Cervical Cancer Treatment
Cervical Cancer Treatment – Sheba Medical Center
In women, the cervix is the lower part of the uterus, or womb. The upper area of the cervix is known as the endocervix and contains glandular cells, while the lower area, called the exocervix, is covered in squamous cells. These regions abut each other in the transformation zone, a location where many cervical cancers originate.
About 90% of all cervical cancers are squamous cell carcinomas originating in the exocervix. A minority of cervical cancers are adenocarcinomas that form in the endocervix. Other cases of cervical cancer are a mixture of these types, known as mixed carcinomas or adenosquamous carcinomas.
The main risk factor for cervical cancer by far is infection with the human papilloma virus (HPV). HPV is spread by sexual contact and in more rare cases by skin on skin contact. HPV infection may cause warts but sometimes exhibits no symptoms at all. While there is no cure for HPV, there are vaccines currently available. People who are immunosuppressed for various reasons, such as HIV infection, have a higher risk of contracting HPV.
Another risk factor for cervical cancer, and many other types of cancer, is smoking. Additionally, a poor diet, obesity, a positive family history, and the use of oral contraceptive pills and certain intrauterine devices may increase the risk for cervical cancer. Finally, women who are under 17 at the time of their first full-term pregnancy carry twice the normal risk of developing cervical cancer.
| Stage 0
Carcinoma in situ. The cancer is only present on the surface of the cervix and has not infiltrated deeper layers or elsewhere in the body
| Stage 1
The cancer has invaded the cervix, but not the uterus itself.
| Stage 2
The cancer has traveled beyond the cervix and uterus, but has not invaded the vagina, pelvic walls, or any lymph nodes.
| Stage 3
The cancer is now present in the vagina and/or pelvic walls, but has not invaded distant organs. It may or may not have invaded pelvic lymph nodes.
| Stage 4
The cancer has invaded nearby and/or distant organs and may be blocking urinary flow.
Some signs and symptoms of cervical cancer include:
- Abnormal vaginal bleeding, including unusual vaginal discharge, bleeding after menstruation, or an unusually heavy period
- Pain during sexual intercourse
One of the first clinical signs of cervical cancer is an abnormal Pap smear. A pathologist will see abnormal cells on the Pap smear and alert the patient’s physician. The physician will usually proceed with a colposcopy, a direct examination of the cervix via the vagina.
Additionally, there are several biopsy techniques to confirm cervical cancer, all offered at Sheba Medical Center. These include biopsy during colposcopy, endocervical curettage, which is a scraping of cells from the cervix, and cone biopsy. Cone biopsy, where cone-shaped tissue is removed from the cervix for analysis, may be both a diagnostic and therapeutic procedure since some cervical cancers can be removed in the procedure.
At Sheba Medical Center, we take an integrative approach to cancer treatment in order to provide our patients with tailor-made medicine. For cervical cancer patients, this involves continuous consultation and teamwork between our medical oncologists, radiation oncologists, gynecologists, surgeons, and gynecologic oncologists. Treatments we provide include conventional chemotherapy, targeted chemotherapy, radiation therapy, brachytherapy, and surgery.
Surgery as well as radiation therapy with adjuvant chemotherapy are often used for early-stage cervical cancer. Chemotherapy alone, or targeted chemotherapy, are used in more advanced stages. Targeted chemotherapy uses advanced, specialized drugs to kill cancer cells while sparing normal cells. This has the benefits of fewer side effects for the patient and the ability to use higher drug concentrations, thus eradicating more cancer cells.
In contrast to external beam radiation, brachytherapy uses internal sources of radiation to eradicate cancer, usually in the form of implanted radioactive beads or pellets. This type of therapy is particularly useful in cervical cancer cases. The advantages of brachytherapy include positioning a radiation source near the malignancy to deliver maximum therapy without the need to penetrate healthy tissue. Also, the beads will naturally lose their radioactivity over time, so no removal is necessary.
Brachytherapy is often used in combination with other cancer treatments like surgery and chemotherapy.
Although brachytherapy is not a new treatment, Sheba is on the cutting edge of this modality. We use a specialized operating room customized with 3D imaging equipment and the high dose radiation (HDR) SMART SEED therapy. This allows our physicians to treat moderate-risk cervical cancer without the need for hormone therapy. Available at only a handful of advanced medical centers around the world, Sheba is at the forefront of this effective technology.
Dr. Ofer Margalit completed M.D. degree, as part of an M.D.-
Specializing in breast cancer treatment, Dr. Tal Shapira-Rot
Dr. Meital Levartovsky is a senior oncologist in GU Unit at
Dr. Moran Gadot is a senior oncologist in GU unit at the Can
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