Treatment


Treatment of cervical cancer depends on the stage of the cancer:
·         Stage 0 – Cervical excision procedure (CKC or LEEP)
·         Stage Ia1 – Hysterectomy without lymph node dissection
·         Stage Ia2-Stage IIa – Radical hysterectomy with a pelvic lymph node dissection or radiation therapy with combination chemotherapy
·         Stage IIb or greater – Radiation therapy with combination chemotherapy
 
There are two basic histological types of cervical cancer; squamous cell and adenocarcinoma. Because adenocarcinoma is thought to have skip lesions (cancerous tissue next to normal tissue and the cancerous tissue), it is treated differently in the earlier stages. A radical hysterectomy with pelvic lymph node dissection or radiation with chemotherapy would be recommended for Stage Ia or greater. A patient with Stage 0 and negative margins could undergo a hysterectomy.
 
It is important to note that despite finding metastasis during surgery, a patient’s stage does not change from the original clinical stage. However, it does influence the treatment options after surgery. Although studies have shown equal 5-year survival rates for either radical hysterectomy versus radiation with chemotherapy, a patient that undergoes surgery and then requires radiation and chemotherapy has a much greater morbidity as a result. The decision to proceed with one or the other is often influenced by the patient’s health status, co-morbid conditions, and the surgeon’s training and experience (60). A patient’s desire to retain her fertility options are discussed and considered in the treatment. There have been some centers that perform radical trachelectomy (removal of the cervix only), however, these are still considered experimental.

Comprehensive Cancer Control Plan

The Cherokee Nation Comprehensive Cancer Control (CNCCC) Project assists in the development of networks and collaboration that produce an infrastructure for a comprehensive approach to cancer within the Cherokee Nation. Since 2003, coalition members and partners have come together to discuss the burden of cancer in Cherokee Nation. Coalition members and partners include local, regional, state and national representatives committed to identifying areas of cancer concern, planning interventions, prioritizing greatest areas of identified need, and then implementing identified strategies and/or providing needed resources. This is the second edition of the Cherokee Nation Comprehensive Cancer Control Plan and will serve, like the first, as an information resource for health care professionals and community members, as well as a tool for the Cherokee Nation Comprehensive Cancer Control Coalition and its respective entities. The coalition is committed to the process of enhancing infrastructure for comprehensive cancer control in the Cherokee Nation with the ultimate goal of reducing morbidity and mortality among the Cherokee community.