If there is any cancer cell that found in pelvic lymph nodes during the surgery process then there will be removal process on lymph nodes that lie along the aorta as treatment for cervical cancer. Tissue that removed will be examine later to find out how far the cancer cell spreading. If the cancer is already spread to the tissue next to the uterus area then you may need some radiation therapy. You may also get combination of chemotherapy and radiation therapy.
If the pathology report showing that the removing tissue has positive margin then you can take pelvic radiation with cisplatin chemotherapy or brachytherapy. It is possible since the cancer cell still in the edges of the tissue and left behind some cancer cell.
Stage 1B and 2A
Common treatment types during this stage are radiation, surgery or chemoradiation. However, the standard treatment that commonly applied is the radical hysterectomy by removing the lymph nodes in the pelvis area. Somehow, the lymph node in the abdomen area is also removed to make sure whether the cancer cell is also spreading there or not. If you want to have baby then radical hysterectomy is the perfect available option.
Another option is the brachytherapy and external beam radiation therapy. Chemo usually will be applied along with the radiation.
Stage 1B2 and 2A2
If you already achieve stage 1B2 and 2A2 then you can choose chemo with radiation therapy. The chemo itself can be cisplatin or cisplatin with fluorouracil. Radiation therapy here will combine the external beam radiation and brachytherapy. If you want another treatment then you may take radical hysterectomy with pelvic lymph nodes removal. When the cancer cell is found in removed lymph nodes or in the edge of removed tissue then you can take surgery and following it with radiation therapy such as concurrent chemoradiation. After that, hysterectomy may be applied.
Stage 2B, 3 and 4A
During this stage, proper treatment for cervical cancer is radiation therapy that is given with chemo or concurrent radiation. The chemo itself can be cisplatin or cisplatin plus fluroroyracil while the radiation will combine brachytherapy and beam radiation. If the spreading of cancer cell is already reach lymph nodes in upper part or abdomen then the cancer may spread in other areas of body. If this happen then you better checking the lymph nodes first before applying any radiation.
Surgery is the one that commonly suggested. Another option is MRI and PET/CT to see the lymph nodes condition. If the lymph nodes is bigger or light then PET study will showing the cancer presence. If it is contain cancer the biopsy is the advised action. When the cancer attacking lymph nodes in upper abdomen area then continuous test is needed to make sure whether the cancer is already spread to the other body part or not.
When you have 4B stage then it means the cancer already spread out from pelvis to other body part. Radiation therapy and chemo is the most common recommended treatment. Standard treatment is platinum compound usage such as cisplatin and carboplatin. These two will goes along with certain drugs such as gemcitabine, topotecan and paclitaxel. Another type of drug to add is avastin.