The Incidence of cervical cancer is hugely different in different countries. Cervical cancer develops in a woman's cervix (the entrance to the womb from the vagina). It mainly affects sexually active women aged between 30 and 45.
As cancer treatments are often complex, hospitals use multidisciplinary teams (MDTs) to treat cervical cancer and tailor the treatment programme to the individual.
MDTs are made up of a number of different specialists who work together to make decisions about the best way to proceed with your treatment.
Your cancer team will recommend what they think the best treatment options are, but the final decision will be yours. In most cases, the recommendations will be:
Cervical cancer is often curable if it's diagnosed at an early stage.
When cervical cancer is not curable, it's often possible to slow its progression, prolong lifespan and relieve any associated symptoms, such as pain and vaginal bleeding. This is known as palliative care.
The different treatment options are discussed in more detail in the following sections.
This is where the cancerous cells are removed using a fine wire and an electrical current.
It's usually done under local anaesthetic (while you're awake but the area is numbed) and can be done at the same time as a colposcopy.
A cone-shaped area of abnormal tissue is removed during surgery. This is usually done under general anaesthetic (while you're asleep).
There are 3 main types of surgery for cervical cancer:
Pelvic exenteration is only offered when cervical cancer has come back.
A trachelectomy is usually only suitable if cervical cancer is diagnosed at a very early stage. It's usually offered to women who want to have children in the future.
During the procedure, the cervix and upper section of the vagina are removed, leaving the womb in place. Your womb will then be reattached to the lower section of your vagina.
It's usually done by keyhole surgery.
Lymph nodes (part of the lymphatic system, the body's waste-removal system) from your pelvis may also be removed.
Compared with a hysterectomy or pelvic exenteration, the advantage of this type of surgery is that your womb remains in place. This means you may still be able to have children.
However, it's important to be aware that the surgeons carrying out this operation cannot guarantee you will still be able to have children.
A stitch will be put in the bottom of your womb during the surgery. This is to help support and keep a baby in your womb in future pregnancies. If you do get pregnant after the operation, your baby will have to be delivered by caesarean section.
It's also usually recommended you wait 6 to 12 months after surgery before trying for a baby so your womb and vagina have time to heal.
A hysterectomy is usually recommended for early cervical cancer. This may be followed by a course of radiotherapy to help prevent the cancer coming back.
Two types of hysterectomies are used to treat cervical cancer:
Short-term complications of a hysterectomy include infection, bleeding, blood clots and accidental injury to your ureter, bladder or rectum.
Although the risk of them is small, long-term complications can be troublesome. They include:
Because your womb is removed during a hysterectomy, you will not be able to have children.
If your ovaries are removed, it will also trigger the menopause if you have not already experienced it.
See complications of cervical cancer for more information about the menopause.
A pelvic exenteration is a major operation that's usually only recommended when cervical cancer comes back. It's offered if the cancer returns to the pelvis but has not spread beyond this area.
A pelvic exenteration involves 2 phases:
Following pelvic exenteration, it may be possible to reconstruct your vagina using skin and tissue taken from other parts of your body. This would mean you could still have sex after the procedure, although it may be several months until you feel well enough to do so.
Radiotherapy may be used on its own or in combination with surgery for early-stage cervical cancer. It may be combined with chemotherapy for advanced cervical cancer, where it can be used to control bleeding and pain.
Radiotherapy can be delivered either:
In most cases, a combination of internal and external radiotherapy will be used. A course of radiotherapy usually lasts about 5 to 8 weeks.
As well as destroying cancerous cells, radiotherapy can sometimes also harm healthy tissue. This means it can cause significant side effects many months, or even years, after treatment.
Brachytherapy aims to reduce harm to surrounding tissue by delivering the radiation as close as possible to the tumor, but it can still cause side effects.
However, the benefits of radiotherapy often tend to outweigh the risks. For some people, radiotherapy offers the only hope of getting rid of the cancer.
Side effects of radiotherapy are common and can include:
Most of these side effects will resolve within about 8 weeks of finishing treatment, although in some cases they can be permanent. It's also possible to develop side effects several months, or even years, after treatment has finished.
If infertility is a concern for you, it may be possible to surgically remove eggs from your ovaries before you have radiotherapy so they can be implanted in your womb at a later date. However, you may have to pay for this.
It may also be possible to prevent an early menopause by surgically removing your ovaries and replanting them outside the area of your pelvis that will be affected by radiation. This is called an ovarian transposition.
Your doctors can provide more information about the possible options for treating infertility and whether you're suitable for an ovarian transposition.
Chemotherapy can be combined with radiotherapy to try to cure cervical cancer, or it can be used as a sole treatment for advanced cancer to slow its progression and relieve symptoms (palliative chemotherapy).
Chemotherapy for cervical cancer usually involves using either a single chemotherapy drug, called cisplatin, or a combination of different chemotherapy drugs to kill the cancerous cells.
Chemotherapy is usually given straight into your vein using a drip. You will probably be seen as an outpatient so will be able to go home once you've received your dose.
As with radiotherapy, these medications can also damage healthy tissue. Side effects are therefore common and can include:
If you do lose your hair, it usually should grow back within 6 months of the completion of your course of chemotherapy.
Some types of chemotherapy medication can damage your kidneys so you may need to have regular blood tests to assess the health of your kidneys.
After you finish your treatment and the cancer has been removed, you'll need to attend regular appointments for testing. This will usually involve a physical examination of your vagina and cervix (if it hasn't been removed).
Because cervical cancer can return, these examinations will be used to look for signs of this happening. If the examination finds anything suspicious, a further biopsy can be done.
Follow-up appointments are usually recommended every 3 to 6 months for the first 2 years, and then every 6 to 12 months for a further 3 years.
Your multidisciplinary team (MDT)
Members of your MDT may include: