Doctors at Perlmutter Cancer Center may use radiation therapy—high levels of energy directed at cancer cells—instead of surgery to manage small tumors confined to the cervix. Radiation therapy may also be used after surgery to destroy any remaining cancer cells or before surgery to shrink tumors.
Our doctors often combine radiation therapy and chemotherapy—the use of drugs to kill cancer cells throughout the body—for larger tumors that are confined to the cervix or for cancer that has spread to other areas of the body. Chemotherapy may also make tumor cells more sensitive to radiation therapy.
Treatment Planning and Guidance
If you receive a diagnosis of cervical cancer, our radiation oncologists may use CT, MRI, and PET scans of the cervix and surrounding tissue and organs, in conjunction with computer planning software, to tailor a treatment plan for you.
This software creates a three-dimensional image of the tumor and surrounding organs and allows our doctors to determine how best to target the cervical cancer. This type of planning is designed to spare healthy tissue, especially the bladder, which stores and empties urine, and the rectum, the last portion of the digestive tract.
Image-guided radiation therapy shows the precise location of your organs, which can shift slightly as you breathe or move during treatment. The technique also allows doctors to track the size and shape of the tumor over several weeks, as radiation therapy begins to shrink it.
Targeted radiation therapy may also help to minimize the amount of radiation that reaches the ovaries, helping to preserve fertility.
Types of Radiation Therapy
Our doctors use external beam radiation therapy, stereotactic body radiation therapy, or brachytherapy to manage cervical cancer.
External Beam Radiation Therapy
External beam radiation therapy is delivered from outside the body to the tumor using a machine called a linear accelerator. This machine rotates around you during therapy, delivering radiation to the tumor from different directions, while minimizing the radiation exposure in nearby healthy tissue.
At Perlmutter Cancer Center, our radiation oncologists use a variety of technologies to deliver highly targeted radiation therapy, tailored to the size, shape, and location of the tumor. For example, they often use an approach called intensity modulated radiation therapy, which allows them to break up the radiation beams into many smaller doses of different strengths, called “minibeams,” so they can precisely target the cancer.
Some forms of external beam radiation therapy require that the linear accelerator start and stop for treatment adjustments. But at NYU Langone, doctors can offer a technology called volumetric modulated arc therapy, in which the machine moves around you in one or several nonstop, 360-degree rotations. This approach lets doctors adjust the angle and intensity of the radiation beams as they are delivered. And because this therapy proceeds without interruption, treatment sessions may be shorter than with other approaches.
Usually, external beam radiation therapy is given once a day, five days a week, for several weeks.
Stereotactic Body Radiation Therapy
Stereotactic body radiation therapy delivers a few high doses of carefully targeted radiation beams to the tumor over several days. Your doctor may use this approach for small cervical cancer tumors or for those that return after other treatments. As with other forms of radiation therapy at NYU Langone, this approach uses imaging guidance to target the tumor while avoiding healthy tissue.
In brachytherapy, doctors place radioactive beads or pellets inside the body. These remain temporarily to manage cervical cancer. If there are several tumors, this internal radiation is often combined with external beam radiation therapy.
With high-dose-rate brachytherapy, doctors at NYU Langone place the beads inside your body using either an intracavitary or an interstitial approach.
During intracavitary brachytherapy for women who no longer have a uterus, the doctor places an applicator with radioactive material into the vagina for several minutes, after which it is removed. In women who have a uterus, the radiation is placed in the upper vagina and in the uterus. Doctors may use a local anesthetic to ensure your comfort during the procedure.
If the cancer has spread to an area of the pelvis that can't be reached easily with the intracavitary approach, the doctor may use the interstitial approach. This involves placing the radiation directly in or near the tumor using a needle or catheter, which is a thin hollow tube. This procedure requires either general anesthesia or regional anesthesia, in which an anesthetic is inserted into the spine with a hollow needle and catheter and numbs the pelvic area.
Our doctors may use brachytherapy for several minutes at a time over the course of a few days or weeks on an outpatient or inpatient basis.
Managing Side Effects
Our doctors carefully plan radiation therapy to minimize side effects such as fatigue, nausea, and irritation to the bladder and rectum, which may cause diarrhea or blood in the urine or stool. Our supportive and integrative services can also help you to manage radiation side effects.
Although our radiation oncologists use highly targeted treatments to help avoid triggering early menopause, which is when a woman stops having her menstrual period at a younger age than expected, this is still possible. Our gynecologic oncologists and fertility experts can discuss options for preserving your ability to have children.
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