Chemotherapy for Cervical Cancer

Cervical cancer begins in the cells of the cervix, the lower part of the uterus that connects to the vagina. Usually, the tumor develops gradually through a series of precancerous changes in the cervical tissues. Over time, abnormal cells may become cancerous and invade deeper layers of the cervix or spread to nearby organs. When detected early, cervical cancer is highly treatable, but it can become life-threatening if left untreated.

Cervical cancer most frequently affects women between the ages of 35 and 55, but it can occur at any age. The leading cause is persistent infection with a high-risk type of human papillomavirus (HPV), a common sexually transmitted infection (STI). Additional risk factors include smoking, a weakened immune system, multiple sexual partners and a lack of routine cervical cancer screening through regular Pap tests and HPV tests. These screenings are critical because early-stage cervical cancer often has no noticeable symptoms.

When cervical cancer symptoms develop, they may include pelvic pain, unusual vaginal discharge or abnormal vaginal bleeding, such as bleeding between menstrual periods or after sexual intercourse. The diagnostic process typically involves a pelvic examination, Pap test, HPV test and follow-up procedures, such as colposcopy and biopsy, to confirm the presence of cancer. Imaging tests may also be used to help the physician assess the extent of the tumor.

Treatment for cervical cancer can vary based on the type and stage of the tumor. Options may include surgery, chemotherapy, radiation therapy, immunotherapy, a clinical trial or a combination of these approaches. Surgical treatment may be sufficient to remove an early-stage tumor. In an advanced case, chemotherapy may be used alongside radiation therapy or as the primary treatment if surgery is not possible.

When is chemotherapy used for cervical cancer?

Chemotherapy can be used in several ways to treat cervical cancer. Often, it is combined with radiation therapy in a regimen known as chemoradiation, a common treatment for locally advanced cancer. Certain chemo agents, such as cisplatin and 5-fluorouracil, have been found to enhance the effectiveness of radiation therapy.

Chemotherapy for cervical cancer may be administered before surgery to shrink the tumor and make it easier to remove, or after surgery to reduce the risk of recurrence. In advanced or metastatic cases where the cancer has spread beyond the cervix, chemo may be used as the primary treatment to slow the progression of the tumor and relieve the related symptoms.

What does chemotherapy for cervical cancer involve?

Chemotherapy involves the use of one or more powerful medications to destroy cancerous cells or stop them from multiplying. The most commonly used chemo agents for cervical cancer are cisplatin, carboplatin and paclitaxel. After entering the bloodstream, the drugs circulate throughout the body to reach widespread cancer cells. In some cases, chemotherapy may be combined with targeted therapy, such as bevacizumab, for enhanced treatment effectiveness.

The specific chemotherapy regimen, drug dosage and treatment duration can vary depending on the type and stage of the tumor and the patient’s overall health. Typically, the medications are administered intravenously in cycles, allowing time for the body to recover between treatment sessions.

What happens during chemotherapy for cervical cancer?

Before each chemotherapy session, the patient will undergo a series of laboratory tests to evaluate kidney and liver function, as well as blood cell counts. These assessments can help the physician confirm that it is safe to proceed. Chemotherapy is a demanding treatment that targets rapidly dividing cells throughout the body. It can potentially suppress bone marrow activity, increasing the risk of infection. It can also place added stress on vital organs, such as the liver and kidneys. If these organs are not functioning properly, the body may struggle to metabolize and eliminate the drugs, which may lead to serious complications, including systemic toxicity. Routine pre-treatment testing will allow for timely adjustments to the treatment plan and help ensure that chemotherapy is delivered as safely and effectively as possible.

During chemotherapy, the patient will receive their prescribed medications through an intravenous (IV) line or port, usually in an outpatient infusion center or hospital setting. Each treatment session can last up to a few hours, depending on the specific drugs used. To help prevent or reduce side effects, the patient may receive anti-nausea medications and hydrating fluids before and after each infusion. The physician will closely monitor the patient’s tolerance and response to chemotherapy throughout the course of treatment, adjusting the dosage and schedule as necessary to ensure an optimal result.

What are the possible side effects of chemotherapy for cervical cancer?

Because chemotherapy focuses on areas of high metabolic activity throughout the body, it can affect cancerous cells as well as normal cells that naturally divide rapidly, such as those in the digestive tract, hair follicles and bone marrow. Damage to healthy cells can lead to a variety of side effects, including:

• Decreased appetite
• Diarrhea
• Fatigue
• Hair thinning and hair loss
• Nausea and vomiting

Blood cell counts often decrease during chemotherapy, raising the risk of infection, anemia or excessive bleeding. Additionally, certain chemo agents, such as cisplatin, can cause hearing loss or kidney issues, while paclitaxel is often associated with numbness or tingling sensations in the hands and feet (peripheral neuropathy). Most side effects of chemotherapy are temporary and resolve after treatment is completed. In the meantime, any discomfort can usually be managed with supportive care.

What are the risks and possible complications of chemotherapy for cervical cancer?

In addition to side effects resulting from damage to healthy cells, chemotherapy has other risks and potential complications. Prolonged suppression of the immune system can increase the risk of severe and recurrent infections. Chemo can also lead to long-term kidney, liver or nerve damage, especially with repeated or high-dose treatments. Though rare, a serious allergic reaction to the medication is also possible.

Due to the potential effects of chemotherapy on the female reproductive system, some women may experience fertility changes or early menopause. To reduce the risk of complications, it is important for the patient to report any new or unusual symptoms to their healthcare team as early as possible.

What to expect during recovery from chemotherapy for cervical cancer

Recovery from chemotherapy is gradual, and the healing process can vary widely among patients. Fatigue is one of the most common lingering effects, and it may take up to several weeks or longer for energy levels to return to normal. Most short-term side effects, such as nausea and hair loss, resolve after the treatment ends, although some issues, such as neuropathy and menstrual cycle changes, may persist.

After chemotherapy, the patient will continue to have follow-up visits to check for signs of cancer recurrence and manage any ongoing health concerns. To promote emotional recovery, many patients benefit from support groups or counseling during this phase of cancer care.

How effective is chemotherapy for cervical cancer?

Chemotherapy can be effective for cervical cancer, especially when used in combination with other treatments, such as radiation therapy. In locally advanced cases, chemoradiation has been shown to significantly improve outcomes. In advanced or metastatic cases, chemotherapy is usually not curative, but it can help slow the progression of the tumor, relieve the symptoms and improve the patient’s quality of life. Through regular monitoring, the physician will continually evaluate the success of treatment and plan the next steps.

Benefit from world-class care at Moffitt Cancer Center

Chemotherapy for cervical cancer is available at all Moffitt locations, and we do not require referrals. If you have questions, you can request an appointment with a specialist in our gynecological clinic by calling 1-888-663-3488 or submitting a new patient registration form online.