Brachytherapy for Cervical Cancer: Making a Difference in Patient Outcomes

Women with cervical cancer who receive image-guided brachytherapy as part of their treatment are more likely to be cured and live longer than those who undergo traditional radiation therapy alone, recent studies reveal. And while many cancer centers now offer brachytherapy, it’s important to seek care at one that plans your treatment using advanced imaging, such as MRI, says radiation oncologist Jessika Contreras, M.D., a specialist at Miami Cancer Institute, part of Baptist Health South Florida.

“There are centers that use only X-ray, but that doesn’t show soft tissues,” says Dr. Contreras. “At Miami Cancer Institute, we use MRI and get much more detail. The anatomy is better delineated.” Quality images are necessary because of the precision required by brachytherapy, a form of internal radiation therapy. Brachytherapy delivers radiation from an applicator that is placed near the cancer cells in the uterus or vagina, while sparing surrounding organs.

Dr. Contreras discussed brachytherapy and other treatments for cervical and endometrial cancer during a live community webinar earlier in January, which is Cervical Cancer Awareness Month. Institute nurse navigators Faith March, R.N., and Rosario Carrigan, R.N., joined Dr. Contreras for “Navigate Your GYN Experience.” The entire program may be viewed here (the password is z5kssT.@).

It’s important for women with cervical cancer to understand that their treatment could be very different from that of someone else with the same diagnosis. Treatment will also vary depending on the size and spread of the disease.

“Previously, we pretty much thought each patient was equal,” Dr. Contreras says. “We are learning there is a lot of biological variability.” Research has led to new treatments and better patient outcomes.

Patients whose cervical cancer is caught very early sometimes undergo surgery and require no further treatment. Others with more advanced disease may have a combination of chemotherapy and external beam radiation with brachytherapy.

Miami Cancer Institute’s nurse navigators play a key role in everything from educating patients about their diagnosis and treatment to connecting them to helpful resources and providing emotional support and guidance. “We are here to help them navigate the system during a time in their lives when everything can seem overwhelming,” says Ms. March. “We help advocate for their care, promote healthy lifestyle choices and self-care, and help with coordination of care.”

While cervical cancer is still the fourth most common cancer among women, the numbers are on the decline and survival rates are improving. Doctors at Miami Cancer Institute are optimistic that this positive trend will continue, thanks to a greater awareness of the importance of screenings, the widespread use of the HPV vaccine, and new technologies and treatment options.

When it comes to treatment, Dr. Contreras says exciting progress is being made in the area of precision medicine, or targeted therapies, using medications that work on specific molecules that some tumors have. Miami Cancer Institute also offers clinical trials and is currently participating in an immunotherapy trial for certain cervical cancer patients that helps the immune system fight cancer. Institute oncology experts always discuss fertility-preservation options for patients who still want to have a family.

Prevention and early detection are key, of course, in the fight against cervical and endometrial cancer. Dr. Contreras urges women to have an annual pelvic exam and follow their primary care physician’s or gynecologist’s recommendation for Pap screenings, which can find changes in cells before cancer develops. She also encourages everyone to adhere to CDC recommendations for the HPV vaccine because HPV, or human papillomavirus, is the cause of more than 95 percent of cervical cancers (although it is not thought to be the cause of endometrial cancers).

Risk factors for endometrial cancer include obesity, supplemental hormones, a poor diet and lack of exercise. Additional risk factors for cervical cancer include having multiple sexual partners, taking medications that suppress the immune system, smoking and not having the HPV vaccine. It’s always good to understand your family history of cancer.