Curing advanced cervical cancer

Advanced cervical cancer means stage 2B or above. It is sometimes possible to cure advanced cervical cancer even if it has come back after your first phase of treatment (recurrent cervical cancer). Whether your cancer can be cured will depend on

• How much cancer there is
• How widespread the cancer is
• Exactly where it has spread to

Unfortunately, it is not usually possible to cure cervical cancer that is stage 4B. That is cervical cancer that has spread to another body organ such as the lungs or liver. If you are looking for information about treating this stage of cancer, go to the CancerHelp UK section on controlling symptoms of advanced cervical cancer.

Advanced cervical cancer can be treated mainly with

• Surgery
• Radiotherapy
• Chemotherapy

Which treatment you have often depends on whether you have been treated before. If you have already had radiotherapy for cervical cancer, you may not be able to have any more. There is a maximum amount that normal body tissues can stand. If you have not had radiotherapy before, you may have both radiotherapy and chemotherapy, or surgery, radiotherapy and chemotherapy.

Women with stage 2B or stage 3 cervical cancer at diagnosis usually have internal and external radiotherapy along with chemotherapy. There is more about radiotherapy and about combined chemoradiation in this section of CancerHelp UK.

Women with stage 4A at diagnosis may have internal and external radiotherapy, along with chemotherapy or radical surgery. Radical surgery means removing the womb and vagina as well as any part of the bladder, bowel or rectum that is affected by the cancer. Or you may have a smaller operation to 'stage' your cancer. This means finding out exactly which areas are affected. After surgery, if this is your first phase of treatment, you would then have external radiotherapy to the affected areas. There is more about the operations you may have in this section of CancerHelp UK.

Cervical cancer can grow and spread locally, within the pelvis. It can also spread to nearby lymph nodes. There are lymph nodes in a chain running up from both groins. It is these lymph nodes that can be a common site of cervical cancer spread.

If you have cervical cancer that has come back after previous radiotherapy treatment, you may be able to have surgery if the cancer has not spread too far. The extent of the surgery depends on how much cancer there is and where exactly it has come back. Your specialist will usually ask you to have a CT scan to see where the cancer is. Or you may have a PET scan if your specialist is thinking that you need a large operation (radical surgery). You will usually need to have an examination under anaesthetic as well. You will probably need to have your womb and cervix removed as well as any part of the bladder or bowel that is affected. You will also need to have any lymph nodes removed that are linked to the areas where the cancer has come back.

You may have chemotherapy to treat any stage of advanced cervical cancer, usually alongside other treatment with surgery or radiotherapy.

Chemotherapy and radiotherapy together is a good option for many cervical cancers. In 2010, the Cochrane Collaboration reviewed the research evidence on this treatment in cervical cancer. They say it improves overall survival rates for all stages of cervical cancer. The combined treatment lowers the risk of the cancer coming back (recurring) near to where it originally started and in other parts of the body. The combined treatment does have more side effects, mainly affecting your bone marrow or bowel, but these generally only last a short time. Unfortunately there was not enough information to show if the long term side effects are any worse with chemoradiation or not.  But if you have any concerns, ask your own specialist about this.

With this type of treatment, you have chemotherapy during your course of radiotherapy. Some doctors call this 'concurrent' chemoradiation. You don't have chemotherapy every day. So some days you'll have both treatments, and others you'll just have radiotherapy. There are different ways of giving this treatment and it depends partly on the drugs your doctor chooses. You may have chemotherapy once a week throughout your radiotherapy course. Or you may have it every 2 or 3 weeks during the radiotherapy course. There is more about combined chemoradiation in this section of CancerHelp UK.