Treatments for stage 1 cervical cancer

The following are treatment options for stage 1 cervical cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Surgery is a main treatment for stage 1 cervical cancer. The type of surgery you are offered will depend on many factors, including your age, the stage and if you want to become pregnant.

A cone biopsy may be offered to women with stage 1A1 cervical cancer who want the option to become pregnant. A cone biopsy removes a cone-shaped piece of tissue from the cervix.

After a cone biopsy, the removed tissue is sent to a lab and examined under a microscope. If there are no cancer cells in the edges of the tissue, you might not need any more treatment. If there are cancer cells in the edges of the tissue, in blood vessels or in lymph vessels in the tissue, or if the cancer is too large, you will probably need to have further treatment.

Find out more about a cone biopsy.

A radical trachelectomy removes the cervix, the upper part of the vagina, some of the structures and tissue around the cervix and lymph nodes in the pelvis. It may be offered for stages 1A2 and small 1B1 cervical cancer (less than 2 cm) if you want to become pregnant after treatment.

Find out more about a radical trachelectomy.

A hysterectomy removes the uterus and cervix. A total hysterectomy is the most common treatment for women with stage 1 cervical cancer who do not want to become pregnant in the future.

Types of hysterectomy for stage 1 cervical cancer include the following:

• a total hysterectomy with or without removal of the lymph nodes in the pelvis for stage 1A1 cervical cancer
• a modified radical hysterectomy with removal of pelvic lymph nodes for stage 1A2 cervical cancer
• a radical hysterectomy with removal of lymph nodes in the pelvis and possible samples of the para-aortic lymph nodes for stage 1B1 cervical cancer
• a radical hysterectomy with removal of lymph nodes in the pelvis and samples of the para-aortic lymph nodes for stage 1B2 cervical cancer

Find out more about a hysterectomy.

Lymph nodes in the pelvis and back of the abdomen (called the para-aortic lymph nodes) may be removed during surgery for stage 1 cervical cancer.

A lymph node dissection is surgery to remove lymph nodes. Lymph nodes in the pelvis and back of the abdomen may be removed during surgery for stage 1 cervical cancer to check for cancer spread. A pelvic lymph node dissection (PLND) is the removal of lymph nodes from the pelvis.

Find out more about a lymph node dissection.

A sentinel lymph node biopsy (SLNB) is the removal of the sentinel lymph node to see if it contains cancer. The sentinel lymph node is the first in a chain or cluster of lymph nodes that cancer cells will most likely spread to first from the original cancer. An SLNB may be done to try to avoid doing a full PLND, which removes more lymph nodes from the pelvis.

Learn more about a sentinel lymph node biopsy.

You may be offered radiation therapy for stage 1 cervical cancer. It is used as the main treatment if you can’t have surgery or choose not to have surgery. It is also used after surgery if there are cancer cells in or close to the edges of the removed tissue, in blood vessels or lymph vessels in the removed tissue or in lymph nodes.

External radiation therapy may be given alone or with intracavitary brachytherapy (a type of internal radiation therapy) for stage 1 cervical cancer. Radiation therapy is usually given 5 days a week for 6 to 7 weeks. Brachytherapy may be given after external radiation therapy.

You may be offered chemoradiation for stage 1B1 cervical cancer. It is often a main treatment for stage 1B2 or higher cervical cancer. It is used if you can’t have surgery or choose not to have surgery. It is also used after surgery if there are cancer cells in or close to the edges of the removed tissue, in blood vessels or lymph vessels in the removed tissue or in lymph nodes.

This treatment combines chemotherapy with external radiation therapy. Chemotherapy is given during the same time period as radiation therapy to make the radiation therapy more effective.

Cisplatin or cisplatin plus 5-fluorouracil (Adrucil, 5-FU) is the chemotherapy that is used. If cisplatin is used, it is usually given once each week during the external radiation therapy schedule. If cisplatin plus 5-FU is used, it is usually given every 4 weeks during radiation therapy.

Talk to your doctor about clinical trials open to women with cervical cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.