Treatments for recurrent cervical cancer

Recurrent cervical cancer means that the cancer has come back after it has been treated. The following are treatment options 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 recur 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.

You may be offered chemoradiation for recurrent cervical cancer. Chemotherapy is given during the same time period as radiation therapy to make the radiation therapy more effective. 5-fluorouracil (Adrucil, 5-FU) plus cisplatin or mitomycin (Mutamycin) or other chemotherapy drugs may be used.

You may be offered radiation therapy for recurrent cervical cancer. Radiation therapy may be external radiation therapy, 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.

For recurrent cervical cancer, radiation therapy may be used to relieve pain, stop bleeding or control other symptoms of advanced cervical cancer (called palliative therapy).

Chemotherapy may be offered for recurrent cervical cancer to relieve pain or control the symptoms of advanced cervical cancer.

Chemotherapy drugs used to treat recurrent cervical cancer are used alone or in combination and include:

• 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
• paclitaxel and topotecan

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.

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 it didn't respond or the cancer comes back, then you may be offered cemiplimab (Libtayo).

Pembrolizumab (Keytruda) may also be offered for recurrent cervical cancer in combination with chemotherapy. It is sometimes given with the targeted therapy drug bevacizumab (Avastin). Pembrolizumab is only used for cervical cancer tumours that have the PD-L1 checkpoint protein.

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 don’t work anymore, they’re 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 can’t have or don’t 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 women with cervical cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.