Can stage IV cervical cancer be cured?
Patients diagnosed with stage IV cervical cancer can be broadly divided into two groups. Patients with disease that is locally confined, but involves adjacent organs in the pelvis, such as the rectum and bladder, have localized stage IVA cervical cancer. Other patients have disease that has spread to distant organs, most commonly the bones, lungs or liver, and have metastatic stage IVB cervical cancer. Cervical cancer diagnosed in this stage is often difficult to treat, however a small minority of patients are cured of disease. Management of patients with metastatic stage IVB disease is aimed at control of symptoms and pain.
Treatment of Localized Stage IVA Cervical Cancer
Stage IVA cervical cancer is currently best managed by a combination of radiation therapy and chemotherapy. Radiation therapy is treatment with high energy x-rays that have the ability to kill cancer cells. Radiation therapy can be administered by a machine that aims x-rays at the body (external beam radiation) or by placing small capsules of radioactive material directly near the cervix (internal or implant radiation). Most patients will receive both kinds of radiation therapy during their course of treatment. External beam radiation therapy for cervical cancer is administered on an outpatient basis for approximately 4 to 6 weeks.
During or immediately following the external beam portion of radiation therapy, patients may also undergo an internal radiation procedure. Placing the radiation within the cervix allows a high dose of radiation to be delivered to the cancer.
Treatment of Metastatic Stage IVB Cervical Cancer
Cervical cancer that has spread to distant organs and bones is difficult to treat and the main goal of treatment is to reduce symptoms and prolong survival. Some patients are offered treatment with chemotherapy for the purpose of prolonging their duration of survival and alleviating symptoms from progressive cancer. Other patients are managed with efforts to reduce pain or bleeding, including local radiation therapy to affected parts of the body.
Other highly specialized forms of therapy like targeted therapy i.e. Bevacizumab and Immunotherapy can be given on case to case basis.