Treatment of Stage II Cervical Cancer

If you have Stage II cervical cancer, you might be treated with high-dose internal and external 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.
• External beam radiation therapy (EBRT) - Radiation from outside the body is focused on the cancer. Most people are treated with EBRT 5 days a week for 5 to 7 weeks as an outpatient. This schedule helps protect healthy cells and tissues by spreading out the total dose of radiation.

You will probably be given chemotherapy (cisplatin with or without 5-fluorouracil) along with the radiation to increase the effectiveness of radiation therapy.

• Platinol^® (cisplatin) - Cisplatin is a platinum compound chemotherapy drug that acts like an alkylating agent. It stops cancer cells from growing, which kills them. Cisplatin is given by an injection into the vein over at least 1 hour. Your dose depends upon the type of cancer you have, your size, and how well your kidneys work.
• Adrucil ^® or Efudex ^® (5-fluorouracil or 5-FU) - 5-FU belongs to the group of chemotherapy drugs known as antimetabolites. 5-FU prevents cells from making DNA and RNA, which stops cells from growing. 5-FU is given as a shot in the vein over 5 to 10 minutes, over 20 to 60 minutes, or continuously over 22 to 24 hours for 1 to 4 days or longer. The treatment can be repeated weekly, every other week, or every 3 weeks. The dose depends on your size.

Another treatment option for some patients with Stage IIA cervical cancer is a radical hysterectomy and pelvic lymph node dissection. You might be treated with radiation therapy before having surgery.

• Radical hysterectomy and pelvic lymph node dissection - The surgeon removes the entire uterus, the tissues next to the uterus (parametria and uterosacral ligaments), the upper part (about 1 inch) of the vagina next to the cervix, and lymph nodes from the pelvis. The ovaries and fallopian tubes are not removed unless there is some other medical reason to do so. When both ovaries and fallopian tubes are removed during the hysterectomy, this process is known as bilateral salpingo-oophorectomy. 

This surgery is usually done through an abdominal incision. But another approach, called laparoscopic-assisted radical vaginal hysterectomy, is done through the vagina. In this procedure, the surgeon uses laparoscopy, a method of examining the inside of the abdomen and pelvis through a tube inserted into a very small surgical incision. The surgeon can remove lymph nodes through the tube without making a large cut in the abdomen. The surgeon can also use the laparoscope to remove the uterus, ovaries, and fallopian tubes through a vaginal incision, so that an abdominal incision is not needed.

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