Treatment options for squamous cell carcinoma in situ include:

  • Cryosurgery
  • Laser surgery
  • Loop electrosurgical excision procedure (LEEP/LEETZ)
  • Cold knife conization
  • Simple hysterectomy (as the first treatment or if the cancer returns after other treatments)

Stage IA1

Treatment for this stage depends on whether or not you want to continue to be able to have children (maintain fertility) and whether or not the cancer has grown into blood or lymph vessels (called lymphovascular invasion).

Treatment options for women who want to maintain fertility:

A cone biopsy is the preferred procedure for women who want to have children after the cancer is treated.

  • If the edges of the cone don’t contain cancer cells (called negative margins), the woman can be watched closely without further treatment as long as the cancer doesn’t come back.
  • If the edges of the cone biopsy have cancer cells (called positive margins), then cancer may have been left behind.

Stage IA2

Treatment for this stage depends in part on whether or not you want to continue to be able to have children (maintain fertility).

Treatment options for women who want to maintain fertility:

  • Cone biopsy with removal of pelvic lymph nodes (pelvic lymph node dissection)
  • Radical trachelectomy with pelvic lymph node dissection

Stages IB and IIA

The main treatment options are surgery, radiation, or radiation given with chemo (concurrent chemoradiation).

Stages IB1 and IIA1

Treatment options for women who want to maintain fertility:

  • trachelectomy with pelvic lymph node dissection

Treatment options for women who don’t want to maintain fertility:

  • hysterectomy with removal of lymph nodes in the pelvis and some lymph nodes from the para-aortic area
  • If none of the lymph nodes are found to have cancer, radiation may still be discussed as an option if the tumor is large, if the tumor has grown into blood or lymph vessels, or if the tumor is invading the surrounding connective tissue that supports organs such as the uterus, bladder, vagina (the stroma).

Stages IB2 and IIA2

Treatment options:

  • This is usually the standard treatment. The chemo may be cisplatin or cisplatin plus fluorouracil. The radiation therapy includes both external beam radiation and brachytherapy.
  • hysterectomy with pelvic lymph node dissection and para-aortic lymph node sampling.


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