Treatment of Stage 0 Cervical Cancer

Treatment options are the same as for precancerous changes (dysplasia or cervical intraepithelial neoplasia [CIN]): All of these cancers can be cured with appropriate treatment.

• Conization - The doctor removes a cone-shaped piece of tissue using a surgical scalpel (cold knife cone biopsy) or laser. Conization can also be done by passing an electrical current through a wire loop (loop electrosurgical excision procedure, or LEEP). Conization lets the pathologist see if abnormal cells are in the tissue beneath the surface of the cervix.
• Cryosurgery (also known as cryotherapy) - The doctor uses a metal probe cooled with liquid nitrogen to kill the abnormal cells by freezing them.
• Laser surgery - The surgeon directs a focused laser beam (a narrow beam of intense light) through the vagina to vaporize (burn off) abnormal cells or to remove a small piece of tissue for study.

A simple hysterectomy may be done if the cancer returns and if you do not want to have more children.

• Simple hysterectomy - The surgeon removes the uterus (womb) and cervix but not the structures next to the uterus (parametria and uterosacral ligaments) or pelvic lymph nodes (bean-shaped structures that help fight infections). The uterus is removed through a surgical incision in the front of the abdomen or through the vagina. The ovaries (pair of female reproductive organs that produce eggs and hormones) and fallopian tubes (two hollow tubes on either side of the uterus where the egg and sperm meet to begin the process of fertilization) are usually left in place unless they are affected by some other disease or the patient is at least 45 to 50 years old. When both ovaries and fallopian tubes are removed during the hysterectomy, this process is known as bilateral salpingo-oophorectomy.

If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision in the abdomen using a laparoscope, a method of examining the inside of the abdomen and pelvis through a tube inserted into a very small surgical incision, the operation is called a total laparoscopic hysterectomy.

If you cannot have surgery because of other medical conditions, your doctor might recommend that you receive internal radiation therapy:

• Internal radiation therapy (brachytherapy) - This technique uses a small pellet of radioactive material placed directly in the vagina near the tumor or in the tumor using thin needles. The radioactive material is left in place while you stay in the hospital for 1 to 3 days. This process might be repeated. This treatment is also known as interstitial radiation therapy.

Stage 0 cancer can recur (come back) in the cervix or vagina after treatment, so close follow-up is very important.

This content has been reviewed and approved by Myo Thant, MD.