Treatment Options for Cervical Cancer

Cervical cancer treatment options are personalized for each patient depending on the size of the tumor and whether the cancer has spread (staging), your age, and overall health. For pre-menopausal women, treatment will also consider whether you would like to have children in the future.

Cervical cancer treatment plans, led by our gynecologic oncologists, include one or more of the following treatments:

• Surgery

• Radiation therapy

• Chemotherapy

• Targeted therapy

• Immunotherapy

The specific set of treatments is largely based on the stage of cervical cancer. For the earliest stages (stage I and IIA), surgery is usually used to remove the cancer. If you are not planning to have children in the future, a hysterectomy is most common. You may also need radiation therapy and chemotherapy after surgery to ensure all of the cancer cells are gone.

For later stages of cervical cancer (IIB, III, and IV), the primary approach is typically radiation combined with chemotherapy. Chemotherapy alone is often used to treat the most advanced cervical cancers because there are cancer cells in areas outside of the reproductive organs.

If biomarker testing indicates a genetic marker is present, a targeted therapy or immunotherapy drug may be added to the treatment plan to slow the growth of the cancer cells.

The gynecologic oncologists at Affiliated Oncologists are dual board-certified, meaning they are highly specialized in both surgical oncology and medical oncology. They are part of a multidisciplinary team and work with the radiation oncologist and other team members to recommend a treatment plan specific to your needs. We offer the latest treatments for cervical cancer, including minimally invasive surgery, in the South Chicago area.

Surgery to Remove Cervical Cancer

Surgery is an option for women with Stage I or II cervical cancer. The specific type of surgery will be based on what the gynecologic oncologist sees from the testing. If they are concerned about the cancer moving to other areas of the body, the surgery may require more than removing only the cancer from the cervix.

• Conization: Cold-knife conization uses a scalpel to remove a cone-shaped piece of tissue from the cervix and the cervical canal. Sometimes, all the cancer can be removed during this procedure.
• Radical trachelectomy: The cervix is removed along with part of the vagina, and the lymph nodes in the pelvic area. The type of surgery is used to remove smaller tumors in women who want to try to get pregnant later on. This is sometimes done using laparoscopy.
• Total hysterectomy: Surgery that removes the cervix and uterus.
• Radical hysterectomy: The surgeon removes the cervix, some tissue around the cervix, the uterus, and part of the vagina. This can be done with laparoscopy, which is considered a minimally invasive surgery technique.

With either a total or a radical hysterectomy, the surgeon may also remove nearby tissues:

• Fallopian tubes and ovaries: A surgical procedure called a salpingo-oophorectomy, where the fallopian tubes and ovaries are removed if cancer has spread to these organs.
• Lymph nodes: Removing nearby lymph nodes to check for cancer. If cancer has reached the lymph nodes, it may be affecting other parts of the body.

[ More about Gynecologic Cancer Surgery at AO ]

Cervical Cancer Chemotherapy

Chemotherapy uses drugs taken by mouth or given through a vein (intravenous) to eliminate cancerous cells. Chemotherapy is often combined with radiation therapy (chemoradiation) or other medications in cases where cancer has not spread. In cases where cancer has spread to distant organs, chemotherapy may be used alone.

You’re most likely to receive chemotherapy in a cancer center like Affiliated Oncologists, under the supervision of a gynecologic oncologist.

Targeted Therapy for Cervical Cancer

Targeted therapy uses drugs or other substances to block the action of specific enzymes, proteins, or other molecules involved in the growth and spread of cancer cells. This type of treatment blocks the growth and spread of cancer cells and limits damage to healthy cells.

Not all tumors have the same targets. To find the most effective treatment, your doctor may recommend biomarker testing to identify the genes, proteins, and other factors in your tumor. Targeted drug therapies are typically used for advanced cervical cancer that has spread or recurred. They are most often administered in pill form.

There are several types of targeted therapy, each serving different purposes:

Antibody-Drug Conjugates (ADCs)

These medications combine a monoclonal antibody with a chemotherapy drug. The antibody binds to a specific protein on the cancer cell, delivering chemotherapy directly to the cancer cell.

Fam-trastuzumab deruxtecan, T-DXd

This ADC drug targets the HER2 protein on HER2-positive cervical cancers that have returned after initial treatment. It is administered by IV every 3 weeks or so.

Tisotumab vedotin-tftv

This ADC is used for late-stage cervical cancer that has recurred after initial treatment. Given via IV every three weeks, it targets the TF protein on cancer cells and delivers chemotherapy directly to them.

RET Inhibitors

In some cervical cancers, tumor cells may have an alteration in the RET gene, leading to abnormal protein production that supports cancer growth. RET inhibitors may be used for advanced cervical cancer with this specific gene change and are taken in capsule form twice a day.

NTRK Inhibitors

A small number of cervical cancers have changes in the NTRK genes, resulting in abnormal TRK proteins that promote cancer growth. NTRK inhibitors target these proteins and are taken orally once or twice a day.

Immunotherapy for Cervical Cancer

Immunotherapy helps a person’s immune system better recognize and fight cancer cells. Immunotherapy drugs are administered through an IV infusion every three or six weeks and enable the immune system to:

• Identify and attack cancer cells while sparing healthy cells

• Adapt to changes in the cancer, reassess, and launch a new attack

• “Remember” cancer cells and target them if cancer recurs

• Enhance immune cells to maximize their ability to fight cancer

PD-1 inhibitors are immunotherapy drugs that block the PD-1 protein on cervical cancer cells. Gynecologic oncologists may recommend immunotherapy for advanced-stage cervical cancer, recurrent cervical cancer, or patients who no longer respond to chemotherapy.

Personalized Cervical Cancer Treatment in the South Chicago Suburbs

Affiliated Oncologists provides care to women with cervical cancer using the most advanced treatment technologies available, including access to clinical trials. We also offer second opinions on diagnoses and treatment plans. Request an appointment at one of our locations in Downers Grove or Chicago Ridge.