CCS adapting to COVID-19 realities to support Canadians during and after the pandemic
Research in cervical cancer
We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better ways to treat cervical cancer. The following is a selection of research showing promise for treating cervical cancer.
We’ve included information from the following sources. Each item has an identity number that links to a brief overview (abstract).
- PubMed, US National Library of Medicine (PMID)
- American Society of Clinical Oncology (ASCO)
- Canadian Cancer Trials and ClinicalTrials.gov (NCT)
Researchers are looking for the best ways to treat cervical cancer using surgery and to improve how surgery is done. Doctors are trying to find out if removing less tissue than standard surgery can lead to good outcomes in women with early stage cervical cancer.
Total (simple) hysterectomy is surgery to remove the cervix and uterus. It is used to treat most women with stage 1A1 cervical cancer. Women with other early stages of cervical cancer (including all other types of stage 1) usually have a radical hysterectomy to remove the cervix, uterus, upper part of the vagina, some surrounding tissue and nearby lymph nodes. Researchers are trying to find out if these women may benefit from just having a total hysterectomy instead. They want to know if removing less tissue allows women to have a better quality of life and sexual health while still preventing the cancer from coming back. Canadian researchers are doing a phase 3 trial to compare a radical hysterectomy with a total hysterectomy in women with a subset of early stage cervical cancer. In both groups of women, pelvic lymph nodes are removed at the time of surgery. The study is currently looking for participants, and the results of the trial are expected in 2020 (ClinicalTrials.gov, NCT 01658930).
Surgery that removes less tissue may be a treatment option for women with stage 1B1 cervical cancer. Researchers studied a group of women younger than 45 years of age with this cancer. They compared the results in those who had less tissue removed (with a total hysterectomy, cone biopsy or radical trachelectomy) to those who had more tissue removed (with a radical hysterectomy). They found that women who had less tissue removed were no more likely to die from cervical cancer than those who had more tissue removed (ASCO, Abstract 5525). Another study found that removing less tissue was linked with lower rates of survival than a radical hysterectomy in women with early stage cervical cancer (New England Journal of Medicine, PMID 30380365).
Find out more about research in cancer surgery.
The following is noteworthy research in chemotherapy for cervical cancer.
Neoadjuvant chemotherapy is given before the main treatment for cancer. Researchers are studying neoadjuvant chemotherapy in women with stage 1B2 to 3B cervical cancer (also called locally advanced cervical cancer) to see if it can help shrink the tumour so it is easier to remove with surgery. Giving chemotherapy before surgery may even help shrink a tumour enough that some women with stage 1B2 cervical cancer can have a cone biopsy or a radical trachelectomy instead of a hysterectomy. A cone biopsy and a radical trachelectomy are examples of fertility-sparing surgeries because a woman can still get pregnant afterward. Research also shows that neoadjuvant chemotherapy may lessen the need for radiation therapy after surgery (ASCO, Abstract e17002; International Journal of Clinical Oncology, PMID 27380169, PMID 27342833). Another study showed that neoadjuvant chemotherapy followed by surgery does not work any better than standard chemoradiation for locally advanced cervical cancer (Journal of Clinical Oncology, PMID 29432076).
Find out more about research in chemotherapy.
Immunotherapy helps strengthen or restore the immune system’s ability to find and destroy cancer cells. Researchers are trying to find out if immunotherapy will be a useful treatment for cervical cancer.
Immune checkpoint inhibitors are showing a lot of promise in the treatment of many types of cancer. The immune system usually stops itself from attacking normal cells in the body. It does this by using specific proteins called checkpoints, which are made by some types of immune system cells. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. Immune checkpoint inhibitors work by blocking these checkpoint proteins so T cells (a type of immune system cell) can recognize, attack, and kill the cancer cells. More research is needed to understand the role that immune checkpoint inhibitors may have in treating cervical cancer (Anticancer Research, PMID 29061774; Medical Oncology, PMID 28477178; Gynecologic Oncology, PMID 29666026).
Human papillomavirus (HPV)vaccines protect against HPV infections, which are linked to cervical and other types of cancer. Researchers are developing vaccines to treat HPV infections. These vaccines stimulate the body to have an immune response and attack HPV-infected cells. This may help destroy precancerous cells in the cervix and cervical cancer cells (Best Practice & Research: Obstetrics & Gynecology, PMID 29108943; Journal of Infectious Diseases, PMID 26518044).
Find out more about research in immunotherapy.
Learn more about cancer research
Researchers continue to try to find out more about cervical cancer. Clinical trials are research studies that test new ways to treat cervical cancer. They also look at ways to prevent, find and manage cancer.
Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for cervical cancer were first shown to be effective through clinical trials.
A type of lymphocyte (white blood cell) that helps control immune response (the immune system’s reaction to the presence of foreign substances in the body), fight infection and destroy abnormal cells, including cancer cells.
Also called T lymphocyte.
Taking action against all cancers
The latest Canadian Cancer Statistics report found that of all newly diagnosed cancers in 2017, half are expected to be lung, colorectal, breast and prostate cancers. Learn what you can do to reduce the burden of cancer.