Treatments for recurrent cervical cancer

Recurrent cervical cancer means that the cancer has come back after it has been treated. You may be offered the following treatments for recurrent cervical cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Cervical cancer can come back in the cervix. It can also come back close to where it first started, such as in the uterus or other organs in the pelvis. It can also come back in distant sites.

Chemoradiation combines chemotherapy with external radiation therapy to make the radiation therapy work better. You may be offered chemoradiation for recurrent cervical cancer. The most commonly used chemotherapy drug is cisplatin, given alone or with the drug 5-fluorouracil.

You may be offered radiation therapy for recurrent cervical cancer. Radiation therapy may be external radiation therapy, internal radiation therapy (called brachytherapy) or both. For recurrent cervical cancer, radiation therapy is often given with chemotherapy, but in some cases it may be used alone as the main treatment.

Radiation therapy can be used to relieve pain, stop bleeding or control other symptoms of recurrent cervical cancer (called palliative therapy).

Find out more about radiation therapy for cervical cancer.

Chemotherapy may be offered to control the symptoms of recurrent cervical cancer or to relieve pain (called palliative therapy). Chemotherapy drugs used to treat recurrent cervical cancer can be used alone or in combinations.

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

• cisplatin and paclitaxel
• carboplatin and paclitaxel

These combinations are often combined with bevacizumab (a targeted therapy drug) or pembrolizumab (an immunotherapy drug) or both.

Other chemotherapy drugs used to treat recurrent cervical cancer include:

• ifosfamide
• irinotecan
• gemcitabine
• topotecan
• vinorelbine

Chemotherapy for cervical cancer is most often given through a needle into a vein (intravenously, or by IV). Chemotherapy without radiation therapy is usually given every 3 to 4 weeks. How long chemotherapy is given depends on the drug combination.

Find out more about chemotherapy for cervical cancer.

Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them to stop the growth and spread of cancer. You may be offered targeted therapy for recurrent cervical cancer. The most common targeted therapy drug used to treat cervical cancer is bevacizumab (Avastin). It is usually given in combination with chemotherapy.

Find out more about targeted therapy for cervical cancer.

Immunotherapy helps to strengthen or restore the immune system’s ability to fight cancer. You may be offered immunotherapy for recurrent cervical cancer.

If chemotherapy was used to treat metastatic cervical cancer but the cancer didn’t respond or it came back, then you may be offered the immunotherapy drug cemiplimab (Libtayo).

Pembrolizumab (Keytruda) may also be offered for recurrent cervical cancer in combination with chemotherapy. It’s sometimes given with the targeted therapy drug bevacizumab.

Find out more about immunotherapy for cervical cancer.

You may be offered one of the following types of surgery for recurrent cervical cancer.

A pelvic exenteration may be used to treat recurrent cervical cancer that comes back in the pelvis but has not spread to the side wall of the pelvis. A pelvic exenteration is not used if cancer comes back in another part of the body.

Find out more about a pelvic exenteration.

A radical hysterectomy may be offered for a small recurrence in the cervix or uterus if you were previously treated with radiation therapy.

Find out more about a hysterectomy.

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments donʼt work anymore, theyʼre not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you canʼt have or donʼt want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Talk to your doctor about clinical trials open to people with cervical cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.