Cervical cancer, while vastly preventable, is still a disease that impacts far too many women in the United States and across the globe.
Cervical cancer originates in the cells of the cervix, which is the lower part of the uterus that connects to the upper vagina. Cervical cancer treatment typically includes surgery, radiation and/or chemotherapy and is determined by its stage at diagnosis, explained Han Cun, MD, a gynecologic oncologist at Endeavor Health Northwest Community Hospital.
Fortunately, advances in treatment for all stages of cervical cancer are improving outcomes and quality of life for patients, Dr. Cun said.
Early-stage cervical cancer treatment
Treatment for early-stage cervical cancer — small tumors that are confined to the cervix — is typically surgical management, which has traditionally meant a hysterectomy. But, more and more surgical studies in the last five years are showing that decreasing the amount of surgery to something less than a radical hysterectomy can provide better outcomes, said Dr. Cun.
Procedures like cold knife conizations remove a section of the cervix, and a simple hysterectomy removes the uterus and cervix, but not other adjacent structures. “Studies have shown that less surgery for these early-stage cancers are just as effective, but provide faster recoveries with fewer complications,” said Dr. Cun.
Later stage cervical cancer treatment
For later stage cervical cancers that have spread beyond the cervix where surgery is no longer an option, treatment has often been a combination of chemotherapy and radiation. Recent studies in 2024 have shown new promise when immunotherapy drugs are added to the treatment, said Dr. Cun.
Metastatic cancer, or stage IV cancer that has spread beyond the pelvis is still considered uncurable, however, depending on the individual tumor profile, immunotherapy medications are improving treatment options and giving patients more time and better quality of life.
“Immunotherapy and ADC (antibody drug conjugates) are providing more treatment options particularly for patients with advanced and recurrent cancers, and we are able to give patients much longer life expectancies with good quality,” said Dr. Cun.
“I recently saw a patient with recurrent cervical cancer who has been living with the disease for more than 13 years,” she said. “It’s very gratifying to have so many more options to care for these patients.”
Preventing cervical cancer
Nearly all cervical cancers are caused by the human papilloma virus (HPV), which is transmitted sexually. Most HPV infections will go away on their own, but if it persists, it can cause changes in the cells of the cervix that may progress into cervical cancer.
The HPV vaccine is critically important and literally lifesaving. The American Cancer Society predicts that more than 13,000 cases of invasive cervical cancer will be diagnosed this year and about 4,320 women will die from the disease in 2025.
“This is a highly preventable cancer with Pap smear screening and HPV vaccines,” stressed Dr. Cun. The HPV vaccine can help protect patients against common strains of HPV that are associated with cervical cancer. Dr. Cun and her colleagues continue to work to raise awareness for the importance of the HPV vaccine as the rate of vaccination in the United States is still slower than in many other countries.
Also, routine PAP tests help doctors monitor changes in cervical cells that might lead to cancer and HPV tests look for strains of the virus that can cause these cell changes.
Screening, which may include Pap smear, HPV test or both, is recommended to begin between at age 21 and continue through age 65. Most efficacious before the onset of sexual activity, the vaccine can be given in two doses to 9 to 14-year-olds, and in three doses to children and young adults over 14, regardless of gender. It is, however, approved up to age 45 by the Food and Drug Administration.
Smoking is another major risk factor for developing cervical cancer as it is known to cause significant damage to the immune system, which makes people more susceptible to HPV infection. Even for those who have smoked for years, it does help to quit now and improve your overall health and decrease your risk of many cancers.
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