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Cervical cancer

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Treatments for stage I cervical cancer

The following are treatment options for stage I cervical cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan. You may be offered one or more of the following treatments.

Surgery

Surgery is the main treatment for stage I cervical cancer. The type of surgery you are offered will depend on many factors, including the specific stage, whether or not you want to become pregnant and any treatments you have already had.

Cone biopsy

A cone biopsy may be offered to women with stage IA1 cervical cancer who want the option to become pregnant. A cone biopsy removes a cone-shaped piece of tissue from the cervix. The cone is formed by removing the outer part of the cervix closest to the vagina and part of the endocervical canal.

After a cone biopsy, the tissue removed is sent to a lab and examined under a microscope. If there are no cancer cells in the edges of the tissue removed (called negative surgical margins), you might not need any more treatment. If there are cancer cells in the edges of the tissue removed (called positive surgical margins) or in blood vessels or lymph vessels in the tissue removed (called lymphovascular invasion), you will likely need to have a radical trachelectomy or radical hysterectomy.

Find out more about cone biopsy.

Radical trachelectomy

A radical trachelectomy removes the cervix, upper part of the vagina, some of the structures and tissue around the cervix (parametrium) and lymph nodes in the pelvis. It may be offered to women with stages IA2 and IB1 (only if the IB1 tumour measures less than 2 cm) cervical cancer who want to become pregnant after treatment.

Find out more about radical trachelectomy.

Hysterectomy

A hysterectomy removes the uterus and cervix. Other organs, ovaries, fallopian tubes, lymph nodes and parts of the vagina may also be removed at the same time. A total hysterectomy is the most common treatment for women with stage I cervical cancer who do not want to become pregnant in the future.

A total hysterectomy may be offered for stage IA1 cervical cancer. A radical hysterectomy may be offered for stages IA2 and IB1 cervical cancer. A radical hysterectomy may also be an option for women with stage IB2 or IIA cervical cancer.

Find out more about hysterectomy.

Lymph node removal

Lymph nodes in the pelvis may removed during surgery for stage I cancer.

Lymph node dissection

Surgery to remove lymph nodes is called a lymph node dissection. Lymph nodes in the pelvis and back of the abdomen (called the para-aortic lymph nodes) may be removed during surgery for stage I cervical cancer to check for cancer spread.

Learn more about lymph node dissection.

Sentinel lymph node biopsy

Sentinel lymph node biopsy (SLNB) is the removal of the sentinel node to see if it contains cancer. The sentinel lymph node is the first lymph node in a chain or cluster of lymph nodes that receives lymph fluid from the area around a tumour. Cancer cells will most likely spread to these lymph nodes. There may be more than one sentinel node, depending on the drainage route of the lymph vessels around the tumour.

SLNB may be offered to women with stage I cervical cancer. A doctor may do SLNB to try to avoid doing a pelvic lymph node dissection (PLND), which removes more lymph nodes from the pelvis. If the sentinel lymph node contains cancer, the surgeon will then do PLND, in most cases. Your healthcare team will discuss your options with you to decide the best treatment based on your personal needs.

Learn more about sentinel lymph node biopsy.

Radiation therapy

You may be offered radiation therapy for stage I 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 (called positive surgical margins). Radiation therapy is also used if there are cancer cells in blood vessels or lymph vessels in or around the tumour (called lymphovascular invasion) or in lymph nodes.

Women who have radiation therapy for stage I cervical cancer may have both external beam radiation therapy and brachytherapy. Radiation therapy is usually given 5 days a week for 5–6 weeks. Brachytherapy may be given after external beam radiation therapy.

Chemoradiation

Chemoradiation is a common treatment option for stage IB2 cervical cancer. This treatment combines chemotherapy with radiation therapy. Chemotherapy is given during the same time period as radiation therapy.

Chemoradiation may be 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 (called positive surgical margins). Chemoradiation is also used if there are cancer cells in blood vessels or lymph vessels in or around the tumour (called lymphovascular invasion) or in lymph nodes.

During chemoradiation, chemotherapy is usually given 5 or 6 times (one treatment per week) during the same time period as external beam radiation therapy. Cisplatin (Platinol AQ) is the chemotherapy drug most commonly used to treat stage I cervical cancer. Cisplatin makes external beam radiation therapy more effective.

Clinical trials

You may be asked if you want to join a clinical trial for cervical cancer. Find out more about clinical trials.

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