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Cervical Cancer Surgery & Treatment

If you think or know you have cervical cancer, you're scared about what this means for your future. Not only are you possibly facing cervical cancer surgery, but a cancer that could disrupt your sex life and ability to have children.

At UVA Health, you'll find experts who've dedicated their careers to caring for women with cervical and other cancers of the female reproductive system. Under the guidance of a gynecologic oncologist, you'll feel well cared for. But you'll also know you're in experienced hands.

Cervical Cancer Surgery & Treatment at UVA Health

Our experts will tailor cervical cancer surgery and other treatments to fight your cancer, but also to help preserve your fertility and sex life.

You may need a combination of treatments. Which treatment makes sense for you depends on many factors:

  • Your age and general health
  • Whether you have a certain type of HPV, the main cause of cervical cancer
  • Stage of the cancer
  • Type of cervical cancer
  • Size of the tumor

As leaders in the field of gynecologic cancer care, our experts offer the full array of surgery and treatment options for all stages of cancer, including:

Cervical Cancer & Your Fertility

Cervical cancer can strike during a woman's childbearing years. Some forms of cervical cancer treatment can damage fertility. If you plan to have children, we'll do everything we can to help preserve your fertility. 

If you're pregnant when your cervical cancer is found, we may need to change or delay treatment so we don't harm your baby. 

Cervical Cancer Surgery to Remove Abnormal Cells 

Because of Pap tests, we can find evidence of cervical cancer before it becomes a full-blown cancer. 

We can remove precancerous cells in your cervix. We sometimes call this stage 0 cervical cancer. We offer procedures to prevent abnormal cells from becoming cancer.

Laser Surgery

We use a laser beam to heat and kill abnormal cells. This intense, narrow beam of light removes the abnormal cells from the cervix.

Cryosurgery

Cryosurgery freezes off abnormal cells. We apply nitrogen or carbon dioxide liquid to a probe. We then insert the probe through your vagina. Then we put the substance on your cervix.

Conization

Conization removes a cone-shaped piece of tissue from the cervix. It uses a scalpel, cold knife, laser beam, or loop electrosurgery (uses a thin wire heated by an electric current).

After we remove the tissue, we can see if the margins around the sample are clear of any abnormal cells. Then we can tell if you need more treatment.

Early-Stage Cervical Cancer Treatment

Our gynecological oncologists not only perform surgery but also oversee chemotherapy. We use drugs to destroy cervical cancer cells. The chemo drugs travel through the body to the cancer cells. You may need chemotherapy:

  • Before cervical cancer surgery to shrink the tumor and decrease the amount of tissue we have to remove
  • In combination with radiation therapy to decrease tumor size
  • To help relieve symptoms of metastatic cancer (when cancer has spread to other parts of the body)
  • To extend survival time

Targeted Therapy

We have medications that can seek out and destroy cancer cells. They can also kill systems that support the cancer cells. One drug used for cervical cancer stops the growth of new blood vessels that help tumors grow. 

Surgery for Advanced Cervical Cancer

Pelvic Exenteration

If your cancer comes back or spreads to nearby organs, you'll need major surgery. We may need to remove organs from your reproductive and digestive systems. This could include your vagina, bladder, rectum, or lower part of the colon.

Pelvic Lymph Node Dissection

Cancer can spread to the lymph nodes located outside the uterus. Once there, cervical cancer can travel to other parts of the body. During surgery, we'll remove some or all lymph nodes suspected of having cancer. We'll then examine the nodes under a microscope.

Radiation Therapy

External Beam Radiation

A machine outside your body produces radiation. The machine directs short bursts of X-rays at the cancer. Generally, this type of radiation therapy lasts 5 days per week for 5-6 weeks. At the end of this cervical cancer treatment, the tumor site often gets an extra dose of radiation.

Brachytherapy

Brachytherapy delivers high-dose radiation to the cancer cells. We place a capsule with radioactive materials into the cervix. We can also put a capsule in the vagina, just outside of the cervix.

This capsule stays in place for 1-3 days. You can have this treatment repeated several days over the course of 1-2 weeks.

You might need to stay in the hospital while the capsules work. You could also take radiation delivery in minutes instead of days. This gets rid of the need for a hospital stay.

Chemotherapy & Chemoradiation

Chemotherapy uses drugs to destroy cervical cancer cells. The drugs enter your bloodstream. They then travel through the body to the cancer cells. You might get chemotherapy:

  • Before cervical cancer surgery — to shrink the tumor and decrease the amount of tissue we need to remove
  • In combination with radiation therapy (chemoradiation) to decrease tumor size
  • To help relieve symptoms of metastatic cancer and extend survival time

You get chemotherapy through an IV. Sometimes you can take it by mouth. You get treatment in 4-6 cycles over a set period of time.

Cervical Cancer Clinical Trials

By coming to Virginia's first NCI-designated comprehensive cancer center, you'll find treatment options if standard therapies aren't enough. We have trials testing new therapies and surgery for cervical cancer. 

Talk to your provider about a cervical cancer clinical trial that might be right for you.

Cervical Cancer Clinical Trials
Research study for adults with gynecological cancer

The Department of Radiation Oncology seeks adults ages 18 and older with gynecological cancers for a research study. The purpose of the study is to determine if tumor cells or tumor materials circulating in the blood can be used as a tool in the future to help guide cancer treatment decisions during or after radiation with or without chemotherapy. You may be eligible for this study if you have been diagnosed with gynecological cancer -such as cervical, vaginal vulvar or endometrial and plan on receiving radiation therapy as a part of your definitive treatment plan. This study involves collecting blood samples from participants at various time points during treatment visits and follow up visits. Clinic follow ups will occur 1 months and 3 months after treatment completion. Study-related blood draws will be completed at no cost.

A Randomized Controlled Trial of Robotic versus Open Radical Hysterectomy for Cervical Cancer (ROCC trial)

The University of Virginia is conducting a clinical research study for adults ages 18 and over, who have early stage cervical cancer that will be treated with surgery. The purpose of this study is to investigate if minimally invasive surgery, called robotic assisted laparoscopy (small incision surgery), is worse than open surgery (otherwise known as a laparotomy) when performing a radical hysterectomy for cervical cancer. The study team will be following you closely throughout your hospital stay and recovery. Your doctor will review the pathologic findings (examination of the tumor tissue) from surgery with you and make recommendations regarding next steps in your care based on those results. After your surgery, your doctor and study team will watch you for side effects and monitor for any signs or symptoms of cancer coming back. They will perform a history and examination every 3 months for 2 years after treatment. After that, they will see and examine you every 6 months for 3 years. Additionally, you will be having a CT scan for follow-up every 6 months for the first 3 years after surgery for follow-up. Study-related procedures that are being done beyond your standard of care will be provided at no cost to you or your insurance. Additional information can be found here: https://clinicaltrials.gov/ct2/show/NCT04831580

A Phase III, Randomized, Double-blind, Placebo-controlled, Multi-centre, Global Study of Volrustomig in Women with High Risk Locally Advanced Cervical Cancer Who Have Not Progressed Following Platinum-based, Concurrent Chemoradiation Therapy (eVOLVE-Cervical)

The University of Virginia seeks adult women ages 18 years and older with locally advanced cervical cancer. You may be eligible for this study if you have histologically documented FIGO 2018 stage IIIC-IVA cervical adenocarcinoma, cervical squamous carcinoma, or cervical adenosquamos carcinoma, with lymph node involvement. This study aims to determine if Volrustomig, a study drug and monovalent, bispecific, humanized IgG1 mAb, is an effective anti-cancer therapy for patients with solid tumors who have not progressed following platinum-based, concurrent chemoradiation therapy. This study is a double-blinded trial in which neither you nor the researcher knows which treatment or intervention you are receiving until the clinical trial is over. Participants will be randomized (assigned by chance) in a 1:1 ratio to 2 groups, Arm A or Arm B. • Arm A: the study drug Volrustomig only • Arm B: a placebo only Both Volrustomig and placebo will be administered as an IV infusion. The length of your participation in this study depends on how your cancer responds to the study drug. It also depends on whether you have side effects from the study drug that makes you want to stop receiving it. This study involves blood sampling, tumor biopsies, physical examination, imaging, and an electrocardiogram (ECG). Study-related procedures that are being done beyond your standard of care will be provided at no cost to you or your insurance. Study Details | Study of Volrustomig in Women With High Risk Locally Advanced Cervical Cancer (eVOLVE-Cervical) | ClinicalTrials.gov

A Phase 3 Randomized, Active-controlled, Open-label, Multicenter Study to Compare the Efficacy and Safety of MK-2870 Monotherapy Versus Treatment of Physician’s Choice as Second-line Treatment for Participants with Recurrent or Metastatic Cervical Cancer (TroFuse-020/GOG-3101/ENGOT-cx20)

The University of Virginia seeks adult women ages 18 years and older with recurrent or metastatic cervical cancer. You may be eligible for this study if: • You have squamous cell carcinoma, adenosquamous carcinoma, or adenocarcinoma of the cervix • You have had one or more prior lines of systemic platinum chemotherapy and prior immunotherapy You will be randomized (assigned by chance) to one of two treatment arms, • Arm 1: MK2870 4mg/kg administered intravenously • Arm2: Treatment of Physician’s choice consisting of one of the following: Pemetrexed, Tisotumab Vedotin, Topotecan, Vinorelbine, Gemcitabine, Irinotecan. This study involves blood draw, imaging of the chest, abdomen and pelvis, electrocardiogram (ECG), Echocardiogram (ECHO) and archival tissue collection. Study-related procedures that are being done beyond your standard of care will be provided at no cost to you or your insurance.

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