Cervical cancer is the fourth most common cancer in women worldwide, and nearly all cases are caused by long-lasting infection with the human papillomavirus, HPV. Treatment has changed more in the past few years than in the previous two decades, with simpler surgery for early cancer, immunotherapy that improves survival in advanced cancer, and new drugs from Europe and China. This article explains the options at each stage.
Early-Stage Cervical Cancer
Small, early cancers are usually treated with surgery. For many years this meant a radical hysterectomy, which removes the tissue around the uterus and can damage bladder and sexual function. The international SHAPE trial showed that for low-risk early cervical cancer, a simple hysterectomy controlled the cancer just as well, with fewer bladder problems and a better quality of life.1 Young women who wish to have children may be candidates for surgery that preserves the uterus.
Locally Advanced Cervical Cancer
Larger cancers, or those that have reached the lymph nodes, are treated with chemotherapy and radiation together, followed by internal radiation called brachytherapy. Two recent trials have improved on this.
Adding immunotherapy. The KEYNOTE-A18 trial, run with the European Network for Gynaecological Oncology Trial groups, enrolled 1,060 women with high-risk cancer. Adding the immunotherapy drug pembrolizumab to chemoradiation reduced the risk of death by 33 percent, with 82.6 percent alive after three years compared with 74.8 percent.2
Chemotherapy first. In the INTERLACE trial, led from University College London, giving six weekly doses of carboplatin and paclitaxel before chemoradiation raised five-year survival to 80 percent, from 72 percent.3
Hyperthermia With Radiation: The Dutch Trial
In the Dutch Deep Hyperthermia Trial, women with advanced cervical cancer received radiation alone or radiation combined with heating of the pelvis. With hyperthermia, 83 percent had complete disappearance of the tumor, compared with 57 percent, and three-year survival was 51 percent, compared with 27 percent.4 Hyperthermia is now part of standard care for cervical cancer in the Netherlands. See our article on hyperthermia.
Advanced and Recurrent Cervical Cancer
Immunotherapy with chemotherapy. In the KEYNOTE-826 trial, adding pembrolizumab to chemotherapy, with or without bevacizumab, extended median survival to about 26 months, from about 17 months.5 In the European BEATcc trial, adding the immunotherapy drug atezolizumab to chemotherapy and bevacizumab extended median survival to 32.1 months, from 22.8 months.6
Cadonilimab, from China. Cadonilimab blocks two immune brakes, PD-1 and CTLA-4, in a single molecule. In the Chinese COMPASSION-16 trial, adding it to chemotherapy, with or without bevacizumab, extended the time before the cancer grew to 12.7 months, from 8.1 months, and reduced the risk of death by about a third.7 It is approved in China.
Tisotumab vedotin. This antibody carries a chemotherapy drug directly to cervical cancer cells. In the innovaTV 301 trial, led by Belgian investigators, it reduced the risk of death by 30 percent compared with standard chemotherapy in women whose cancer had returned.8
Testing the Tumor
Tumor testing for PD-L1, HER2 and mismatch repair helps select immunotherapy and targeted drugs, and full sequencing can reveal other treatable changes. See our articles on tumor DNA and RNA sequencing, how immunotherapy works and uterine cancer.
Prevention
The HPV vaccine and regular screening with HPV testing can prevent most cervical cancers, which is why the World Health Organization has set a goal of eliminating cervical cancer as a public health problem.
Integrative Research in Cervical Cancer
Oral enzyme therapy during radiation. In a randomized trial of 120 women receiving radiation for locally advanced cervical cancer, those who also took a combination of protein-digesting enzymes, from the same family as the pineapple enzyme bromelain, had significantly fewer and milder side effects, including bladder symptoms, skin changes and irritation of the vaginal lining (Dale and colleagues, Cancer Chemotherapy and Pharmacology, 2001). See our article on bromelain.
Green tea extract for precancerous lesions, from Korea. In a Korean study of women with HPV-related precancerous changes of the cervix, green tea extract applied as an ointment or taken as capsules led to improvement in 69 percent of women, compared with 10 percent of untreated women (Ahn and colleagues, European Journal of Cancer Prevention, 2003). This was a small study of precancer, not cancer, and larger trials are needed.
These are some of the natural and integrative options studied in cervical cancer, and others have promising research as well. Which may fit your situation depends on your tumor testing, your current treatment and possible drug interactions. In a consultation, Dr. Silver, MD, educates you on these options and the research behind them. Request a consultation.
How Cancer Expert MD Helps
Cancer Expert MD provides education and consultation for people with every type and stage of cancer, and specializes in Stage IV and metastatic cancer. Our guide to what to do when treatment stops working explains re-testing and the next steps, and our book, The New Reality of Cancer, covers testing and treatment across all cancers, including hyperthermia and immunotherapy.
Frequently Asked Questions
Does immunotherapy help cervical cancer?
Yes. Adding pembrolizumab to chemoradiation reduced the risk of death by 33 percent in high-risk locally advanced cervical cancer, and immunotherapy with chemotherapy extends survival in advanced cancer.
Does hyperthermia help cervical cancer?
In the Dutch Deep Hyperthermia Trial, adding hyperthermia to radiation nearly doubled three-year survival, to 51 percent from 27 percent.
Is a radical hysterectomy always needed?
Not for low-risk early cancer. The SHAPE trial found a simple hysterectomy worked just as well, with fewer bladder problems.
What is cadonilimab?
A Chinese immunotherapy drug that blocks two immune brakes at once. With chemotherapy, it reduced the risk of death by about a third in advanced cervical cancer.
About the author. Dr. Silver, MD, graduated from Temple University School of Medicine, trained as an interventional cardiologist, and has practiced medicine for nearly fifty years. A lymphoma survivor of about twenty-five years, he is co-author, with Dr. Lindmeier, DHSc, of The New Reality of Cancer: The Science of Recovery. Read more about Dr. Silver, MD.
Research by Dr. Lindmeier, DHSc, cancer educator and co-author of The New Reality of Cancer.
This article is for general education only and is not individual medical advice. Always consult your own doctor before making any changes to your care.
© 2026 Lovely LYF LLC. All rights reserved. This article draws on the research in The New Reality of Cancer and may not be copied, republished or distributed without written permission.
For more in-depth information on this topic and many others, get our book, The New Reality of Cancer: The Science of Recovery.
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References
- Plante M, Kwon JS, Ferguson S, et al. Simple versus radical hysterectomy in women with low-risk cervical cancer (SHAPE). New England Journal of Medicine. 2024;390(9):819–829.
- Lorusso D, Xiang Y, Hasegawa K, et al. Pembrolizumab or placebo with chemoradiotherapy followed by pembrolizumab or placebo for newly diagnosed, high-risk, locally advanced cervical cancer (ENGOT-cx11/GOG-3047/KEYNOTE-A18): overall survival results. The Lancet. 2024.
- McCormack M, Eminowicz G, Gallardo D, et al. Induction chemotherapy followed by standard chemoradiotherapy versus standard chemoradiotherapy alone in patients with locally advanced cervical cancer (GCIG INTERLACE). The Lancet. 2024.
- van der Zee J, González González D, van Rhoon GC, et al. Comparison of radiotherapy alone with radiotherapy plus hyperthermia in locally advanced pelvic tumours: a prospective, randomised, multicentre trial (Dutch Deep Hyperthermia Group). The Lancet. 2000;355(9210):1119–1125.
- Monk BJ, Colombo N, Tewari KS, et al. First-line pembrolizumab + chemotherapy versus placebo + chemotherapy for persistent, recurrent, or metastatic cervical cancer: final overall survival results of KEYNOTE-826. Journal of Clinical Oncology. 2023.
- Oaknin A, Gladieff L, Martínez-García J, et al. Atezolizumab plus bevacizumab and chemotherapy for metastatic, persistent, or recurrent cervical cancer (BEATcc). The Lancet. 2024.
- Wu X, et al. Cadonilimab plus platinum-based chemotherapy with or without bevacizumab as first-line treatment for persistent, recurrent, or metastatic cervical cancer (COMPASSION-16). The Lancet. 2024.
- Vergote I, González-Martín A, Fujiwara K, et al. Tisotumab vedotin as second- or third-line therapy for recurrent cervical cancer (innovaTV 301). New England Journal of Medicine. 2024;391(1):44–55.
This article is for education only. It is not medical advice and does not diagnose or treat any condition. Cancer Expert MD has no financial relationship with any laboratory, drug maker, supplement company, clinic or hospital.
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