Chemotherapy for cervical cancer

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. It is sometimes used to treat cervical cancer. Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of chemotherapy. You may also receive other treatments.

Chemotherapy is often combined with radiation therapy to treat cervical cancer. This is called chemoradiation. The 2 treatments are given during the same time period.

Chemotherapy is given for different reasons. You may have chemotherapy or chemoradiation to destroy cancer cells in the body when you are first diagnosed or if the cancer comes back (recurs) after treatment.

Chemotherapy or chemoradiation can also be given to:

• destroy cancer cells left behind after surgery and reduce the risk that the cancer will come back (called adjuvant chemotherapy)
• relieve pain or control the symptoms of advanced cervical cancer (called palliative chemotherapy)

Chemotherapy is usually a systemic therapy. This means that the drugs travel through the blood to reach and destroy cancer cells all over the body, including those that may have broken away from the primary tumour in the cervix.

The most common chemotherapy drugs used to treat cervical cancer are:

• cisplatin
• carboplatin (Paraplatin, Paraplatin AQ)
• paclitaxel (Taxol)
• topotecan (Hycamtin)
• gemcitabine (Gemzar)
• 5-fluorouracil (Adrucil, 5-FU)
• ifosfamide (Ifex)
• docetaxel (Taxotere)
• irinotecan (Camptosar)
• mitomycin (Mutamycin)
• vinorelbine (Navelbine)
• epirubicin (Pharmorubicin)
• doxorubicin (Adriamycin)

The most common chemotherapy drug combinations used to treat cervical cancer are:

• cisplatin and ifosfamide
• cisplatin and paclitaxel
• cisplatin and gemcitabine
• cisplatin and topotecan

Cisplatin is the most common chemotherapy drug used in chemoradiation for cervical cancer. Cisplatin and 5-FU may also be used. It is given with external radiation therapy. The chemotherapy acts as a radiosensitizer, which means it allows the radiation to work better. Cisplatin is usually given once a week during radiation therapy. Cisplatin and 5-FU is usually given every 4 weeks during radiation therapy.

Side effects can happen with any type of treatment for cervical cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Chemotherapy may cause side effects because it can damage healthy cells as it kills cancer cells. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after chemotherapy. Sometimes late side effects develop months or years after chemotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of chemotherapy will depend mainly on the type of drug, the dose, how it’s given, if chemotherapy is given at the same time (chemoradiation) and your overall health. Side effects of chemoradiation can be more severe than those of chemotherapy alone.

Some common side effects of chemotherapy drugs used for cervical cancer are:

• fatigue
• low blood cell counts
• nausea and vomiting
• sore mouth and throat
• loss of appetite
• diarrhea
• hair loss
• skin problems
• peripheral nerve damage ( peripheral neuropathy)
• treatment-induced menopause
• fertility problems

Tell your healthcare team if you have these side effects or others you think might be from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.