American Board of Internal Medicine (ABIM) Certification Practice Exam

What treatment is recommended for patients with stage IB through stage IV cervical cancer?

1. Surgery only

2. Radiation therapy and concurrent chemotherapy

3. Only chemotherapy

4. Immunotherapy

The correct answer is: Radiation therapy and concurrent chemotherapy

For patients with stage IB through stage IV cervical cancer, the recommended treatment is radiation therapy combined with concurrent chemotherapy. This approach is well-established in clinical guidelines as it enhances the efficacy of treatment by taking advantage of the synergistic effects of both modalities. The chemotherapy works to sensitize the cancer cells to radiation, making them more susceptible to destruction. In more advanced stages of cervical cancer, surgery alone is often insufficient because of the potential for residual disease and metastatic spread. By incorporating radiation therapy, especially in cases where surgery isn't feasible or has been performed inadequately, the overall survival rates can be improved. Combined modality treatment is particularly crucial for addressing both locally advanced disease and any microscopically involved nodes. Chemotherapy alone, while effective in some contexts, does not provide the same local control as radiation when dealing with cervical cancer, especially at higher stages. Immunotherapy, although a promising area in cancer treatment, is not the standard approach for cervical cancer unless in a clinical trial or specific cases with certain genetic markers. Thus, the combination of radiation therapy and concurrent chemotherapy stands out as the most effective treatment strategy for managing cervical cancer that has progressed to stages IB through IV.