Is cervical cancer curable?
Due to early detection and treatment, the prognosis of cervical cancer is excellent for most patients. The chances of a cure depends largely on the type of cervical cancer and the stage at which cervical cancer is diagnosed.
Cervical cancer occurs when abnormal cells in the lining of the cervix grow uncontrollably. There is a high chance of a cure if cervical cancer is diagnosed and treated when the disease is at an early stage. Early-stage disease is when the cancer is confined to the cervix and has not spread to other parts of the body. We refer to a cure as there being no traces of cancer after treatment.
Cancer Council Australia estimates there will be 913 cases of cervical cancer diagnosed in Australia in 2021. Across all stages, patients diagnosed with cervical cancer have an average 74% five-year survival rate. Australia’s cervical cancer screening and vaccination program has contributed to an increase in survival rates for cervical cancer over time. Cervical cancer screening picks up early-stage cancer before symptoms appear. Cervical cancer patients are also often diagnosed at an early stage because abnormal vaginal bleeding often develops at this stage, which when presented to a doctor should prompt investigation. This is why it is important to see your doctor if you have any abnormal bleeding, particularly bleeding in postmenopausal women.
Cervical cancer diagnosis is made through a biopsy, which takes a tissue sample from the cervix for analysis under the microscope. A colposcopy will be performed if a cervical cancer screening test returns a positive result for both HPV and abnormal cells, or if your doctor recommends investigation of cervical cancer symptoms.
If cancer is found after it has spread outside the cervix (locally advanced cancer which is stage 2 or 3), it may still respond well to treatment and can often be kept under control.
If the cancer is diagnosed at stage 4, a cure is less likely. Stage 4 is when cancer has spread to the bladder or rectum or beyond the pelvis to the lungs, liver or bones. For women diagnosed at an advanced stage, cure rates are lower, and in some patients treatment may aim to slow down the progression of the cancer, increase longevity and improve quality of life.
What treatment will cure cervical cancer?
For early stage disease, surgery may be the only treatment needed when the tumour is in the cervix only.
A cone biopsy may be used to remove early-stage cervical cancer (stage 1a) by removing a cone-shaped piece of tissue from the cervix. This procedure can be performed only on tumours a few millimetres in size. It may be performed with or without surgical exploration of the pelvic lymph nodes (depending on other factors). A woman retains her fertility after this procedure.
A radical trachelectomy may be required for cervical cancer stages 1a or 1b and involves removal of the entire cervix and the tissue next to the cervix (parametria). This procedure is mostly done in combination with a removal of pelvic lymph nodes. This procedure preserves the uterus for fertility reasons.
If fertility is not desired, a radical hysterectomy is another option which removes the uterus, cervix, and soft tissue around the cervix and top of the vagina. The ovaries can be removed or preserved, depending on some factors, including the patient's age. The procedure is often offered in combination with a lymph node removal.
Overall, surgeons are confident that there is a low likelihood of the cancer returning after these procedures.
There is always a chance that cancer of all types and stages may recur. Cancer may recur locally in the area of the vagina (local recurrence), in the area of the pelvic lymph nodes (pelvic recurrence) or at distant sites (liver, lung). If a patient is well and without recurrence for 3 years, the risk of a recurrence after this period becomes low. After 5 years the chances of it retuning decreases even further.
A gynaecological oncologist can discuss what type of surgery might be best for you. Like most types of cancer, the outcomes are better when cervical cancer is found and treated early.
Treatment of cervical cancer stages 2 to 4 does not rely on surgical treatment. In such patients, radiation treatment, chemotherapy or a combination of both play key roles to achieve good patient outcomes.
If you would like to read about treatment and outcomes of cervical cancer, please refer to the Cervical Cancer page.
If you wish to discuss your prognosis and treatment options please contact Dr Obermair for an appointment.