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ASCO Educational Book; 2009
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Challenges in the Management of Invasive Cervical Cancer

Sujana Movva, MD, Michael Gold, MD, Perry Grigsby, MD, and Claire Verschraegen, MD

From the Cancer Research and Treatment Center, University of New Mexico, Albuquerque, NM (Drs. Movva and Verschraegen); the Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN (Dr. Gold); and the Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (Dr. Grigsby)

Authors’ disclosures of potential conflicts of interest are found at the end of this article.

Address reprint requests to Claire Verschraegen, MD, University of New Mexico Cancer Center, 900 Camino de Salud, Albuquerque, NM 87131; e-mail: cverschraegen{at}salud.unm.edu

Overview: Cancer of the cervix is the second most common malignancy for women worldwide. In the last 20 years, numerous advances have been made in the medical management of cervical cancer, including preventive vaccination, chemoradiation, and neoadjuvant chemotherapy. Treatment of metastatic disease is at best palliative. Platinum-based chemotherapy remains the standard of care for inoperable patients with recurrent disease. The use of novel therapeutic approaches targeted to the carcinogenic processes leading to the ontogenesis of cervical cancer should be promoted in clinical studies to improve outcome of patients. This chapter will review challenging areas of cervical cancer care: the use of lymphadenectomy, the impact of imaging procedures, and the care of patients at the end of life.