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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="PDQ Cancer Information Summaries [Internet]" /><meta name="citation_title" content="Cervical Cancer Treatment (PDQ®)" /><meta name="citation_publisher" content="National Cancer Institute (US)" /><meta name="citation_date" content="2022/04/06" /><meta name="citation_author" content="PDQ Adult Treatment Editorial Board" /><meta name="citation_pmid" content="26389422" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK65985/" /><meta name="citation_keywords" content="cervical cancer" /><meta name="citation_keywords" content="cervical cancer" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Cervical Cancer Treatment (PDQ®)" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Cancer Institute (US)" /><meta name="DC.Contributor" content="PDQ Adult Treatment Editorial Board" /><meta name="DC.Date" content="2022/04/06" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK65985/" /><meta name="description" content="Cervical cancer treatment options can include surgery, radiation therapy, chemotherapy, and/or targeted therapy. Learn more about the diagnosis and treatment of newly diagnosed and recurrent cervical cancer in this expert-reviewed summary." /><meta name="og:title" content="Cervical Cancer Treatment (PDQ®)" /><meta name="og:type" content="book" /><meta name="og:description" content="Cervical cancer treatment options can include surgery, radiation therapy, chemotherapy, and/or targeted therapy. Learn more about the diagnosis and treatment of newly diagnosed and recurrent cervical cancer in this expert-reviewed summary." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK65985/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/pdqcis/CDR0000062961/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK65985/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="NONE" />
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65985_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65985_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65985_"><span class="title" itemprop="name">Cervical Cancer Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: April 6, 2022.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062961__335">This PDQ cancer information summary has current information about the treatment of cervical cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000062961__336">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000062961__117"><h2 id="_CDR0000062961__117_">General Information About Cervical Cancer</h2><div id="CDR0000062961__117.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062961__118">Cervical cancer is a disease in which malignant (cancer) cells
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form in the tissues of the cervix.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__122">Human papillomavirus (HPV) infection is the major risk factor
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for cervical cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__127">There are usually no signs or symptoms of early cervical cancer
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but it can be detected early with regular check-ups.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__130">Signs and symptoms of cervical cancer include vaginal bleeding and
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pelvic pain.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__134">Tests that examine the cervix are used to diagnose cervical cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__138">Certain factors affect prognosis (chance
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of recovery) and treatment options.</a></div></li></ul></div><div id="CDR0000062961__118"><h3>Cervical cancer is a disease in which malignant (cancer) cells
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form in the tissues of the cervix.</h3><p id="CDR0000062961__120">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046133/" class="def">cervix</a> is the lower,
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narrow end of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046645/" class="def">uterus</a> (the
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hollow, pear-shaped <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a> where a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046400/" class="def">fetus</a> grows). The cervix leads from the uterus to
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the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a> (birth canal).</p><div id="CDR0000062961__263" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Anatomy%20of%20the%20female%20reproductive%20system&p=BOOKS&id=579421_CDR0000609921.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000609921.jpg" alt="Anatomy of the female reproductive system; drawing shows the uterus, myometrium (muscular outer layer of the uterus), endometrium (inner lining of the uterus), ovaries, fallopian tubes, cervix, and vagina." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Anatomy of the female reproductive system. The organs in the female reproductive system include the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus has a muscular outer layer called the myometrium and an inner lining called the endometrium. </p></div></div><p id="CDR0000062961__121">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444973/" class="def">Cervical cancer</a> usually develops slowly over time. Before <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>
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appears in the cervix, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> of
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the cervix go through changes known as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045675/" class="def">dysplasia</a>, in which <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> cells
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begin to appear in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044102/" class="def">cervical</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>. Over time, the abnormal cells may become cancer cells and start to grow and
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spread more deeply into the cervix and to surrounding areas. </p><p id="CDR0000062961__243">Cervical cancer in children is rare.</p><p id="CDR0000062961__337">See the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summaries for more information about cervical cancer:</p><ul id="CDR0000062961__338"><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000062817/">Cervical Cancer Prevention</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000304518/">Cervical Cancer Screening</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000799642/">Childhood Cervical and Vaginal Cancer Treatment</a>
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</div></li></ul></div><div id="CDR0000062961__122"><h3>Human papillomavirus (HPV) infection is the major risk factor
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for cervical cancer.</h3><p id="CDR0000062961__sm_CDR0000753255_10"><div class="milestone-start" id="CDR0000062961__sm_CDR0000753255_1"></div>Anything that increases your chance of getting a disease
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is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045873/" class="def">risk factor</a>. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444973/" class="def">cervical cancer</a>.</p><p id="CDR0000062961__sm_CDR0000753255_12">Risk factors for cervical cancer include the following:</p><ul id="CDR0000062961__sm_CDR0000753255_3"><li class="half_rhythm"><div>Being <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infected</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045714/" class="def">human
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papillomavirus</a> (HPV). This is the most important risk factor for cervical cancer.</div></li><li class="half_rhythm"><div>Being exposed to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drug</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044873/" class="def">DES</a> (diethylstilbestrol) while in the mother's <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044473/" class="def">womb</a>.</div></li></ul><p id="CDR0000062961__sm_CDR0000753255_13">In women who are infected with HPV, the following risk factors add to the increased risk of cervical cancer:</p><ul id="CDR0000062961__sm_CDR0000753255_14"><li class="half_rhythm"><div> Giving birth to many children.</div></li><li class="half_rhythm"><div>Smoking <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000748148/" class="def">cigarettes</a>.</div></li><li class="half_rhythm"><div>Using <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443306/" class="def">oral contraceptives</a> ("the Pill") for a long time.</div></li></ul><p id="CDR0000062961__sm_CDR0000753255_15">There are also risk factors that increase the risk of HPV infection:</p><ul id="CDR0000062961__sm_CDR0000753255_16"><li class="half_rhythm"><div>Having a weakened <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> caused by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045727/" class="def">immunosuppression</a>. Immunosuppression weakens the body’s ability to fight infections and other diseases. The body's ability to fight HPV infection may be lowered by long-term immunosuppression from: <dl id="CDR0000062961__sm_CDR0000753255_17" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">being infected with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044366/" class="def">human immunodeficiency virus</a> (HIV).</p></dd><dt>-</dt><dd><p class="no_top_margin">taking <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">medicine</a> to help prevent <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a> rejection after a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046631/" class="def">transplant</a>.</p></dd></dl></div></li><li class="half_rhythm"><div>Being sexually active at a young age.</div></li><li class="half_rhythm"><div>Having many sexual partners.</div></li></ul><p id="CDR0000062961__sm_CDR0000753255_11">Older age is a main risk factor for most cancers. The chance of getting cancer increases as you get older. <div class="milestone-end"></div></p></div><div id="CDR0000062961__127"><h3>There are usually no signs or symptoms of early cervical cancer
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but it can be detected early with regular check-ups.</h3><p id="CDR0000062961__129">Early cervical cancer may not cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>. Women should have regular
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check-ups, including tests to check for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045714/" class="def">human papillomavirus</a> (HPV) or abnormal cells in the cervix. The
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> (chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>) is
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better when the cancer is found early.</p></div><div id="CDR0000062961__130"><h3>Signs and symptoms of cervical cancer include vaginal bleeding and
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pelvic pain.</h3><p id="CDR0000062961__132">These and other signs and symptoms may be caused by cervical cancer or by other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a>.
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Check with your doctor if you have any of the following:</p><ul id="CDR0000062961__133"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044308/" class="def">Vaginal</a> bleeding (including bleeding after sexual intercourse).</div></li><li class="half_rhythm"><div>Unusual vaginal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443583/" class="def">discharge</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045087/" class="def">Pelvic</a>
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pain.</div></li><li class="half_rhythm"><div>Pain during sexual intercourse.</div></li></ul></div><div id="CDR0000062961__134"><h3>Tests that examine the cervix are used to diagnose cervical cancer.</h3><p id="CDR0000062961__136">The following procedures may be used:</p><ul id="CDR0000062961__137"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000798522/" class="def">health history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322873/" class="def">Pelvic exam</a></b>: An exam of the vagina, cervix, uterus, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tubes</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovaries</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046588/" class="def">speculum</a> is inserted into the vagina and the doctor or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269445/" class="def">nurse</a> looks at the vagina and cervix for signs of disease. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045978/" class="def">Pap test</a> of the cervix is usually done. The doctor or nurse also inserts one or two <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046302/" class="def">lubricated</a>, gloved fingers of one hand into the vagina and places the other hand over the lower <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> to feel the size, shape, and position of the uterus and ovaries. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.<div id="CDR0000062961__265" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Pelvic%20exam&p=BOOKS&id=579421_CDR0000609924.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000609924.jpg" alt="Pelvic exam; drawing shows a side view of the female reproductive anatomy during a pelvic exam. The uterus, left fallopian tube, left ovary, cervix, vagina, bladder, and rectum are shown. Two gloved fingers of one hand of the doctor or nurse are shown inserted into the vagina, while the other hand is shown pressing on the lower abdomen. The inset shows a woman covered by a drape on an exam table with her legs apart and her feet in stirrups." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Pelvic exam. A doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand. This is done to feel the size, shape, and position of the uterus and ovaries. The vagina, cervix, fallopian tubes, and rectum are also checked.</p></div></div></div></li><li class="half_rhythm"><div><b>Pap test</b>: A procedure that uses a small brush to collect cells from the surface of the cervix and the area around it. The cells are viewed under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to find out if they are abnormal. This procedure is also called a Pap smear.<div id="CDR0000062961__289" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Pap%20test&p=BOOKS&id=579421_CDR0000609927.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000609927.jpg" alt="Pap test; drawing shows a side view of the female reproductive anatomy during a Pap test. A speculum is shown widening the opening of the vagina. A brush is shown inserted into the open vagina and touching the cervix at the base of the uterus. The rectum is also shown. One inset shows the brush touching the center of the cervix. A second inset shows a woman covered by a drape on an exam table with her legs apart and her feet in stirrups." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Pap test. A speculum is inserted into the vagina to widen it. Then, a brush is inserted into the vagina to collect cells from the cervix. The cells are checked under a microscope for signs of disease.</p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000666689/" class="def">Human papillomavirus (HPV) test</a></b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046590/" class="def">laboratory test</a> used to check <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045671/" class="def">DNA</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046568/" class="def">RNA</a> for certain types of HPV <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a>. Cells are collected from the cervix and DNA or RNA from the cells is checked to find out if an infection is caused by a type of HPV that is linked to cervical cancer. This test may be done using the sample of cells removed during a Pap test. This test may also be done if the results of a Pap test show certain abnormal cervical cells.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046438/" class="def">Endocervical
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curettage</a></b>: A procedure to collect cells or tissue from the cervical canal using a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046460/" class="def">curette</a> (spoon-shaped instrument). Tissue samples are taken and checked under a microscope for signs of cancer. This procedure is sometimes done at the same time as a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045989/" class="def">colposcopy</a>.</div></li><li class="half_rhythm"><div><b>Colposcopy</b>: A procedure in which a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046465/" class="def">colposcope</a> (a lighted, magnifying instrument) is used to check the vagina and cervix for abnormal areas. Tissue samples may be taken using a curette (spoon-shaped instrument) or a brush and checked under a microscope for signs of disease.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">Biopsy</a></b>: If abnormal
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cells are found in a Pap test, the doctor may do a biopsy. A sample of tissue
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is cut from the cervix and viewed under a microscope by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> to check for signs of cancer. A biopsy that removes
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only a small amount of tissue is usually done in the doctor’s office. A woman
|
|
may need to go to a hospital for a cervical <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046752/" class="def">cone
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biopsy</a> (removal of a larger, cone-shaped sample of cervical
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tissue).</div></li></ul></div><div id="CDR0000062961__138"><h3>Certain factors affect prognosis (chance
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of recovery) and treatment options.</h3><p id="CDR0000062961__239">The prognosis depends on the following:</p><ul id="CDR0000062961__240"><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer (the size of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> and whether it
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affects part of the cervix or the whole cervix, or has spread to the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> or other places in the
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body).</div></li><li class="half_rhythm"><div>The type of cervical cancer.</div></li><li class="half_rhythm"><div>The patient's age and general health.</div></li><li class="half_rhythm"><div>Whether the patient has a certain type of human papillomavirus (HPV).</div></li><li class="half_rhythm"><div>Whether the patient has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044366/" class="def">human immunodeficiency virus</a> (HIV).</div></li><li class="half_rhythm"><div>Whether the cancer has just been <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> or has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back).</div></li></ul><p id="CDR0000062961__241">Treatment options depend on the following:</p><ul id="CDR0000062961__242"><li class="half_rhythm"><div>The stage of the cancer.</div></li><li class="half_rhythm"><div>The type of cervical cancer.</div></li><li class="half_rhythm"><div>The patient's desire to have
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children.</div></li><li class="half_rhythm"><div>The patient’s age.</div></li></ul><p id="CDR0000062961__141">Treatment of cervical cancer during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000666677/" class="def">pregnancy</a> depends on the stage
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of the cancer and the stage of the pregnancy. For cervical cancer found early
|
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or for cancer found during the last trimester of pregnancy, treatment may be
|
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delayed until after the baby is born. For more information, see the section on <a href="#CDR0000062961__296">Cervical Cancer During Pregnancy</a>.</p></div></div><div id="CDR0000062961__142"><h2 id="_CDR0000062961__142_">Stages of Cervical Cancer</h2><div id="CDR0000062961__142.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062961__143">After cervical cancer has been diagnosed, tests are done to
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find out if cancer cells have spread within the cervix or to other parts of the
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body. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__252">There are three ways that cancer spreads in the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__286">Cancer may spread from where it began to other parts of the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__1354">Abnormal cells may form in the lining of the cervix (carcinoma in situ).</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__1357">The following stages are used for cervical cancer:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062961__1365">Stage I</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__1368">Stage II</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__1375">Stage III</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__1382">Stage IV</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000062961__1403">Cervical cancer can recur (come back) after it has been treated.</a></div></li></ul></div><div id="CDR0000062961__143"><h3>After cervical cancer has been diagnosed, tests are done to
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find out if cancer cells have spread within the cervix or to other parts of the
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body. </h3><p id="CDR0000062961__145">The process used to find out if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread within the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046133/" class="def">cervix</a> or to other parts of the body
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is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">staging</a>. The information
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gathered from the staging process determines the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the disease. It is important to know the
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stage in order to plan treatment. </p><p id="CDR0000062961__317">The following tests and procedures
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may be used in the staging process:</p><ul id="CDR0000062961__146"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT
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scan)</b>: A procedure that makes a series of detailed pictures of areas inside the
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body, taken from different angles. The pictures are made by a computer linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> machine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or swallowed to help the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> show up more clearly. This procedure is also called computed tomography,
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computerized tomography, or computerized axial tomography.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046140/" class="def">PET scan</a> (positron emission tomography scan)</b>: A procedure to find <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the body. A small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044033/" class="def">glucose</a> (sugar) is injected into a vein. The PET <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a> rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic resonance imaging)</b>: A procedure that uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046157/" class="def">Ultrasound</a> exam</b>: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046587/" class="def">sonogram</a>. This picture can be printed to be looked at later.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304687/" class="def">Chest x-ray</a></b>: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000793499/" class="def">Lymph node biopsy</a></b>: The removal of all or part of a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph node</a>. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the lymph node tissue under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to check for cancer cells.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045988/" class="def">Cystoscopy</a></b>: A procedure to look inside the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046640/" class="def">urethra</a> to check for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> areas. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046455/" class="def">cystoscope</a> is inserted through the urethra into the bladder. A cystoscope is a thin, tube-like instrument with a light and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000572035/" class="def">lens</a> for viewing. It may also have a tool to remove tissue samples, which are checked under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> of cancer. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045556/" class="def">Laparoscopy</a></b>: A surgical procedure to look at the organs inside the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> to check for signs of disease. Small <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046353/" class="def">incisions</a> (cuts) are made in the wall of the abdomen and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044360/" class="def">laparoscope</a> (a thin, lighted tube) is inserted into one of the incisions. Other instruments may be inserted through the same or other incisions to perform procedures such as removing organs or taking tissue samples to be checked under a microscope for signs of disease.
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</div></li><li class="half_rhythm"><div>
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<b>Pretreatment surgical staging</b>: <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> (an operation) is done to find out if the
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cancer has spread within the cervix or to other parts of the body. In some
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cases, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444973/" class="def">cervical cancer</a> can be removed at the same time. Pretreatment
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surgical staging is usually done only as part of a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a>. </div></li></ul><p id="CDR0000062961__147">The results of these tests are viewed together with the results of
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the original tumor <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a> to
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determine the cervical cancer stage.</p></div><div id="CDR0000062961__252"><h3>There are three ways that cancer spreads in the body.</h3><p id="CDR0000062961__252_69">Cancer can spread through <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045764/" class="def">lymph system</a>, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>:</p><ul id="CDR0000062961__252_70"><li class="half_rhythm"><div>Tissue. The cancer spreads from where it began by growing into nearby areas.
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</div></li><li class="half_rhythm"><div>Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269462/" class="def">lymph vessels</a> to other parts of the body.
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</div></li><li class="half_rhythm"><div>Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> to other parts of the body.
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</div></li></ul></div><div id="CDR0000062961__286"><h3>Cancer may spread from where it began to other parts of the body.</h3><p id="CDR0000062961__286_66">When cancer spreads to another part of the body, it is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a>. Cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> break away from where they began (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>) and travel through the lymph system or blood.</p><ul id="CDR0000062961__286_67"><li class="half_rhythm"><div>Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> tumor) in another part of the body.</div></li><li class="half_rhythm"><div>Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.</div></li></ul><p id="CDR0000062961__288">The metastatic tumor is the same type of cancer as the primary tumor. For example, if cervical cancer spreads to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>, the cancer cells in the lung are actually cervical cancer cells. The disease is metastatic cervical cancer, not lung cancer.</p><div id="CDR0000062961__342" class="box"><h3><span class="title">metastasis: how cancer spreads</span></h3><div class="caption"><p>Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.</p></div><p><a href="https://www.youtube.com/watch?v=fQwar_-QdiQ" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div></div><div id="CDR0000062961__1354"><h3>Abnormal cells may form in the lining of the cervix (carcinoma in situ).</h3><p id="CDR0000062961__1356">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046488/" class="def">carcinoma in situ</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> are found in the innermost lining of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046133/" class="def">cervix</a>. These abnormal cells may become <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> and spread into nearby normal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>.</p></div><div id="CDR0000062961__1357"><h3>The following stages are used for cervical cancer:</h3><div id="CDR0000062961__1365"><h4>Stage I</h4><p id="CDR0000062961__1360">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045886/" class="def">stage I</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has formed and is found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046133/" class="def">cervix</a> only.</p><p id="CDR0000062961__1361">Stage I is divided into stages IA and IB, based on the size of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> and the deepest point of tumor invasion.</p><ul id="CDR0000062961__1362"><li class="half_rhythm"><div>Stage IA: Stage IA is divided into stages IA1 and IA2, based on the deepest point of tumor invasion.<div id="CDR0000062961__1387" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IA1%20and%20IA2%20cervical%20cancer&p=BOOKS&id=579421_CDR0000658902.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000658902.jpg" alt="Stage IA1 and IA2 cervical cancer; drawing shows a cross-section of the cervix and vagina. An inset shows cancer cells in the cervix that can only be seen under a microscope. The cancer in stage IA1 is not more than 3 mm deep. The cancer in stage IA2 is more than 3 but not more than 5 mm deep." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IA1 and IA2 cervical cancer. A very small amount of cancer that can only be seen under a microscope is found in the tissues of the cervix. In stage IA1, the cancer is not more than 3 millimeters deep. In stage IA2, the cancer is more than 3 but not more than 5 millimeters deep.</p></div></div><ul id="CDR0000062961__1364"><li class="half_rhythm"><div>In stage IA1, a very small amount of cancer that can only be seen with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> is found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> of the cervix. The deepest point of tumor invasion is 3 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044215/" class="def">millimeters</a> or less.</div></li><li class="half_rhythm"><div>In stage IA2, a very small amount of cancer that can only be seen with a microscope is found in the tissues of the cervix. The deepest point of tumor invasion is more than 3 millimeters but not more than 5 millimeters.</div></li></ul><div id="CDR0000062961__260" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Millimeters%20(mm)&p=BOOKS&id=579421_CDR0000578121.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000578121.jpg" alt="Millimeters; drawing shows millimeters (mm) using everyday objects. A sharp pencil point shows 1 mm, a new crayon point shows 2 mm, and a new pencil-top eraser shows 5 mm." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Millimeters (mm). A sharp pencil point is about 1 mm, a new crayon point is about 2 mm, and a new pencil eraser is about 5 mm.</p></div></div></div></li><li class="half_rhythm"><div>Stage IB: Stage IB is divided into stages IB1, IB2, and IB3, based on the size of the tumor and the deepest point of tumor invasion. <ul id="CDR0000062961__1367"><li class="half_rhythm"><div>In stage IB1, the tumor is 2 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller and the deepest point of tumor invasion is more than 5 millimeters.<div id="CDR0000062961__1388" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IB1%20cervical%20cancer&p=BOOKS&id=579421_CDR0000658903.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000658903.jpg" alt="Stage IB1 cervical cancer; drawing shows a cross-section of the cervix and vagina and cancer in the cervix that is smaller than 2 cm. An inset shows cancer that is more than 5 mm deep. Also shown is a 2-cm scale that shows 10 mm is equal to 1 cm." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IB1 cervical cancer. The cancer is 2 centimeters or smaller and is more than 5 millimeters deep.</p></div></div></div></li><li class="half_rhythm"><div>In stage IB2, the tumor is larger than 2 centimeters but not larger than 4 centimeters.<div id="CDR0000062961__1389" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IB2%20and%20IB3%20cervical%20cancer&p=BOOKS&id=579421_CDR0000800957.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000800957.jpg" alt="Stage IB2 and IB3 cervical cancer; drawing shows two cross-sections of the cervix and vagina. The drawing on the left shows stage IB2 cancer in the cervix that is larger than 2 cm but not larger than 4 cm. The drawing on the right shows stage IB3 cancer in the cervix that is larger than 4 cm." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IB2 and IB3 cervical cancer. In stage IB2, the cancer is larger than 2 centimeters but not larger than 4 centimeters. In stage IB3, the cancer is larger than 4 centimeters. </p></div></div></div></li><li class="half_rhythm"><div>In stage IB3, the tumor is larger than 4 centimeters.</div></li></ul><div id="CDR0000062961__1370" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Tumor%20sizes%20are%20often%20measured%20in%20centimeters%20(cm)%20or%20inches&p=BOOKS&id=579421_CDR0000415526.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000415526.jpg" alt="Drawing shows different sizes of a tumor in centimeters (cm) compared to the size of a pea (1 cm), a peanut (2 cm), a grape (3 cm), a walnut (4 cm), a lime (5 cm), an egg (6 cm), a peach (7 cm), and a grapefruit (10 cm). Also shown is a 10-cm ruler and a 4-inch ruler." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Tumor sizes are often measured in centimeters (cm) or inches. Common food items that can be used to show tumor size in cm include: a pea (1 cm), a peanut (2 cm), a grape (3 cm), a walnut (4 cm), a lime (5 cm or 2 inches), an egg (6 cm), a peach (7 cm), and a grapefruit (10 cm or 4 inches).</p></div></div></div></li></ul></div><div id="CDR0000062961__1368"><h4>Stage II</h4><p id="CDR0000062961__1371">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045887/" class="def">stage II</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread to the upper two-thirds of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a> or to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> around the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046645/" class="def">uterus</a>.</p><p id="CDR0000062961__1372">Stage II is divided into stages IIA and IIB, based on how far the cancer has spread. </p><div id="CDR0000062961__1390" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20II%20cervical%20cancer&p=BOOKS&id=579421_CDR0000658904.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000658904.jpg" alt="Stage II cervical cancer; drawing shows two cross-sections of the uterus, cervix, and vagina. The drawing on the left shows stages IIA1 and IIA2 cancer in the cervix that is 4 cm and has spread to the upper two-thirds of the vagina. The drawing on the right shows stage IIB cancer that has spread from the cervix to the tissue around the uterus." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage II cervical cancer. In stages IIA1 and IIA2, cancer has spread from the cervix to the upper two-thirds of the vagina but has not spread to the tissue around the uterus. In stage IIA1, the cancer is 4 centimeters or smaller. In stage IIA2, the cancer is larger than 4 centimeters. In stage IIB, cancer has spread from the cervix to the tissue around the uterus.</p></div></div><ul id="CDR0000062961__1373"><li class="half_rhythm"><div>Stage IIA: Cancer has spread from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046133/" class="def">cervix</a> to the upper two-thirds of the vagina but has not spread to the tissue around the uterus. Stage IIA is divided into stages IIA1 and IIA2, based on the size of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>.<ul id="CDR0000062961__1374"><li class="half_rhythm"><div>In stage IIA1, the tumor is 4 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller.</div></li><li class="half_rhythm"><div>In stage IIA2, the tumor is larger than 4 centimeters.</div></li></ul></div></li><li class="half_rhythm"><div>Stage IIB: Cancer has spread from the cervix to the tissue around the uterus.</div></li></ul></div><div id="CDR0000062961__1375"><h4>Stage III</h4><p id="CDR0000062961__1377">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045888/" class="def">stage III</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread to the lower third of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a> and/or to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000410631/" class="def">pelvic wall</a>, and/or has caused <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidney</a> problems, and/or involves <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.</p><p id="CDR0000062961__1378">Stage III is divided into stages IIIA, IIIB, and IIIC, based on how far the cancer has spread.</p><ul id="CDR0000062961__1379"><li class="half_rhythm"><div>Stage IIIA: Cancer has spread to the lower third of the vagina but has not spread to the pelvic wall.
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<div id="CDR0000062961__1391" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIIA%20cervical%20cancer&p=BOOKS&id=579421_CDR0000670190.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000670190.jpg" alt="Stage IIIA cervical cancer; drawing shows a cross-section of the cervix and vagina. Cancer is shown in the cervix and in the full length of the vagina." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIIA cervical cancer. Cancer has spread to the lower third of the vagina but has not spread to the pelvic wall.</p></div></div></div></li><li class="half_rhythm"><div>Stage IIIB: Cancer has spread to the pelvic wall; and/or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> has become large enough to block one or both <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046638/" class="def">ureters</a> or has caused one or both kidneys to get bigger or stop working.<div id="CDR0000062961__1392" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIIB%20cervical%20cancer&p=BOOKS&id=579421_CDR0000670191.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000670191.jpg" alt="Stage IIIB cervical cancer; drawing shows cancer in the cervix and pelvic wall. Also shown is cancer blocking the right ureter and an enlarged right ureter and right kidney. The uterus, bladder, and vagina are also shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIIB cervical cancer. Cancer has spread to the pelvic wall and/or the tumor has become large enough to block one or both ureters or has caused one or both kidneys to get bigger or stop working.</p></div></div></div></li><li class="half_rhythm"><div>Stage IIIC: Stage IIIC is divided into stages IIIC1 and IIIC2, based on the spread of cancer to the lymph nodes.<div id="CDR0000062961__1393" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIIC%20cervical%20cancer&p=BOOKS&id=579421_CDR0000800958.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000800958.jpg" alt="Stage IIIC cervical cancer; drawing shows stage IIIC1 cancer that has spread from the cervix to lymph nodes in the pelvis and stage IIIC2 cancer that has spread from the cervix to lymph nodes in the abdomen near the aorta." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIIC cervical cancer. In stage IIIC1, cancer has spread to lymph nodes in the pelvis. In stage IIIC2, cancer has spread to lymph nodes in the abdomen near the aorta.</p></div></div><ul id="CDR0000062961__1381"><li class="half_rhythm"><div>In stage IIIC1, cancer has spread to lymph nodes in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a>.</div></li><li class="half_rhythm"><div>In stage IIIC2, cancer has spread to lymph nodes in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> near the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044527/" class="def">aorta</a>.</div></li></ul></div></li></ul></div><div id="CDR0000062961__1382"><h4>Stage IV</h4><p id="CDR0000062961__1384">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045889/" class="def">stage IV</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread beyond the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a>, or has spread to the lining of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>, or has spread to other parts of the body.</p><p id="CDR0000062961__1385">Stage IV is divided into stages IVA and IVB, based on where the cancer has spread.</p><ul id="CDR0000062961__1386"><li class="half_rhythm"><div>Stage IVA: Cancer has spread to nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045087/" class="def">pelvic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a>, such as the bladder or rectum.<div id="CDR0000062961__1394" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVA%20cervical%20cancer&p=BOOKS&id=579421_CDR0000713967.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000713967.jpg" alt="Stage IVA cervical cancer; drawing and inset show cancer that has spread from the cervix to the bladder and rectal wall." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVA cervical cancer. Cancer has spread to nearby pelvic organs, such as the bladder or rectum.</p></div></div></div></li><li class="half_rhythm"><div>Stage IVB: Cancer has spread to other parts of the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a>, bones, or distant <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.<div id="CDR0000062961__1395" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVB%20cervical%20cancer&p=BOOKS&id=579421_CDR0000713968.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000713968.jpg" alt="Stage IVB cervical cancer; drawing shows other parts of the body where cervical cancer may spread, including the lymph nodes, lung, liver, and bone. An inset shows cancer cells spreading from the cervix, through the blood and lymph system, to another part of the body where metastatic cancer has formed." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVB cervical cancer. Cancer has spread to other parts of the body, such as the lymph nodes, lung, liver, or bone.</p></div></div></div></li></ul></div></div><div id="CDR0000062961__1403"><h3>Cervical cancer can recur (come back) after it has been treated.</h3><p id="CDR0000062961__1405">The cancer may come back in the cervix or in other parts of the body.</p></div></div><div id="CDR0000062961__180"><h2 id="_CDR0000062961__180_">Treatment Option Overview</h2><div id="CDR0000062961__180.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062961__181">There are different types of treatment for patients with
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cervical cancer. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__185">Five types of standard treatment are used:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062961__187">Surgery </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__191">Radiation therapy
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__194">Chemotherapy </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__1396">Targeted therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__1346">Immunotherapy</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000062961__197">New types of treatment are being tested in clinical trials.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__343">Treatment for cervical cancer may cause side effects.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__254">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__256">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062961__258">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000062961__181"><h3>There are different types of treatment for patients with
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cervical cancer. </h3><p id="CDR0000062961__183">Different types of treatment are available for patients with
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444973/" class="def">cervical cancer</a>. Some treatments are
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some are being tested in
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. A
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treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve current
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treatments or obtain information on new treatments for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>.
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When clinical trials show that a new treatment is better than the
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standard treatment, the new
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treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.</p></div><div id="CDR0000062961__185"><h3>Five types of standard treatment are used:</h3><div id="CDR0000062961__187"><h4>Surgery </h4><p id="CDR0000062961__189"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> (removing the
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cancer in an operation) is sometimes used to treat cervical cancer. The
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following surgical procedures may be used:</p><ul id="CDR0000062961__190"><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046468/" class="def">Conization</a>:
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A procedure to remove a cone-shaped piece of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046133/" class="def">cervix</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044102/" class="def">cervical</a> canal. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the tissue under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to look for cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>. Conization may be used to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> or treat a cervical <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a>. This procedure is also called a cone biopsy.</div><div class="half_rhythm">Conization may be done using one of the following procedures:<dl id="CDR0000062961__332" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000752844/" class="def">Cold-knife conization</a>: A surgical procedure that uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257527/" class="def">scalpel</a> (sharp knife) to remove <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> tissue or cancer.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322859/" class="def">Loop electrosurgical excision procedure</a> (LEEP): A surgical procedure that uses electrical current passed through a thin wire loop as a knife to remove abnormal tissue or cancer.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322858/" class="def">Laser surgery</a>:
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A surgical procedure that uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045748/" class="def">laser</a> beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046324/" class="def">lesion</a> such as a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>.</p></dd></dl></div><div class="half_rhythm">The type of conization procedure used depends on where the cancer cells are in the cervix and the type of cervical cancer.</div></li><li class="half_rhythm"><div class="half_rhythm">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045929/" class="def">Total hysterectomy</a>: Surgery to remove the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046645/" class="def">uterus</a>, including the cervix. If the uterus and cervix are taken out through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a>, the operation is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044308/" class="def">vaginal</a> hysterectomy. If the uterus and cervix are taken out through a large <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046353/" class="def">incision</a> (cut) in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, the operation is called a total <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046684/" class="def">abdominal</a> hysterectomy. If the uterus and cervix are taken out through a small incision in the abdomen using a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044360/" class="def">laparoscope</a>, the operation is called a total <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045556/" class="def">laparoscopic</a> hysterectomy.<div id="CDR0000062961__266" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Hysterectomy&p=BOOKS&id=579421_CDR0000612116.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000612116.jpg" alt="Hysterectomy; drawing shows the female reproductive anatomy, including the ovaries, uterus, vagina, fallopian tubes, and cervix. Dotted lines show which organs and tissues are removed in a total hysterectomy, a total hysterectomy with salpingo-oophorectomy, and a radical hysterectomy. An inset shows the location of two possible incisions on the abdomen: a low transverse incision is just above the pubic area and a vertical incision is between the navel and the pubic area." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Hysterectomy. The uterus is surgically removed with or without other organs or tissues. In a total hysterectomy, the uterus and cervix are removed. In a total hysterectomy with salpingo-oophorectomy, (a) the uterus plus one (unilateral) ovary and fallopian tube are removed; or (b) the uterus plus both (bilateral) ovaries and fallopian tubes are removed. In a radical hysterectomy, the uterus, cervix, both ovaries, both fallopian tubes, and nearby tissue are removed. These procedures are done using a low transverse incision or a vertical incision.</p></div></div></div></li><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322879/" class="def">Radical hysterectomy</a>:
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Surgery to remove the uterus, cervix, part of the vagina, and a wide area of ligaments and tissues around these <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a>. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovaries</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tubes</a>, or nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> may also be removed.</div></li><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000765862/" class="def">Modified radical hysterectomy</a>: Surgery to remove the uterus, cervix, upper part of the vagina, and ligaments and tissues that closely surround these organs. Nearby lymph nodes may also be removed. In this type of surgery, not as many tissues and/or organs are removed as in a radical hysterectomy.</div></li><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000700147/" class="def">Radical trachelectomy</a>: Surgery to remove the cervix, nearby tissue and lymph nodes, and the upper part of the vagina. The uterus and ovaries are not removed.</div></li><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322852/" class="def">Bilateral salpingo-oophorectomy</a>: Surgery to remove both ovaries and both
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fallopian tubes.</div></li><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322874/" class="def">Pelvic exenteration</a>: Surgery to remove the lower <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046462/" class="def">colon</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a>. The cervix, vagina, ovaries, and nearby lymph nodes are also removed. Artificial openings (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045104/" class="def">stoma</a>) are made for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urine</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046605/" class="def">stool</a> to flow from the body to a collection bag. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269468/" class="def">Plastic surgery</a> may
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be needed to make an artificial vagina after this operation.</div></li></ul></div><div id="CDR0000062961__191"><h4>Radiation therapy
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</h4><p id="CDR0000062961__193"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. There are two types of radiation therapy:</p><ul id="CDR0000062961__339"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the area of the body with cancer. Certain ways of giving radiation therapy can help keep radiation from damaging nearby healthy tissue. This type of radiation therapy includes the following:<dl id="CDR0000062961__340" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335073/" class="def">Intensity-modulated radiation therapy</a> (IMRT): IMRT is a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045582/" class="def">3-dimensional</a> (3-D) radiation therapy that uses a computer to make pictures of the size and shape of the tumor. Thin beams of radiation of different intensities (strengths) are aimed at the tumor from many angles.</p></dd></dl></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> that are placed directly into or near the cancer.</div></li></ul><p id="CDR0000062961__341">The way the radiation therapy is given depends on the type and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer being treated. External and internal radiation therapy are used to treat cervical cancer, and may also be used as
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to relieve
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</p></div><div id="CDR0000062961__194"><h4>Chemotherapy </h4><p id="CDR0000062961__196"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). </p><p id="CDR0000062961__272">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/cervical" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Cervical Cancer</a> for more information.</p></div><div id="CDR0000062961__1396"><h4>Targeted therapy</h4><p id="CDR0000062961__1398"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do.</p><p id="CDR0000062961__3454"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">Monoclonal antibody</a> therapy is a type of targeted therapy.</p><ul id="CDR0000062961__1406"><li class="half_rhythm"><div class="half_rhythm">Monoclonal antibodies: Monoclonal antibodies are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">proteins</a> made in the laboratory to treat many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that may help cancer cells grow. The antibodies are able to then kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infusion</a>. They may be used alone or to carry drugs, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046622/" class="def">toxins</a>, or radioactive material directly to cancer cells.</div><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046115/" class="def">Bevacizumab</a> is a monoclonal antibody that binds to a protein called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044222/" class="def">vascular endothelial growth factor</a> (VEGF) and may prevent the growth of new <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> that tumors need to grow. Bevacizumab is used to treat cervical cancer that has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046283/" class="def">metastasized</a> (spread to other parts of the body) and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a> cervical cancer.</div></li></ul><div id="CDR0000062961__1401" class="box"><h3><span class="title">monoclonal antibodies: how monoclonal antibodies treat cancer</span></h3><div class="caption"><p>How do monoclonal antibodies work to treat cancer? This video shows how monoclonal antibodies, such as trastuzumab, pembrolizumab, and rituximab, block molecules cancer cells need to grow, flag cancer cells for destruction by the body’s immune system, or deliver harmful substances to cancer cells. </p></div><p><a href="https://www.youtube.com/watch?v=dxnjAc-rqz8" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div><p id="CDR0000062961__1402">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/cervical" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Cervical Cancer</a> for more information.</p></div><div id="CDR0000062961__1346"><h4>Immunotherapy</h4><p id="CDR0000062961__1348"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This cancer treatment is a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">biologic therapy</a>.</p><p id="CDR0000062961__1349"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000772606/" class="def">Immune checkpoint inhibitor</a> therapy is a type of immunotherapy.</p><ul id="CDR0000062961__1350"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000777027/" class="def">PD-1</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000797389/" class="def">PD-L1</a> inhibitor therapy: PD-1 is a protein on the surface of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044928/" class="def">T cells</a> that helps keep the body’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045722/" class="def">immune responses</a> in check. PD-L1 is a protein found on some types of cancer cells. When PD-1 attaches to PD-L1, it stops the T cell from killing the cancer cell. PD-1 and PD-L1 inhibitors keep PD-1 and PD-L1 proteins from attaching to each other. This allows the T cells to kill cancer cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">Pembrolizumab</a> is a type of PD-1 inhibitor.</div></li></ul><div id="CDR0000062961__1351" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Immune%20checkpoint%20inhibitor&p=BOOKS&id=579421_CDR0000774646.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65985.13/bin/CDR0000774646.jpg" alt="Immune checkpoint inhibitor; the panel on the left shows the binding of proteins PD-L1 (on the tumor cell) to PD-1 (on the T cell), which keeps T cells from killing tumor cells in the body. Also shown are a tumor cell antigen and T cell receptor. The panel on the right shows immune checkpoint inhibitors (anti-PD-L1 and anti-PD-1) blocking the binding of PD-L1 to PD-1, which allows the T cells to kill tumor cells." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Immune checkpoint inhibitor. Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, help keep immune responses in check. The binding of PD-L1 to PD-1 keeps T cells from killing tumor cells in the body (left panel). Blocking the binding of PD-L1 to PD-1 with an immune checkpoint inhibitor (anti-PD-L1 or anti-PD-1) allows the T cells to kill tumor cells (right panel).</p></div></div><div id="CDR0000062961__1352" class="box"><h3><span class="title">immune checkpoint inhibitors</span></h3><div class="caption"><p>Immunotherapy uses the body’s immune system to fight cancer. This animation explains one type of immunotherapy that uses immune checkpoint inhibitors to treat cancer.</p></div><p><a href="https://www.youtube.com/watch?v=GIUu239FWMg" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div><p id="CDR0000062961__1353">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/cervical" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Cervical Cancer</a> for more information.</p></div></div><div id="CDR0000062961__197"><h3>New types of treatment are being tested in clinical trials.
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</h3><p id="CDR0000062961__200"> Information about clinical trials is available from the
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<a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062961__343"><h3>Treatment for cervical cancer may cause side effects.</h3><p id="CDR0000062961__343_73">For information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> caused by treatment for cancer, see our <a href="https://www.cancer.gov/about-cancer/treatment/side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Side Effects</a> page.</p></div><div id="CDR0000062961__254"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000062961__254_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000062961__254_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000062961__254_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000062961__256"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000062961__256_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurring</a> (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000062961__256_30">Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trials search</a> webpage. Clinical trials supported by other organizations can be found on the <a href="https://clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov</a> website.</p></div><div id="CDR0000062961__258"><h3>Follow-up tests may be needed.</h3><p id="CDR0000062961__258_33">Some of the tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> the cancer or to find out the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000062961__258_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> has changed or if the cancer has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back). These tests are sometimes called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044671/" class="def">follow-up</a> tests or check-ups.</p><p id="CDR0000062961__315">Your doctor will ask if you have any of the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or symptoms, which may mean the cancer has come back:</p><ul id="CDR0000062961__316"><li class="half_rhythm"><div>Pain in the abdomen, back, or leg.</div></li><li class="half_rhythm"><div>Swelling in the leg.</div></li><li class="half_rhythm"><div>Trouble urinating.</div></li><li class="half_rhythm"><div>Cough.</div></li><li class="half_rhythm"><div>Feeling tired.</div></li></ul><p id="CDR0000062961__309">For cervical cancer, follow-up tests are usually done every 3 to 4 months for the first 2 years, followed by check-ups every 6 months. The check-up includes a current health <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689078/" class="def">history</a> and exam of the body to check for signs and symptoms of recurrent cervical cancer and for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390292/" class="def">late effects</a> of treatment.</p></div></div><div id="CDR0000062961__1407"><h2 id="_CDR0000062961__1407_">Treatment of Carcinoma in Situ</h2><p id="CDR0000062961__345">For information about the treatments listed below, see the <a href="#CDR0000062961__185">Treatment Option Overview</a> section.</p><p id="CDR0000062961__203">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046488/" class="def">carcinoma in situ</a> may include the following:</p><ul id="CDR0000062961__204"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046468/" class="def">Conization</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000752844/" class="def">cold-knife conization</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322859/" class="def">loop electrosurgical excision procedure</a> (LEEP), or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322858/" class="def">laser
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surgery</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045718/" class="def">Hysterectomy</a> for
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women who cannot or no longer want to have children. This is done only if the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> cannot be completely removed by conization.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation
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therapy</a> for women who cannot have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li></ul><p id="CDR0000062961__TrialSearch_1407_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062961__205"><h2 id="_CDR0000062961__205_">Treatment of Stage IA Cervical Cancer</h2><p id="CDR0000062961__3450">For information about the treatments listed below, see the <a href="#CDR0000062961__185">Treatment Option Overview</a> section.</p><p id="CDR0000062961__311"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045886/" class="def">Stage IA cervical cancer</a> is separated into stage IA1 and IA2.</p><p id="CDR0000062961__333">Treatment for stage IA1 may include the following:</p><ul id="CDR0000062961__312"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046468/" class="def">Conization</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045929/" class="def">Total hysterectomy</a> with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322852/" class="def">bilateral salpingo-oophorectomy</a>.</div></li></ul><p id="CDR0000062961__313">Treatment for stage IA2 may include the following:</p><ul id="CDR0000062961__314"><li class="half_rhythm"><div>Modified <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322879/" class="def">radical hysterectomy</a> and removal of
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000700147/" class="def">Radical trachelectomy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation
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therapy</a> for women who cannot have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li></ul><p id="CDR0000062961__TrialSearch_205_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062961__290"><h2 id="_CDR0000062961__290_">Treatment of Stages IB and IIA Cervical Cancer</h2><p id="CDR0000062961__3451">For information about the treatments listed below, see the <a href="#CDR0000062961__185">Treatment Option Overview</a> section.</p><p id="CDR0000062961__291">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045886/" class="def">stage IB</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045887/" class="def">stage IIA cervical cancer</a> may include the following:</p><ul id="CDR0000062961__292"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a>
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with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> given at the same time.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322879/" class="def">Radical hysterectomy</a> and removal of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045087/" class="def">pelvic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> with or without
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radiation therapy to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a>, plus chemotherapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000700147/" class="def">Radical trachelectomy</a>.</div></li><li class="half_rhythm"><div>Chemotherapy followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li><li class="half_rhythm"><div>Radiation therapy alone.</div></li></ul><p id="CDR0000062961__TrialSearch_290_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062961__293"><h2 id="_CDR0000062961__293_">Treatment of Stages IIB, III, and IVA Cervical Cancer</h2><p id="CDR0000062961__3452">For information about the treatments listed below, see the <a href="#CDR0000062961__185">Treatment Option Overview</a> section.</p><p id="CDR0000062961__294">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045887/" class="def">stage IIB</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045888/" class="def">stage III</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045889/" class="def">stage IVA cervical cancer</a> may include the following:</p><ul id="CDR0000062961__295"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> given at the same time.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045087/" class="def">pelvic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> followed by radiation therapy with or without chemotherapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of chemotherapy to shrink the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> followed by surgery.</div></li><li class="half_rhythm"><div>A clinical trial of chemotherapy and radiation therapy given at the same time, followed by chemotherapy.</div></li></ul><p id="CDR0000062961__TrialSearch_293_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062961__225"><h2 id="_CDR0000062961__225_">Treatment of Stage IVB Cervical Cancer</h2><p id="CDR0000062961__3453">For information about the treatments listed below, see the <a href="#CDR0000062961__185">Treatment Option Overview</a> section.</p><p id="CDR0000062961__226">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045889/" class="def">stage IVB cervical
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cancer</a> may include the following:</p><ul id="CDR0000062961__227"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative
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therapy</a> to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> caused by the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> and improve
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a>.</div></li><li class="half_rhythm"><div>Chemotherapy as palliative therapy to relieve symptoms caused by the cancer and improve quality of life.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">Clinical trials</a> of new anticancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> or drug
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combinations.</div></li></ul><p id="CDR0000062961__TrialSearch_225_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062961__229"><h2 id="_CDR0000062961__229_">Treatment of Recurrent Cervical Cancer</h2><p id="CDR0000062961__346">For information about the treatments listed below, see the <a href="#CDR0000062961__185">Treatment Option Overview</a> section.</p><p id="CDR0000062961__230">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444973/" class="def">cervical cancer</a> may include the
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following:</p><ul id="CDR0000062961__231"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>.</div></li><li class="half_rhythm"><div>Chemotherapy and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a>.</div></li><li class="half_rhythm"><div>Chemotherapy as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative
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therapy</a> to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> caused by the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> and improve
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322874/" class="def">Pelvic exenteration</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">Clinical trials</a> of
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new anticancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> or drug combinations.</div></li></ul><p id="CDR0000062961__TrialSearch_229_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062961__296"><h2 id="_CDR0000062961__296_">Cervical Cancer During Pregnancy</h2><div id="CDR0000062961__297"><h3>General Information About Cervical Cancer During Pregnancy</h3><p id="CDR0000062961__298">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444973/" class="def">cervical cancer</a> during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000666677/" class="def">pregnancy</a> depends on the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> and how long the patient has been pregnant. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689578/" class="def">imaging tests</a> may be done to determine the stage of the disease. To avoid exposing the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046400/" class="def">fetus</a> to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic resonance imaging) is used.</p></div><div id="CDR0000062961__3455"><h3>Treatment of Carcinoma in Situ During Pregnancy</h3><p id="CDR0000062961__3456">Usually, no treatment is needed for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046488/" class="def">carcinoma in situ</a> during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000666677/" class="def">pregnancy</a>. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045989/" class="def">colposcopy</a> may be done to check for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045741/" class="def">invasive cancer</a>.</p></div><div id="CDR0000062961__3457"><h3>Treatment of Stage I Cervical Cancer During Pregnancy</h3><p id="CDR0000062961__3458">For information about the treatments listed below, see the <a href="#CDR0000062961__185">Treatment Option Overview</a> section.</p><p id="CDR0000062961__3459"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000666677/" class="def">Pregnant</a> women with slow-growing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045886/" class="def">stage I cervical cancer</a> may be able to delay treatment until the second trimester of pregnancy or after delivery. </p><p id="CDR0000062961__3460">Pregnant women with fast-growing stage I cervical cancer may need immediate treatment. Treatment may include:</p><ul id="CDR0000062961__3461"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046468/" class="def">Conization</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000700147/" class="def">Radical trachelectomy</a>.</div></li></ul><p id="CDR0000062961__3462">Women should be tested to find out if the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>. If cancer has spread to the lymph nodes, immediate treatment may be needed.</p></div><div id="CDR0000062961__3463"><h3>Treatment of Stages II, III, and IV Cervical Cancer During Pregnancy</h3><p id="CDR0000062961__3464">For information about the treatments listed below, see the <a href="#CDR0000062961__185">Treatment Option Overview</a> section.</p><p id="CDR0000062961__3465">Treatment for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045887/" class="def">stage II</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045888/" class="def">stage III</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045889/" class="def">stage IV cervical cancer</a> during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000666677/" class="def">pregnancy</a> may include the following:</p><ul id="CDR0000062961__3466"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> to shrink the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> in the second or third trimester of pregnancy. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> may be done after delivery.</div></li><li class="half_rhythm"><div>Radiation therapy plus chemotherapy. Talk with your doctor about the effects of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> on the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046400/" class="def">fetus</a>. It may be necessary to end the pregnancy before treatment begins.</div></li></ul></div></div><div id="CDR0000062961__247"><h2 id="_CDR0000062961__247_">To Learn More About Cervical Cancer</h2><p id="CDR0000062961__248">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about cervical cancer, see the following: </p><ul id="CDR0000062961__249"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/types/cervical" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cervical Cancer Home Page</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000062817/">Cervical Cancer Prevention</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000304518/">Cervical Cancer Screening</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000799642/">Childhood Cervical and Vaginal Cancer Treatment</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/drugs/cervical" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Cervical Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/types/surgery/lasers" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Lasers to Treat Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/understanding-cervical-changes" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Understanding Cervical Changes: A Health Guide for Women</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Human Papillomavirus (HPV) Vaccines</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/types/cervical/pap-hpv-testing-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">HPV and Pap Testing</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies/targeted-therapies-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Targeted Cancer Therapies</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/types/immunotherapy" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Immunotherapy to Treat Cancer</a>
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</div></li></ul><p id="CDR0000062961__247_40">For general <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information and other resources from the National Cancer Institute, see the following:</p><ul id="CDR0000062961__247_41"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">About Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Staging</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a>
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</div></li><li class="half_rhythm"><div><a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors and Caregivers</a>
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</div></li></ul></div><div id="CDR0000062961__AboutThis_1"><h2 id="_CDR0000062961__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062961__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000062961__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000062961__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000062961__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000062961__AboutThis_6">This PDQ cancer information summary has current information about the treatment of cervical cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000062961__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000062961__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
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</p><p id="CDR0000062961__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000062961__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000062961__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000062961__AboutThis_12">Clinical trials can be found online at <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. For more information, call the <a href="https://www.cancer.gov/contact/contact-center" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Information Service</a> (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000062961__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000062961__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000062961__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000062961__AboutThis_21">PDQ® Adult Treatment Editorial Board. PDQ Cervical Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/cervical/patient/cervical-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/cervical/patient/cervical-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389422]</p><p id="CDR0000062961__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 3,000 scientific images.
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</p></div><div id="CDR0000062961__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000062961__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000062961__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000062961__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK65985</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/26389422" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">26389422</a></span></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65985.13/?report=reader">PubReader</a></li><li><a href="/books/NBK65985.13/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65985" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65985" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Cervical Cancer Treatment (PDQ®): Patient Version. 2022 Apr 6. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK65985.24/">NBK65985.24</a></span> September 13, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK65985.23/">NBK65985.23</a></span> March 1, 2024</li><li><span class="bk_col_itm"><a 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class="bk_col_itm"><a href="/books/NBK65985.12/">NBK65985.12</a></span> January 6, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK65985.11/">NBK65985.11</a></span> August 24, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK65985.10/">NBK65985.10</a></span> May 13, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK65985.9/">NBK65985.9</a></span> May 8, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK65985.8/">NBK65985.8</a></span> November 8, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65985.7/">NBK65985.7</a></span> March 1, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65985.6/">NBK65985.6</a></span> January 18, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65985.5/">NBK65985.5</a></span> March 28, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65985.4/">NBK65985.4</a></span> October 13, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65985.3/">NBK65985.3</a></span> July 14, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65985.2/">NBK65985.2</a></span> May 13, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65985.1/">NBK65985.1</a></span> June 12, 2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000062961__117" ref="log$=inpage&link_id=inpage">General Information About Cervical Cancer</a></li><li><a href="#CDR0000062961__142" ref="log$=inpage&link_id=inpage">Stages of Cervical Cancer</a></li><li><a href="#CDR0000062961__180" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000062961__1407" ref="log$=inpage&link_id=inpage">Treatment of Carcinoma in Situ</a></li><li><a href="#CDR0000062961__205" ref="log$=inpage&link_id=inpage">Treatment of Stage IA Cervical Cancer</a></li><li><a href="#CDR0000062961__290" ref="log$=inpage&link_id=inpage">Treatment of Stages IB and IIA Cervical Cancer</a></li><li><a href="#CDR0000062961__293" ref="log$=inpage&link_id=inpage">Treatment of Stages IIB, III, and IVA Cervical Cancer</a></li><li><a href="#CDR0000062961__225" ref="log$=inpage&link_id=inpage">Treatment of Stage IVB Cervical Cancer</a></li><li><a href="#CDR0000062961__229" ref="log$=inpage&link_id=inpage">Treatment of Recurrent Cervical Cancer</a></li><li><a href="#CDR0000062961__296" ref="log$=inpage&link_id=inpage">Cervical Cancer During Pregnancy</a></li><li><a href="#CDR0000062961__247" ref="log$=inpage&link_id=inpage">To Learn More About Cervical Cancer</a></li><li><a href="#CDR0000062961__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK66058/">Health Professional Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389479" 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<style type="text/css">
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<title>Twitter</title>
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<path class="st20" d="M192.9,88.1c-5,2.2-9.2,2.3-13.6,0.1c5.7-3.4,6-5.8,8.1-12.3c-5.4,3.2-11.4,5.5-17.6,6.7 c-10.5-11.2-28.1-11.7-39.2-1.2c-7.2,6.8-10.2,16.9-8,26.5c-22.3-1.1-43.1-11.7-57.2-29C58,91.6,61.8,107.9,74,116 c-4.4-0.1-8.7-1.3-12.6-3.4c0,0.1,0,0.2,0,0.4c0,13.2,9.3,24.6,22.3,27.2c-4.1,1.1-8.4,1.3-12.5,0.5c3.6,11.3,14,19,25.9,19.3 c-11.6,9.1-26.4,13.2-41.1,11.5c12.7,8.1,27.4,12.5,42.5,12.5c51,0,78.9-42.2,78.9-78.9c0-1.2,0-2.4-0.1-3.6 C182.7,97.4,189.2,93.7,192.9,88.1z"></path>
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<li class="list-inline-item"><a href="https://www.facebook.com/nationallibraryofmedicine" aria-label="Facebook" rel="noopener noreferrer" target="_blank">
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<style type="text/css">
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<title>Facebook</title>
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<path class="st10" d="M159,99.1h-24V88.4c0-5,3.3-6.2,5.7-6.2h16.8V60l-24.4-0.1c-22.1,0-26.2,16.5-26.2,27.1v12.1H90v22.5h16.9 v67.5H135v-67.5h21.7L159,99.1z"></path>
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<circle class="st110" cx="123.6" cy="123.2" r="108.2"></circle>
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</svg>
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</a></li>
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<li class="list-inline-item"><a href="https://www.youtube.com/user/NLMNIH" aria-label="Youtube" target="_blank" rel="noopener noreferrer"><svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" x="0px" y="0px" viewBox="0 0 249 249" style="enable-background:new 0 0 249 249;" xml:space="preserve">
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<title>Youtube</title>
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<style type="text/css">
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.st4 {
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fill: none;
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stroke: #FFFFFF;
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.st5 {
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fill: #FFFFFF;
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</style>
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<circle class="st4" cx="124.2" cy="123.4" r="108.2"></circle>
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<g transform="translate(0,-952.36218)">
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<path class="st5" d="M88.4,1037.4c-10.4,0-18.7,8.3-18.7,18.7v40.1c0,10.4,8.3,18.7,18.7,18.7h72.1c10.4,0,18.7-8.3,18.7-18.7 v-40.1c0-10.4-8.3-18.7-18.7-18.7H88.4z M115.2,1058.8l29.4,17.4l-29.4,17.4V1058.8z"></path>
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</g>
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</svg></a></li>
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</div>
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<div class="col-lg-3 col-12">
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<p class="address_footer text-white">National Library of Medicine<br />
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<a href="https://www.google.com/maps/place/8600+Rockville+Pike,+Bethesda,+MD+20894/@38.9959508,-77.101021,17z/data=!3m1!4b1!4m5!3m4!1s0x89b7c95e25765ddb:0x19156f88b27635b8!8m2!3d38.9959508!4d-77.0988323" class="text-white" target="_blank" rel="noopener noreferrer">8600 Rockville Pike<br />
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Bethesda, MD 20894</a></p>
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<div class="col-lg-3 col-12 centered-lg">
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<p><a href="https://www.nlm.nih.gov/web_policies.html" class="text-white">Web Policies</a><br />
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<a href="https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/freedom-information-act-office" class="text-white">FOIA</a><br />
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<a href="https://www.hhs.gov/vulnerability-disclosure-policy/index.html" class="text-white" id="vdp">HHS Vulnerability Disclosure</a></p>
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</div>
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<div class="col-lg-3 col-12 centered-lg">
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<p><a class="supportLink text-white" href="https://support.nlm.nih.gov/">Help</a><br />
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<a href="https://www.nlm.nih.gov/accessibility.html" class="text-white">Accessibility</a><br />
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<a href="https://www.nlm.nih.gov/careers/careers.html" class="text-white">Careers</a></p>
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<div class="row">
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<div class="col-lg-12 centered-lg">
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<nav class="bottom-links">
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<ul class="mt-3">
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<li>
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<a class="text-white" href="//www.nlm.nih.gov/">NLM</a>
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</li>
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<li>
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<a class="text-white" href="https://www.nih.gov/">NIH</a>
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<li>
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<a class="text-white" href="https://www.hhs.gov/">HHS</a>
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<li>
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<a class="text-white" href="https://www.usa.gov/">USA.gov</a>
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