Is Cervical Cancer Curable?

If you’ve been diagnosed with cervical cancer, your first concern may be about cure and survival. When detected early, cervical cancer is highly treatable and curable. More advanced cases of cervical cancer can also be treated, often with successful outcomes.

The uterus (womb) and vagina connect through a hollow tube called the cervix. Cervical cancer starts in the cells that line the cervix.

Early diagnosis through tests including Pap smears often catch abnormal cells at a precancerous stage or an early stage of cervical cancer. The stage of cancer you have when diagnosed and issues such as response to treatment and overall health play important roles in your potential prognosis.

This article will focus on the factors that impact survival rates and prognosis (likely outcome) for cervical cancer. It will also discuss treatment options, and what you should do if cervical cancer returns.

Factors That Influence Prognosis

The American Cancer Society estimates that 14,100 new cases of invasive cervical cancer will be diagnosed during 2022. Invasive cervical cancer is cancer that has spread from the surface of the cervix deeper into cervical tissues or other parts of the body.

The amount of cancer in the cervix and the extent of spread are significant determinants for survival rates. Other factors that influence prognosis include response to treatment and overall health.

The five-year relative survival rate for cervical cancer is broken down into these three groups:

• Localized: 92% (cancer has not spread outside of the cervix or uterus)
• Regional: 58% (cancer has spread to nearby lymph nodes)
• Distant: 17% (cancer has spread to nearby organs and/or distant parts of the body)

This data is tracked by the Surveillance, Epidemiology, and End Results (SEER) database. The National Cancer Institute maintains the SEER database. 

Relative survival rates are estimates. They're based on the experience of cervical cancer patients who were diagnosed more than five years ago. Relative survival rate numbers don't take new, improved treatments or individual factors into account. They're not set in stone and don't indicate what will happen in your case.

Stage of Cervical Cancer

Cancer stage is determined by the amount of spread that has occurred. The lower the stage, the less the cancer has spread. Cancer that is caught early with little to no spread is easier to treat and cure than later stages earmarked by spread to other organs and distant parts of the body.

Cervical cancer is broken down into stages, ranging in severity from 1 to 4. The International Federation of Gynecology and Obstetrics (FIGO) staging system is used to classify each stage accordingly:

Stage 1: This is localized cancer that has not spread out of the cervix. If you have stage 1 cervical cancer, your cancer has spread from the surface of the cervix deeper into cervical tissues. This stage is typically asymptomatic (has no symptoms). Stage 1 cervical cancer often responds very well to treatment. Many treatments for stage 1 disease do not affect fertility.

Stage 2: This is regional cancer that has spread outside of the cervix and uterus. It has not reached nearby lymph nodes or organs. You may have symptoms such as pelvic pain or bleeding from vaginal sex. You may also notice abnormal menstrual bleeding, such as spotting between periods or heavier bleeding during menstruation.  

Stage 3: At this stage, cervical cancer has spread outside the cervix into the pelvic walls or lower portion of the vagina. It may also have spread into nearby lymph nodes. The tumors may be large enough to adversely affect kidney function. You may have symptoms such as trouble urinating, back pain, swollen legs, and see blood in your urine.

Stage 4: Stage 4 cervical cancer has spread to nearby organs or other areas of the body, such as the bones, lungs, liver, or brain. Recurrent cervical cancer (cancer that has returned) is included in this stage. Your symptoms during stage 4 will be influenced by the location of metastasis (spread). They may include fatigue, weakness, and trouble breathing.  

Type of Cervical Cancer

The cervix is made up of two parts. Each part is covered in a different type of cell. The type of cervical cell that becomes malignant (cancerous) may impact prognosis.

The two parts of the cervix are:

• Endocervix: The endocervix is the part of the cervix that leads into the uterus. It is covered with glandular cells. Cervical cancers that develop from glandular cells are called adenocarcinomas. 
• Ectocervix: This part of the cervix is also referred to as the exocervix. It is the outer part of the cervix. The ectocervix is covered with squamous cells. Nine out of 10 cervical cancers are squamous cell carcinomas that begin in the ectocervix.

Squamous cell carcinomas and adenocarcinomas are the most common types of cervical cancer. Some tumors may contain both types of cells, although this is less common. Tumors with both types of cells are known as mixed carcinomas or adenosquamous carcinomas.

Some data indicate that adenocarcinomas are harder to treat and produce worse outcomes than squamous cell carcinomas. One study notes that the difference in survival rates between the two have only been noted when there is regional spread, not localized or distant spread.

Response to Treatment

Cervical cancer treatment is designed to stop cancer from growing or spreading. Sometimes, treatments may not be as effective as you and your healthcare team had hoped they would be.

In some instances, cancer cells may be unresponsive to cancer medications before they've even been tried. Treatments that were effective at first can also stop working. This is known as treatment resistance, chemotherapy resistance, or drug resistance. Drug resistance can happen within weeks, or gradually over months or years.

When your response to treatment is less than optimal, it gives cancer cells an opportunity to grow and form new tumors. This can cause a recurrence or relapse.

Doctors often combat this phenomenon by using new treatments. These include combining and coadministering various combinations of cancer drugs. 

Overall Health

The stronger you are, the better able you may be to handle the rigors of treatments such as chemotherapy and surgery. That's one of the reasons why self-care and good nutrition are so important after getting a cancer diagnosis.

You may also have chronic health conditions that complicate your treatment choices or impact recovery. Cancer treatments, including chemotherapy and radiation, can worsen heart failure (the heart does not pump enough blood for the body's needs), abnormal heart rhythms, and high blood pressure.

If you have diabetes, cancer treatments may make it harder for you to manage blood glucose levels. This may lead to poor wound healing. It may also mean delaying cancer treatments such as surgery.  

If you have one or more coexisting conditions, keep an open dialogue with all of the specialists in charge of your care. Managing multiple conditions can be challenging but isn't uncommon or impossible.

Treatment Options

Cervical cancer treatment is determined in large part by stage and spread. Your age and overall health will also be determinant factors. Based on your response to treatment, you may have one or more treatment types.

Surgery

Surgery may be done to diagnose or treat cervical cancer. There are several surgical procedures that may be used. They include:

Cone biopsy (conization): Cone biopsies are a type of excisional surgery (removing tissue with a cutting instrument) used to diagnose or treat precancers and cancers. They’re done in people with precancerous changes to the cervix and in people with stage 1 cervical cancer who wish to remain fertile.

Cone biopsies are outpatient procedures. A cone-shaped portion of tissue is removed from the area of the cervix where cancer is most likely to be found.

If the edges of the cone have negative margins (are free from cancer), no additional treatment may be needed. If the edges of the cone biopsy have positive margins (cancer cells have been found), additional treatments will be needed.

Radical trachelectomy: This is another fertility-saving procedure. The cervix and upper part of the vagina are removed, often via laparoscopy (surgery performed by instruments inserted through small incisions with the aid of a camera). Nearby lymph nodes will also be removed to check for spread.

Simple hysterectomy: More invasive cervical cancer may be treated with a simple hysterectomy. The cervix and uterus are removed in this procedure, but the structures next to the uterus (parametria and uterosacral ligaments) are left intact.

Radical hysterectomy: Cancer that has spread outside the cervix and uterus may be treated with a radical hysterectomy. In addition to the cervix and uterus, the parametria and uterosacral ligaments will be removed. The upper part of the vagina, located next to the cervix, will also be removed. Lymph nodes will be excised as well to check for cancer spread.

Pelvic exenteration: This extensive surgical procedure may be done in people whose cervical cancer has returned after treatment. Your surgeon will remove all of the tissues taken out during a radical hysterectomy. The bladder, vagina, rectum, and part of the colon will also be removed.

Lymph node removal: Several procedures may be recommended to remove nearby lymph nodes. These procedures are typically done during surgeries such as a hysterectomy (removal of the uterus). Lymph node removal procedures include pelvic lymph node dissection (removes all lymph nodes in the pelvis to examine for cancer), and para-aortic lymph node sampling (removing and examining the lymph nodes around the aorta).

Chemotherapy

Chemotherapy uses anticancer drugs to kill cancer cells throughout the body. If you have advanced cervical cancer that has spread to distant organs or tissues, this treatment may be used. Chemotherapy is also used when cervical cancer returns.

Chemo medications may be given via intravenous infusion or orally. You may be given one or several types of drugs.

Chemotherapy may be used alone or in conjunction with radiation. This treatment is referred to as concurrent chemoradiation.     

Radiotherapy (Radiation)

Radiation may be used to treat cervical cancer at various stages. In some instances, it may be used as a sole treatment. It may also be done before or after surgery, or in conjunction with chemotherapy.

If you have advanced cervical cancer, radiation may be used as a palliative treatment (to reduce symptoms such as pain but not intended to cure).

In stage 1, external beam radiation to the pelvis plus brachytherapy (internally applied radiation) may be used if you don’t wish to preserve your fertility.

Targeted Drug Therapy

Targeted drug therapy uses medications to target the proteins on cancer cells that support their spread and growth. Targeted therapy medications inhibit the action of these proteins or destroy them so that cancer cells die or are slowed down. These medications may be used alone or in conjunction with other treatments, such as chemotherapy.

Targeted drugs may be used during stage 4 to treat recurrent or metastatic cervical cancer. They may also be used during earlier stages to treat locally advanced cervical cancer (a large tumor or it has grown into the tissues around the cervix).

Immunotherapy

Immunotherapy utilizes medications that boost the immune system so that your body can better fight off cancer. Immunotherapy drugs help your immune system recognize and destroy cancer cells throughout the body.

Immunotherapy may be used alone or with chemotherapy to treat recurrent cancer. It may also be used, with or without chemotherapy, to treat cervical cancer that has spread to distant sites or that isn't shrinking in response to traditional treatments.    

Can Cancer Come Back?

Cervical cancer can come back months or years after treatment and remission. Remission refers to the decrease or complete disappearance of cancer signs and symptoms. Remission can be partial or complete.

Cancer that returns is known as recurrence. Cervical cancer recurrence may be caused by cancer cells that were undetected at the time of treatment. It can also be caused by new cancer cell growth.

Recurrent cervical cancer can be local (in the cervix), regional (in nearby lymph nodes or tissues), or distant (in other parts of the body).  The location of the recurrence will determine the treatment you have.

It can be scary and upsetting to find out your cancer has returned, especially if it has been in remission for some time. Recurrent cervical cancer can be challenging to treat.

However, treatments may be used to prolong life and keep you comfortable, active, and thriving. These include chemoradiation, targeted therapy, and surgery. You may also wish to talk to your healthcare team about participating in a clinical trial.  

What If Your Cancer Cannot Be Treated?

Stage 4 cervical cancer is usually considered incurable. It’s up to you how long you wish to continue with aggressive treatments at this stage.

Cancer treatments can also stop working. If you’ve tried many options without success, it may be time to reassess the pros and cons of continuing treatment, especially if you’re grappling with challenging side effects.

If you choose to end treatment or believe your cancer can’t be treated successfully, talk to the people on your medical team. Choose the ones you trust and feel most comfortable with. This may be your oncologist, therapist, or hospital social worker.

Ask for their opinion on your options, including whether you should continue treatment or stop. This may also be a good time to seek a second opinion from an oncologist (a cancer specialist) from another medical facility. Finding out about clinical trials you may be eligible for can also be an option.

If it feels comfortable, talk to your loved ones and family members. It is your body and your life, but your decisions will impact the people who love you.

Take advantage of palliative care options that lessen your symptoms. Doing so can increase your quality of life so you can enjoy the people and activities you love for a longer time.

This will be a challenging time for you. It may help to know that whatever decision you make for yourself will be the right one.

Summary

Cervical cancer is treatable and curable if it is caught early. Cervical cancer is identified in stages, from 1 to 4. The stage your cancer is in when you are first diagnosed can have an impact on your prognosis. The higher the stage, the more spread that has occurred.

There are treatments for cervical cancer at every stage. Stage 4 cervical cancer is usually incurable. However, hope is always possible.

A Word From Verywell

No matter what stage it’s in, it’s difficult to learn you have cervical cancer. At this time, it’s vitally important to remain up-to-date and informed about your options.

This doesn’t mean you have to study like a medical student and read all the new research (unless you want to). It does mean having a cancer team in place you trust, so they keep you informed about treatments that may benefit you.

It’s also important to stay healthy and well-nourished. Take care of yourself by getting enough sleep and reducing stress as best you can. Whether or not your cancer is deemed curable, do your best to keep hope and serenity alive.