How is Cervical Cancer Treated?

This is the eighth page in the Understanding Cervical Cancer Guide. This guide was developed by the HealthTree Education Team and was last updated and reviewed on June 16, 2026.

The treatment for cervical cancer depends on the stage of the cancer, the type of cancer, the size of the tumor, your age, and your overall health. Whether you wish to become pregnant in the future is also an important factor. Treatment is best planned by a team of specialists that includes a gynecologic oncologist, a radiation oncologist, and a medical oncologist.

Getting a second opinion from another experienced cervical cancer team is normal and encouraged.

Treatment for early-stage cervical cancer

For cervical cancer that is small and confined to the cervix, surgery alone can often cure the cancer. Radiation therapy is an equally effective option for early-stage disease and may be preferred in some situations.

Surgery for early-stage cervical cancer

• Conization or LEEP. For very early cervical cancer that has invaded only a tiny amount, a cone biopsy or LEEP procedure may remove all of the cancer while preserving the uterus. This option is sometimes used for people who wish to become pregnant in the future.
• Simple hysterectomy. Removal of the uterus and cervix. Used for some Stage IA cancers. It is not necessary to remove the ovaries in most cases, especially in people who have not yet gone through menopause.
• Radical hysterectomy. Removal of the uterus, cervix, upper part of the vagina, and the tissues that connect the uterus to the pelvis. Lymph nodes in the pelvis are also removed to check whether cancer has spread. A radical hysterectomy is the standard surgery for Stage IB1 and IB2 cervical cancers.
• Radical trachelectomy. An operation that removes the cervix and upper vagina but leaves the uterus in place. It is an option for selected people with small tumors who want to preserve the ability to become pregnant. A trachelectomy is only appropriate for carefully selected patients and should be done at a center with experience in this procedure.

Minimally invasive surgery

Some cervical cancer surgeries can be done through small incisions using laparoscopic or robotic techniques. Clinical trials published in 2018 and 2019 showed that open surgery led to better cancer outcomes than minimally invasive radical hysterectomy for early-stage cervical cancer. Many gynecologic oncologists now recommend open surgery for radical hysterectomy. Talk to your surgeon about the approach that is best for your situation.

Sentinel lymph node mapping

During surgery, some doctors use a technique called sentinel lymph node mapping to identify the first lymph nodes where cancer cells would likely spread. This can reduce the number of lymph nodes that need to be removed, lowering the risk of a complication called lymphedema. Sentinel lymph node mapping for cervical cancer is used at many specialized centers.

Treatment for locally advanced cervical cancer

Locally advanced cervical cancer is cancer that has grown beyond the cervix but has not yet spread to distant parts of the body. This generally includes Stages IB3 through IVA. The standard treatment is chemoradiation, which means radiation therapy given at the same time as chemotherapy.

Radiation therapy

Radiation therapy uses high-energy beams to destroy cancer cells. For cervical cancer, radiation is often given in two forms at the same time:

• External beam radiation therapy. Radiation delivered from outside the body to the pelvis and, when needed, the lymph nodes in the abdomen. Modern techniques such as intensity-modulated radiation therapy, known as IMRT, allow doctors to deliver radiation precisely to the tumor while protecting nearby healthy tissues such as the bladder and bowel.
• Brachytherapy. Radiation delivered from inside the body by placing a small radioactive source directly into or near the cervix. Brachytherapy delivers a very high dose of radiation to the tumor while limiting the dose to nearby organs. It is an essential part of definitive radiation treatment for cervical cancer and is given after external beam radiation is completed.

Chemotherapy with radiation

Cisplatin is the chemotherapy drug most commonly used alongside radiation for locally advanced cervical cancer. The chemotherapy makes the radiation more effective at killing cancer cells. Giving chemotherapy and radiation together is called concurrent chemoradiation and is the standard of care for locally advanced cervical cancer.

Immunotherapy for cervical cancer

Immunotherapy helps the body's immune system find and destroy cancer cells. It has become an important part of treatment for advanced and recurrent cervical cancer.

• Pembrolizumab. Pembrolizumab is a checkpoint inhibitor that blocks a protein called PD-1, which some cancer cells use to hide from the immune system. It is approved for use alongside chemotherapy for advanced cervical cancer. Studies have shown that adding pembrolizumab to chemotherapy significantly improves survival for people with advanced cervical cancer, particularly those whose tumors have a positive PD-L1 score.
• Other checkpoint inhibitors. Other immunotherapy drugs targeting the PD-1 and PD-L1 pathway are being studied for cervical cancer in clinical trials.

Chemotherapy for recurrent or metastatic cervical cancer

For cervical cancer that has come back or spread to distant parts of the body, chemotherapy is commonly used. The most common combination is cisplatin or carboplatin together with paclitaxel and, now, pembrolizumab. Other drugs such as topotecan, bevacizumab, and gemcitabine are also used in certain situations.

• Bevacizumab. Bevacizumab is a targeted therapy that blocks a protein called VEGF, which tumors use to grow new blood vessels. Adding bevacizumab to chemotherapy has been shown to improve survival in people with recurrent or metastatic cervical cancer.

Treating recurrent and metastatic cervical cancer

When cervical cancer returns, treatment depends on where it has come back, what treatments were used before, and your overall health. For cancer that returns only in the pelvis after surgery, radiation therapy can sometimes cure the disease. For cancer that returns after prior radiation, an operation called pelvic exenteration may be considered for carefully selected patients. This surgery removes the uterus, cervix, vagina, bladder, and sometimes the rectum. For cancer that has spread to distant parts of the body, the goal of treatment shifts to controlling the cancer and maintaining quality of life.

Supportive and palliative care for cervical cancer

Treating the symptoms of cancer and the side effects of treatment is called supportive and palliative care. This is an important part of cancer care at every stage. Supportive care can include:

• Pain management
• Management of treatment-related side effects such as fatigue, nausea, diarrhea, skin changes from radiation, and neuropathy from chemotherapy.
• Lymphedema therapy. Swelling of the legs can occur after lymph node removal or radiation to the pelvis. A physical therapist who specializes in lymphedema can help manage this.
• Sexual health support. Surgery and radiation can affect vaginal health and sexual function. A sexual health specialist or pelvic floor physical therapist can help address these concerns.
• Nutritional support from a registered dietitian
• Mental health support and counseling

There is a common misconception that palliative care is only given at the end of life. Palliative and supportive care can be given at any time during cancer treatment to improve comfort and quality of life.

Follow-up care after treatment

After cervical cancer treatment ends, regular follow-up appointments are essential. Follow-up visits help detect signs of recurrence early, monitor for side effects of treatment, and support recovery. Follow-up typically includes physical examinations, pelvic exams, and imaging as clinically indicated. Appointments are usually more frequent in the first two years after treatment, when the risk of recurrence is highest, and continue at decreasing intervals for at least five years.