lymph nodes are removed. This procedure can be done using a significant cut in the abdomen, called a laparotomy, or a smaller cut, called a laparoscopy.
Bilateral salpingo-oophorectomy: If necessary, this surgery removes both the fallopian tubes and ovaries. It is performed at the same time as a hysterectomy.
Extension: removal of the vagina, uterus, rectum, lower colon, or bladder if cervical cancer has spread to these organs after radiation therapy. Exenteration is rarely recommended. It is often used for those whose cancer has returned after radiation treatment.
Radical trachelectomy: A surgical procedure in which the uterus is removed, but the uterus is left intact. This includes pelvic lymph node dissection. This surgery can be used for young patients who want to preserve their fertility. This procedure has become an alternative to hysterectomy for some patients.
Complications from surgery vary depending on the extent of the procedure. Sometimes, patients have significant bleeding, infection, or damage to the urinary and intestinal systems. Because these surgical procedures affect sexual health, patients should discuss their symptoms and concerns with the doctor in detail before surgery. Doctors can help reduce the side effects of surgery. Other surgical procedures can create an artificial vagina if the extensive surgical procedure affects sexual function.
Bilateral salpingo-oophorectomy: If necessary, this surgery removes both the fallopian tubes and ovaries. It is performed at the same time as a hysterectomy.
Extension: removal of the vagina, uterus, rectum, lower colon, or bladder if cervical cancer has spread to these organs after radiation therapy. Exenteration is rarely recommended. It is often used for those whose cancer has returned after radiation treatment.
Radical trachelectomy: A surgical procedure in which the uterus is removed, but the uterus is left intact. This includes pelvic lymph node dissection. This surgery can be used for young patients who want to preserve their fertility. This procedure has become an alternative to hysterectomy for some patients.
Complications from surgery vary depending on the extent of the procedure. Sometimes, patients have significant bleeding, infection, or damage to the urinary and intestinal systems. Because these surgical procedures affect sexual health, patients should discuss their symptoms and concerns with the doctor in detail before surgery. Doctors can help reduce the side effects of surgery. Other surgical procedures can create an artificial vagina if the extensive surgical procedure affects sexual function.
Radiation therapy
Radiation therapy uses high-energy X-rays or particles to destroy cancer cells. The most common radiation treatment type is external-beam radiation therapy, in which radiation is given from a machine outside the body. Internal radiation therapy or brachytherapy is when radiation treatment is given using implants. A radiation therapy schedule usually consists of a fixed number of treatments given over a period of time.A combination of low-dose weekly chemotherapy and radiation therapy is often used for early-stage cervical cancer. Radiation therapy combined with chemotherapy aims to increase the effectiveness of radiation treatment. This combination controls pelvic cancer to cure cancer without surgery. It may also be given to kill microscopic cancer that may remain after surgery.
Side effects of radiation therapy can include fatigue, upset stomach, mild skin reactions, and loose stools. Side effects of internal radiation therapy may include abdominal pain and bowel obstruction, although this is uncommon. Most side effects go away after cervical cancer treatment is over. After radiation therapy, the vaginal area may lose elasticity, so women may want to use a vaginal dilator, a plastic or rubber cylinder inserted into the vagina, to avoid narrowing. Women who receive external-beam radiation therapy will lose the ability to become pregnant, and premenopausal women will enter menopause unless the ovaries are surgically removed from the pelvis.
Sometimes, doctors advise their patients not to have sex during radiation therapy. Regular sexual activity can be resumed within a few weeks after cervical cancer treatment if the patient feels ready.
Chemotherapy
Chemotherapy uses drugs to stop or kill cancer cells. Different chemotherapy is given depending on the stage. One difference is how chemotherapy enters the body and which cells it affects.A chemotherapy schedule usually consists of a fixed number of cycles over a period of time. A patient may be given one drug at a time or a combination of different drugs given simultaneously.
Although chemotherapy can be given orally, all drugs used to treat cervical cancer are given intravenously (IV). IV chemotherapy is delivered directly into a vein or through a thin tube called a catheter; A tube is temporarily placed in a large vein to facilitate the injection.
Side effects of chemotherapy depend on the patient and the dose used. However, they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite and diarrhea. Side effects usually go away after cervical cancer treatment is complete.
Rarely, some medications can cause some hearing loss. Others may cause kidney damage; Therefore, patients may be given extra fluids intravenously to protect their kidneys.
Not all tumors have the same target; Doctors may recommend tests to better understand gene and protein changes in individual tumors.
When cervical cancer returns after treatment, it is called recurrent cancer, and if cervical cancer spreads outside the pelvis, it is called metastatic disease; It can be treated with platinum-based chemotherapy and the targeted therapy bevacizumab (Avastin). The FDA has two drugs similar to bevacizumab, bevacizumab-AWB (Mvac) and bevacizumab-BVJR (ZiraBev), that are approved for the treatment of advanced cervical cancer.
Additionally, in 2021, the FDA granted accelerated approval to the targeted therapy tisotumab vedotin (HuMax-TF) for the treatment of recurrent or metastatic cervical cancer that has progressed during or after chemotherapy. Tisotumab vedotin is a targeted therapy called an antibody-drug conjugate that binds to cancer cell targets and then releases small amounts of the anticancer drug directly into the tumor cells.
The immune checkpoint inhibitor pembrolizumab (Keytruda) is used to treat cervical cancer that has recurred or spread to other parts of the body during or after chemotherapy. It can be combined with chemotherapy with or without bevacizumab in patients with recurrent or metastatic cervical cancer whose tumors express PD-L1. 4. Some cancer cells express the PD-L1 protein, which binds to the PD-1 protein on T cells. T cells are cells of the immune system that kill specific other cells, such as cancer cells. When PD-1 and PD-L1 proteins bind, T cells do not attack cancer cells. Pembrolizumab is a PD-1 inhibitor, so it blocks the binding between PD-1 and PD-L1, which allows T cells to find and attack cancer cells.
Different immunotherapies can cause different side effects. Common side effects include skin reactions, diarrhea, flu-like symptoms, and weight changes. Talk to your doctor about possible side effects of the immunotherapy recommended for you.
Although chemotherapy can be given orally, all drugs used to treat cervical cancer are given intravenously (IV). IV chemotherapy is delivered directly into a vein or through a thin tube called a catheter; A tube is temporarily placed in a large vein to facilitate the injection.
Side effects of chemotherapy depend on the patient and the dose used. However, they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite and diarrhea. Side effects usually go away after cervical cancer treatment is complete.
Rarely, some medications can cause some hearing loss. Others may cause kidney damage; Therefore, patients may be given extra fluids intravenously to protect their kidneys.
Targeted therapy
Targeted therapy targets any factors that contribute to the growth and development of cancer cells. It can be a specific protein, gene or tissue environment. These treatments are simple and do not damage surrounding cells like chemotherapy or radiotherapy.Not all tumors have the same target; Doctors may recommend tests to better understand gene and protein changes in individual tumors.
When cervical cancer returns after treatment, it is called recurrent cancer, and if cervical cancer spreads outside the pelvis, it is called metastatic disease; It can be treated with platinum-based chemotherapy and the targeted therapy bevacizumab (Avastin). The FDA has two drugs similar to bevacizumab, bevacizumab-AWB (Mvac) and bevacizumab-BVJR (ZiraBev), that are approved for the treatment of advanced cervical cancer.
Additionally, in 2021, the FDA granted accelerated approval to the targeted therapy tisotumab vedotin (HuMax-TF) for the treatment of recurrent or metastatic cervical cancer that has progressed during or after chemotherapy. Tisotumab vedotin is a targeted therapy called an antibody-drug conjugate that binds to cancer cell targets and then releases small amounts of the anticancer drug directly into the tumor cells.
Immunotherapy
Immunotherapy, also known as biologic therapy, is designed to boost the body's natural defenses to fight cancer. It uses substances made by the body or in a laboratory to improve, target or restore immune system function.The immune checkpoint inhibitor pembrolizumab (Keytruda) is used to treat cervical cancer that has recurred or spread to other parts of the body during or after chemotherapy. It can be combined with chemotherapy with or without bevacizumab in patients with recurrent or metastatic cervical cancer whose tumors express PD-L1. 4. Some cancer cells express the PD-L1 protein, which binds to the PD-1 protein on T cells. T cells are cells of the immune system that kill specific other cells, such as cancer cells. When PD-1 and PD-L1 proteins bind, T cells do not attack cancer cells. Pembrolizumab is a PD-1 inhibitor, so it blocks the binding between PD-1 and PD-L1, which allows T cells to find and attack cancer cells.
Different immunotherapies can cause different side effects. Common side effects include skin reactions, diarrhea, flu-like symptoms, and weight changes. Talk to your doctor about possible side effects of the immunotherapy recommended for you.
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