Cervical Cancer

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At the Swedish Cancer Institute, women with cervical cancer – as well as women with ovarian and uterine cancer – receive care through a nationally recognized gynecological cancer program. This includes the expertise of a renowned team of physicians, surgeons and other specialists. All Swedish cervical-cancer patients benefit from a multidisciplinary approach to care that encompasses leading-edge imaging techniques, the latest in treatment options and a full selection of high-quality support services.

Members of our multidisciplinary care teams meet regularly to share information and discuss patient cases, in order to determine an integrated course of care for each person.

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Overview

The American Cancer Society estimates that in 2021 14,480 women will be diagnosed with cervical cancer (310 in Washington State), and 4,290 women will die of this disease. Women with cervical cancer typically present in two broad groups: early-stage disease found on a Pap smear or annual pelvic exam and advanced stage disease which usually presents with more advanced symptoms to an emergency department or urgent care clinic.  Fortunately, widespread cervical cancer screening programs in the United States utilizing Pap smears and HPV testing, as well as HPV vaccination programs in girls and young women, have resulted in cervical cancer dropping well out of the “top ten” cancers in our country, whereas in many parts of the world it is the most common or second most common cancer in women.

There are two main types of cervical cancer, squamous cell carcinoma of the cervix, which arises on the outside of the cervix and comprises approximately 85% of all cancers, and adenocarcinoma of the cervix, which originates inside the cervical canal and can present with more advanced disease and a higher risk of having lymph node involvement.

Gynecologic oncologists at Swedish Cancer Institute have been involved in the development of some of the most significant advances in the treatment of this disease, from a study published in the Journal of Clinical Oncology in 2000 showing that adding chemotherapy to radiation for the treatment of cervical cancer after surgery significantly improves survival (which helped lead to a National Cancer Institute Bulletin recommending chemotherapy be given with radiation to improve survival in this disease) to surgical innovations including being the first group in Washington State to perform radical hysterectomy for cervical cancer utilizing the robotic platform.

In addition, Swedish has a highly specialized radiation oncology program which uses advanced radiation techniques spearheaded by Dr. Daniela Buscariollo which aims to optimize cure rates while minimizing radiation toxicity.

Symptoms

This disease typically presents with irregular vaginal bleeding or bleeding after sexual intercourse, and some women present with a watery or foul-smelling vaginal discharge.  Patients with advanced cancer can present with pelvic pain, kidney blockage, and leg swelling.

Diagnosis

Ideally women have cervical cancer detected early when abnormal cells are detected on a Pap smear performed by their primary care physician or OB/GYN, and these cancers are frequently diagnosed with a simple cervical biopsy, or a larger cervical biopsy called a “LEEP” procedure or cervical conization biopsy.

Women with more advanced disease will frequently be diagnosed in an emergency department setting with complaints of pain or bleeding which leads to imaging with CT scan which can show findings of disease spread including kidney blockage, a pelvic mass, or lymph node enlargement.

Cervical cancer is staged clinically, with Stage I cancers involving the cervix without spread, Stage II cancer involving the tissues below or next to the cervix, Stage III cancers spreading to the lower vagina or the pelvic sidewall, and Stage IV cancers adjacent organs or distant sites including lymph nodes or lung tissue.

Treatment

The gynecologic oncology and pelvic surgery team at Swedish Cancer Institute coordinate patient treatment plans, which can include surgery alone, surgery followed by radiation with chemotherapy, or radiation with chemotherapy (“chemorads”). Physicians develop an individualized plan with the patient in a multidisciplinary format, including a gynecologic oncologist, radiation oncologist, and specialized radiologists involved in reading cancer imaging studies, depending on the patient’s cancer stage and wishes after reviewing treatment options. 

Women with early-stage disease are typically treated with either simple hysterectomy or radical hysterectomy, while patients with more advanced stage disease are usually treated with a combination of radiation and chemotherapy. 

For more advanced stage disease or recurrent cancer, newer therapies including angiogenesis inhibitors or immunotherapy are frequently incorporated into the treatment plan to improve outcomes, and patients are offered clinical trials using novel anti-cancer therapies whenever possible.

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Research and Clinical Trials

If your physician believes you are a good candidate to participate in a clinical trial evaluating a new treatment or more effective combinations of treatments — and you agree — you will have access to the very latest in research treatments. 

At any given time, the Swedish Cancer Institute offers patients more than 140 clinical-research studies involving most types of cancers. Additionally, our physician specialists collaborate with other regional and national research groups, including  Southwest Oncology Group, National Cancer Institute, Puget Sound Oncology Consortium and Fred Hutchinson Cancer Research Center.

Education and Support for Patients and Families

Beyond physical health, the Swedish Cancer Institute is committed to the emotional well-being of our patients and their families. We offer:

Complementary therapies include:

See Patient Support and Resources and Services for the Body, Mind and Spirit at Swedish.

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