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Treatment options for cervical cancer

Your treatment options will depend on the type of cervical cancer, how big it is, whether it has spread to anywhere else in the body and your general health. It can also depend on your preferences.

We know that talking with and asking questions of healthcare professionals can feel intimidating, which is why we are here to support you at every step. We can listen to what’s going on or help you prepare for your appointment.

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On this page:

Treatments for different stages of cervical cancer

Your treatment options will depend on where in your cervix the cancer is, how big it is, whether it has spread to anywhere else in your body, and your general health.

This means the cervical cancer is small and contained within the cervix. This normally means stage 1A to 1B cervical cancer. Depending on how big the cancer is and where it is in your cervix, you may be able to have: 

  • large loop excision of the transformation zone (LLETZ)
  • cone biopsy
  • bigger surgery, such as a trachelectomy or hysterectomy.

Sometimes you may also have surgery to remove your lymph nodes. If your healthcare team feel that there is a risk that the cancer may come back after surgery you may have chemotherapy together with radiotherapy (chemoradiation) after surgery.

Read about treatment for cervical cancer >

This means that the cancer is larger and has spread outside of the cervix to nearby areas. This normally means stages 1B2 to 4A.  You with normally be treated with chemotherapy and radiotherapy (chemoradiation).

You may also have surgery to remove your lymph nodes.

Read about treatment for cervical cancer >

Advanced cervical cancer is cancer that has spread outside of the pelvis to other parts of the body. This usually means stage 4B cervical cancer. You may be able to have:

  • chemotherapy with radiotherapy (chemoradiation) if the cancer has not spread to many areas outside of the pelvis
  • chemotherapy with a drug called bevacizumab (Avastin)  
  • other treatments for the symptoms of advanced cervical cancer.

Read about advanced cervical cancer >

Cervical cancer that comes back is sometimes called recurrent cervical cancer. This may also be considered as advanced cancer. 

If the cancer has come back after you have already had treatment, you may be able to have more treatment to control the cancer. This usually depends on whether the cancer has come back in your pelvis or if it has spread outside the pelvis, and what treatments you have had before: 

  • If the cancer has come back and has not spread outside the pelvis, you may be able to have a type of surgery called pelvic exenteration or laterally extended endopelvic resection (LEER).
  • If the cancer has not spread to many areas outside of the pelvis, you may be able to have chemotherapy alongside radiotherapy (chemoradiation).
  • If you have symptoms caused by the cancer, you may be able to have other treatments to help manage or control these.

Read about advanced cervical cancer >

Your multidisciplinary team (MDT)

In most hospitals, a team of specialists will figure out which treatment or combination of treatments will be best for you. This is called a multidisciplinary team (MDT). Your MDT will look at:

  • all of your test results
  • any previous treatments 
  • your diagnosis.  

You may meet your MDT at your local hospital. If you are referred to another specialist hospital for certain treatments, you may meet them there instead. 

Your MDT may include:

  • a clinical nurse specialist (CNS) nurse – your main contact if you have any questions or worries outside of your appointments
  • a consultant oncologist, consultant gynaeoncologist or consultant surgeon – a doctor who specialises in treating cancers, usually with surgery
  • a clinical oncologist or clinical gynaeoncologist – a doctor who specialises in treating cancer with radiotherapy, chemotherapy and other targeted therapies
  • a pathologist or histopathologist – an expert who specialises in how diseases affect the body
  • a radiologist – an expert who specialises in diagnosing and treating diseases using scans and images
  • a clinical psychologist – an expert who can help you manage the emotional impact of cervical cancer.   

Depending on the treatment and support you need, your MDT might also include other healthcare professionals:

  • A dietician, who can talk to you about what to eat to help you manage any symptoms and side effects. 
  • A physiotherapist, who can work with you on any physical challenges or side effects.  
  • A psychologist or counsellor, who can talk to you about the effects of your diagnosis and treatment on your health and wellbeing. 
  • A research nurse or doctor, who might talk to you about including any results from your treatment in medical research. 
  • A radiographer, if you are having scans or radiotherapy treatment.

Your MDT are there to guide you in your treatment decisions. They usually recommend which treatments they think are best for you. However, it is really important you feel comfortable and confident in the treatment you have. It needs to be your decision too. We have some suggestions below for how to get involved in the decision-making process.

Preparing for your appointment

There will be a lot of information to take in at your appointments. Preparing for that can help make sure you get all the information you need to make your decisions, as well as letting the team know about what you want. 

Here are our tips:

  • You may find it helpful to research different options before your appointment, so you have an idea of what to expect. Read our information about cervical cancer treatments >
  • Speak to your CNS before your appointment, so you can ask questions and get a sense of what’s important to you.
  • Write down any questions and take a list to your appointment.
  • Take a pen and paper to write down the answers to your questions.
  • Ask if they have any printed or online information they can share with you – it can be useful to read through this later on in your own time.

You may also want to bring someone with you for support and to help you remember any information. This may not be allowed at the moment because of the COVID-19 pandemic but, if this would be helpful for you, it is important to ask. If they can’t come into the hospital, you may be able to have them on a phone or video call, or ask them to wait outside.

Questions to ask

You may already know what you want to ask your healthcare team. But if you aren’t sure, here are our suggestions:

  • What are all of the possible treatments I could have?
  • What is the aim of the treatment?
  • What could happen if I don’t have this treatment? 
  • What could the short-term and long-term side effects be?

You may also find it helpful to find out about how treatment will affect your day-to-day life – physically, emotionally and practically. You could ask: 

  • How long will I need to stay in the hospital for?
  • Will I need to take time off work or education?
  • How long might it take to recover from treatment?
  • Will I need someone to help me at home during treatment or while I recover?
  • Does the hospital offer any emotional support, like counselling? 

Thinking about fertility 

If becoming pregnant is important to you, it is important to tell your healthcare team and ask any questions at this point. You can ask how each treatment option will affect whether you are able to get pregnant and have children. 

Sometimes it is possible to have treatment which aims to preserve your womb and your ability to become pregnant or have children. You might hear this called fertility preservation treatment. 

It isn’t always possible to have fertility preservation treatment. In this case, you can ask to be referred to a fertility specialist. They can talk to you about possible options for fertility. You may be able to have your eggs stored, which means you have the option of surrogacy.  

Read about fertility and cervical cancer >

The impact of COVID-19

You and your healthcare team may need to think about the COVID-19 pandemic while making decisions about treatment. Depending on your treatment options, your healthcare team may talk to you about:       :

  • the potential for your treatment to be delayed
  • changing how often you would have treatment – so you visit the hospital less 
  • using telephone calls and video calls to avoid face-to-face appointments where possible
  • needing a test to check for COVID-19 before each treatment session.

All of these decisions are being made so you can get the treatment you need, while keeping you and hospital staff protected from COVID-19.   

Read about COVID-19 and healthcare >

Getting a second opinion

A second opinion is where you see another healthcare professional to get their opinion on your diagnosis or treatment. It is not a legal right, but most MDTs will agree to arrange one for you. It will usually be in a different hospital.  

There are a number of reasons why you might ask for a second opinion. It could be:

  • to confirm what you or your healthcare team are already thinking about, so that you can feel more confident in the treatment
  • because you are unsure about the treatment options you are discussing and you want to find out if there are other options. 

Read about getting a second opinion on the Cancer Research UK website >

Making your decision

We all make decisions in different ways. You might want to talk to other people or decide by yourself. Some people like to go with their instinct, while others like to do a lot of research. 

Here are our suggestions for making a decision about treatment.

Talking to your MDT is helpful because they are the experts in cervical cancer treatment. But talking to the people close to you can be just as important. 

If you have a partner, you may want to involve them in the decision and figure out the impact it will have on your lives together. Or you might find friends and family offer a different perspective or a new angle to think about.

It can help to write a list of pros and cons for each option. This can help you figure out what’s important to you and how well the treatment options fit with that.

You might be someone who likes to know as much as possible to help you make a decision. There are lots of reliable health websites that explain different treatments, including:

Sometimes it can be helpful to hear from someone who has had the treatment you are considering. It’s important to remember that everyone has a different experience of treatment and recovery.

Our Forum is a welcoming community where you can hear lots of experiences – as well as ask questions, if you’d like to. 

Join our Forum >

Sometimes people need to make decisions about cervical cancer treatment quite quickly. Speak to your healthcare team about what is possible, if you feel you need more time to think.  

Read about making treatment decisions on the Macmillan Cancer Support website >

More support with making treatment decisions

We know having to think about treatment options, especially while you are still processing a cervical cancer diagnosis, can be difficult. Remember that your healthcare team are there to support you with any questions or concerns – and we are here too. 

Our trained volunteers can listen, talk through options and help you understand what’s going on via our free Helpline on 0808 802 8000. 

Check our Helpline opening hours >

Sometimes connecting with others who have gone through a similar experience can be helpful. Our online Forum lets our community give and get support. You can read through the messages or post your own – whichever feels most comfortable.

Join our Forum >

 

Thank you to all the experts who checked the accuracy of this information, and the volunteers who shared their personal experience to help us develop it.

References

  • British Gynaecological Cancer Society (2020). Cervical Cancer Guidelines: Recommendations for Practice. Web: www.bgcs.org.uk/wp-content/uploads/2020/05/FINAL-Cx-Ca-Version-for-submission.pdf. Accessed October 2020.
  • Cibula, D. et al (2018). The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology guidelines for the management of patients with cervical cancer. Radiotherapy Oncology. 127;3. pp.404-416.

We write our information based on literature searches and expert review. For more information about the references we used, please contact [email protected]

Read more about how we research and write our information >

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Date last updated: 
03 Nov 2020
Date due for review: 
03 Nov 2023
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