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University of Florida Proton Therapy Institute

Since cancers begin in different ways, are located in different parts of the body, and have different ways of spreading, cancer treatments come in several different forms. Some new cancer treatments, like proton therapy, eradicate tumors with fewer cancer treatment side effects.

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Cervical Cancer

Cervical cancer is a disease in which cancer cells develop in the lower, narrow portion of the uterus. The American Cancer Society estimates that there will be over 9,700 new cases of cervical cancer and 3,700 deaths from this disease in the United States in 2006. Most of these cancers develop over an extended period of time, as cells gradually begin to appear abnormal and then become malignant. The most common cause of cervical cancer is Human papillomavirus (HPV). Regular gynecologic examinations are important because early cervical cancer may cause no symptoms and PAP smears can help in the early detection and successful treatment of the disease. Cervical cancer that is more advanced may cause abnormal vaginal discharge or bleeding, pelvic pain or painful intercourse. These cancers can spread into the tissues surrounding the cervix, lymph nodes or other areas of the body.

The chance of successfully treating a cervical cancer is determined by the stage, size and type of cancer. Early cervical cancers are usually treated with surgery, but can also be treated effectively with radiotherapy. More advanced cervical cancer is usually treated with radiation therapy given at the same time as a low dose of chemotherapy to sensitize the cancer cells to the radiation.

Conventional radiation therapy uses high-energy X-rays to damage and kill cancer cells. These X-rays must travel through normal tissues and organs such as the bladder and rectum to reach the cervix. This radiation may cause damage to these normal tissues producing treatment side effects such as temporary or occasionally permanent urinary, gastrointestinal, or sexual dysfunction.

The two most common methods of delivering radiation are conventional external beam radiation therapy and internal radiation or brachytherapy. Both methods use X-rays as a source of radiation. X-rays are very lightweight packets of energy that pass through tissue creating damage along their paths. External beam radiation is delivered by a machine called a linear accelerator that gives a daily dose of radiation to the patient over several weeks.

Internal radiation, or brachytherapy, is done by placing holders for radiation sources into the uterus and upper vagina or by placing catheters to hold radiation seeds into the tissues around the cervix. This placement of holders is usually done in the operating room under anesthesia. The radioactive sources release their radiation into the cervix and surrounding tissues while they are in place, usually for two days or less. It is common to use more than one brachytherapy procedure in a course of treatment for locally advanced cervical cancer. The combination of external and internal radiation is effective at killing cancer cells and curing patients, but treatment side effects sometimes limit the dose needed for the best chance of cure.

Protons, which are positively charged particles, can also be used to deliver radiation therapy. A cyclotron is used to accelerate the protons to the best energy for each patient. Protons deposit less energy in normal tissues than X-rays, and therefore may cause fewer cancer treatment side effects and complications. Proton radiation therapy has been used to treat a few uncommon types of cancer for more than forty years in centers over the world. However, advances in imaging and computer technology now allow the efficient and safe application of proton therapy to a broad range of cancers.

The University of Florida department of Radiation Oncology has a history of more than 30 years of clinical research and has plans to develop protocols for the treatment of patients with advanced cervical cancer.

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