Despite increasing early detection of cervical cancer, in 2022, it is estimated that 14,100 women will be diagnosed with invasive cervical cancer in the United States. Of these women, an estimated 4,280 of them will die from the disease [1].
Over the years, the death rate due to cervical cancer has decreased significantly, and the cause can be considered multifactorial. Increased screening and preventative measures account for the prevention of cervical cancer and early detection. Additionally, treatment options have improved outcomes for women with cervical cancer. Treatment selection depends heavily on cancer location and the degree of invasion. Treatment options include surgery, chemotherapy, and chemoradiation.
Surgery
Various surgical procedures are indicated for in situ carcinoma of the cervix, stages IA, IB, and IIA. Surgical options include conization, hysterectomy, total or modified, radical trachelectomy, and additional lymphadenectomy [2]. It is important to consider and discuss the reproductive status and desires of the patient when selecting a surgical procedure. In most situations, surgery is preferred over primary radiation therapy [3].
Chemotherapy
Chemotherapy can be given alone, such as when surgery is not feasible or in conjunction with other therapies. For locally advanced cervical cancer, cisplatin is often used. Cisplatin can be used only or in combination with fluorouracil [4].
Chemoradiation
Chemoradiation is the standard treatment for locally advanced cervical cancer. Further research has been conducted to evaluate the safety and efficacy of chemoradiation in the treatment of cervical cancer. A Brazilian study found that chemoradiation resulted in reduced pelvic floor muscle function, particularly in the late treatment phase [5].
In conclusion, while several treatment options exist for cervical cancer, ongoing research is essential to help further improve patient quality of life and disease-free survival. It is essential to tailor a treatment plan that best fits each patient, maintaining a good quality of life and safety measures.
Sources:
[1] Cervical cancer – statistics. (2022, February 16). Cancer.Net. https://www.cancer.net/cancer-types/cervical-cancer/statistics#:%7E:text=This%20year%2C%20an%20estimated%2014%2C480,diagnosed%20with%20invasive%20cervical%20cancer
[2] Cervical cancer treatment (PDQ®)–health professional version. (2022, February 16). National Cancer Institute. https://www.cancer.gov/types/cervical/hp/cervical-treatment-pdq#_85
[3] Straughn, J. M., Yashar, C. Management of locally advanced cervical cancer. UpToDate. February 14, 2022. Accessed March 7, 2022. https://www.uptodate.com/contents/management-of-locally-advanced-cervical-cancer?search=radiation%20for%20cervical%20cancer%20treatment&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
[4] Li, J., Liu, H., Li, Y., Li, J., Shen, L., Long, W., Yang, C., Xu, H., Xi, W., Cai, R., & Feng, W. (2022). Comparison of outcomes and side effects for neoadjuvant chemotherapy with weekly cisplatin and paclitaxel followed by chemoradiation vs. chemoradiation alone in stage IIB–IVA cervical cancer: study protocol for a randomized controlled trial. Trials, 23(1). https://doi.org/10.1186/s13063-021-05986-z
[5] Miguel, T. P., Laurienzo, C. E., Faria, E. F., Sarri, A. J., Castro, I. Q., Júnior, R. J. A., da Cunha Andrade, C. E. M., Vieira, M. D. A., & dos Reis, R. (2020). Chemoradiation for cervical cancer treatment portends high risk of pelvic floor dysfunction. PLOS ONE, 15(6), e0234389. https://doi.org/10.1371/journal.pone.0234389
