Dear OncoLink "Ask The Experts,"
My sister has been diagnosed with Stage Ib1 cervical cancer. She has had her second cone biopsy performed about a week ago and the tumor has been removed. The Oncologist was not happy with margins so has suggested a radical hysterectomy with pelvic lymph node dissection, in case the cancer has spread.
My question to you is: - is the cancer at Stage 1b1 treatable and curable and how probable is it that the cancer has gone into her lymph nodes. My sister is 37 years of age, has had no abnormal smear tests and has not had any symptoms of cervical cancer.
Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health System, responds:
Stage Ib1 indicates that the tumor appears clinically to be confined to the cervix, and is less than 4 cm in diameter. Conization would not be adequate treatment for such a cancer. Radical hysterectomy, which involves removal of the uterus and cervix, along with the parametrium (the tissue between the cervix and the pelvic wall) and the upper, is combined with pelvic lymph node dissection as treatment for women with early cervical cancer who are candidates for major surgery. The chance of metastatic cancer in the lymph nodes is about 15%. When done by an experienced gynecologic cancer surgeon, the operation is generally well tolerated, with cure rates of about 85%. Patients, who have cancer found in the lymph nodes, or have other high-risk features, will benefit from post-operative radiotherapy and chemotherapy.