Treatment: Chemotherapy

Chemotherapy is a systemic treatment with anticancer drugs.

The main goal of chemotherapy is to attack cancer cells and prevent the formation of new cells. Cancer cells quickly divide and multiple when left untreated.  In the early stages, this form of treatment is used to attack all the cancer cells and cure the disease. However, chemotherapy is also used to slow down progression of cervical cancer once it has spread throughout your body.

Can Chemotherapy help in cervical cancer?

Some years ago is was shown in several clinical studies that cisplatin-based chemotherapy could improve the outcome in women affected by locally advanced cervical cancer. Based on these findings, a recommendation was issued by the National Cancer Institute that cisplatin-based chemotherapy should be added to the treatment in women receiving radiation therapy.
This approach is called "chemoradiation" or "concurrent chemotherapy and radiotherapy".

Methods of Chemotherapy

Many different methods of chemotherapy exist.  Tablets or creams can be taken at home. However, most chemotherapy drugs are injected directly into your bloodstream.  These sessions normally take place at a hospital and can last from 30 minutes to several hours. A combination of 2 or more drugs is often used to increase the effectiveness of the treatment by killing as many cancer cells as possible.  Drugs may be injected into the vein in the back of your hand or in a thin tube that leads from your chest to a vein near your heart. This tube may be left in your body for several months so that the drugs can be more easily injected when necessary.

Treatments sessions have to be alternated with periods of rest to allow your body to sufficiently recover. Another reason for this cycle is that chemotherapy can only kill cancer cells that are actively dividing.  Therefore, repeat sessions are necessary to kill cells that were inactive or resting during your previous treatments.  The length of time you will need to undergo the sessions varies greatly depending on the type and severity of the cancer, as well as the success rate of the current method.

Chemotherapy Side Effects

Chemotherapy is often very effective in treating cervical cancer. Unfortunately, this method of treatment usually causes a long list of side effects.  The treatment is unable to distinguish between healthy and cancerous cells - chemotherapy targets all the quick-dividing cells within the body.  Consequently, you may experience nausea, mouth ulcers, diarrhea, extreme fatigue, constipation and an increased tendency to develop infections.  In addition, women normally suffer hair loss which is often considered one of the most devastating effects of chemotherapy.  Although this physical symptom isn’t painful, this side effect can be extremely damaging to a woman’s self-esteem and confidence.

High doses of chemotherapy can also destroy your body’s own immune cells. More serious side effects include the possibility of growth problems in children undergoing treatment and a potential for developing learning disabilities. This form of treatment can also lead to infertility in a small percentage of women.  The chemotherapy drugs specifically used to fight cervical cancer can also lead to kidney problems in a small percentage of patients. Your kidneys may become permanently damaged unless you discontinue treatment. For this reason, women with cervical cancer must have a blood test done before each treatment and they must drink plenty of liquids. These preventative measures will minimize your risk of kidney damage.

Combination Therapy

Chemotherapy is very effective in treating cervical cancer, especially when combined with other methods such as radiotherapy. The treatment does produce many side effects, but drugs are available to combat many of these adverse effects. Furthermore, most of the side effects will disappear once your chemotherapy sessions are finished. The bottom line is you should gather lots of information regarding chemotherapy in order to make an informed decision regarding your treatment options.

Cancer Stages and Chemotherapy

Usually chemotherapy is used in combination with radiation therapy, in several cancer stages:

Stage IB:

Radiation therapy plus chemotherapy
Radical hysterectomy followed by radiation therapy plus chemotherapy

Stage IIA:

Radiation therapy plus chemotherapy

Stage IIB:

Internal and external radiation therapy combined with chemotherapy

Stage III:

Internal and external radiation therapy combined with chemotherapy

Stage IVA:

Internal and external radiation therapy combined with chemotherapy

Stage IVB:

Chemotherapy or radiation therapy as palliative therapy to relieve symptoms

What is the benefit of chemotherapy in cervical cancer?

Studies have shown that several subgroups of women affected by cervical cancer can benefit from chemotherapy. These are women with locally advancer cancer, women with recurrent cancer, and also women with advanced cancer receiving chemotherapy as palliative treatment. One other option, which is still an experimental approach, is to administer chemotherapy to shrink cancerous tissue before doing surgery or radiation therapy. This approach is called "neoadjuvant therapy".

A 2001 Cochran review  reported that chemoradiation helped women with cervical cancer live longer, particularly in early stage cervical cancer. Some studies have shown that cisplatin works best in combination with radiotherapy in treating these early stage cancers. 
Other therapeutics used in clinical trials for cervical cancer are Ifosfamide, 5-Fluorouracil or 5 FU, Irinotecan and Paclitaxel (Taxol).




Resources/Links:

Clin Adv Hematol Oncol. 2006 Apr;4(4):279-86. Chemotherapy in the management of cervical carcinoma. (Link to PUBMED Abstract)

National Cancer Institute -  www.cancer.gov (Cancer Treatment Information)

Eur J Surg Oncol. 2006 May 11;Management of cervical cancer.(Link to PUBMED Abstract)

CancerHelp UK (cervical cancer chemotherapy)

This page was last updated:

June 12,  2006

It is not the intention of Cervicalcancer.org to provide specific medical advice, but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided, and Cervicalcancer.org urges you to consult with a qualified physician for diagnosis and for answers to your personal questions.
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