Chemotherapy. These drugs are injected into the vein or taken orally to enter the bloodstream to be distributed throughout the body. Chemotherapy is often used alongside radiation treatment as these anti-cancer drugs help the radiation work better. If cancer has spread or come back after surgery or radiation treatment then chemo may be used. Chemo treatments usually are given in cycles (i.e., weekly, every 3 weeks) depending on how you recover from each treatment. Common side-effects of chemotherapy are loss of appetite, nausea and vomiting, mouth sores, hair loss, and fatigue. Common chemo drugs are:
- Carboplatin
- Cisplatin
- Paclitaxel (Taxol©)
- Topotecan
Radiation therapy. Uses high-energy x-rays to destroy cancer cells. The main types of radiation therapy are external beam radiation therapy (EBRT) and brachytherapy. EBRT aims the x-rays directly at the cancer from outside the body. EBRT is often combined with chemotherapy (concurrent chemoradiation) to make the radiation more effective. Brachytherapy is internal radiation using a device with radioactive material that is placed in the vagina near the cervix. Radiation therapy can cause skin rashes, abnormal vaginal bleeding, nausea, fatigue, and vomiting.
Immunotherapy. Uses medicine that stimulates the immune system to destroy cancer cells. This therapy is often used when cervical cancer spreads or comes back. A common immunotherapy drug is pembrolizumab (Keytruda©). It is given in an intravenous infusion every 3 weeks. Possible side effects of immunotherapy are headache, skin rash, loss of appetite, diarrhea, constipation, and joint/muscle pain.
Surgery. Used to diagnose and stage cervical cancer and as a treatment in early-stage cancers. Two common surgeries are ablation and excisional surgery. Ablation uses extremely cold temperatures (cryosurgery) or a laser (laser ablation) to destroy abnormal cervical tissues. Excisional surgery, or conization, cuts out pre-cancerous tissues and removes them from the cervix.
Targeted therapy. These drugs directly target cancer cells by stopping the formation of blood vessels that feed tumors. The formation of blood vessels is known as angiogenesis. Targeted drugs,or angiogenesis inhibitors, block the protein that is in charge of making new blood vessels for tumors. The most common angiogenesis inhibitor used as a targeted therapy for cervical cancer is called bevacizumab or Avastin©. Common side effects of targeted therapy drugs are high blood pressure, fatigue, and nausea.
Hysterectomy or trachelectomy. In some cases of invasive cervical cancer, a simple or radical hysterectomy is ordered. A simple hysterectomy involves the removal of the uterus and the cervix without removing the ligaments next to the uterus. In a radical hysterectomy, the surgeon will remove the uterus, the tissues next to the uterus, the cervix, and the upper part of the vagina next to the cervix. A trachelectomy is a procedure that removes the cervix but allows a woman to still have children.