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Chemoradiation for cervical cancer

This page tells you about the combination treatment of chemotherapy and radiotherapy for cervical cancer.

 

A quick guide to what’s on this page

Chemoradiation for cervical cancer

Doctors often use a combination of chemotherapy and radiotherapy to treat cervical cancer. They call this chemoradiation. You are most likely to have this treatment if you have anything from a stage 1B2 cancer to a stage 4A cancer. A stage 1B2 cervical cancer is still within the cervix, but is bigger than 4cm across. A stage 4A cancer is one that has spread from the cervix, into the womb and into surrounding tissues, such as the bowel or bladder.

With this treatment, you have chemotherapy during your course of radiotherapy. You don't have chemotherapy every day, so some days you'll have both treatments and other days you'll just have radiotherapy. There are different ways of having this treatment and it depends partly on the chemotherapy drugs your doctor gives you.

Side effects of chemoradiation treatment

Having radiotherapy and chemotherapy together can be quite intensive. You may be prone to getting infections due to the chemotherapy. And you may also have radiotherapy side effects such as diarrhoea, bladder inflammation (radiation cystitis), and soreness and redness of your vulva or back passage.

Most side effects are temporary and can be managed well. Let your doctor or nurse know about any side effects you have so that they can help.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating cervical cancer section.

 

 

Combined chemotherapy and radiotherapy treatment

Until recently cervical cancer was most likely to be treated with radiotherapy or surgery to remove the cervix, womb and lymph nodes. This type of surgery is called a hysterectomy. Following clinical trials, doctors now know that giving chemotherapy at the same time as radiotherapy (chemoradiation) gives the best chance of curing cervical cancer.

Giving radiotherapy and chemotherapy at the same time seems to work better at killing cancer cells than having these treatments on their own. The reason for this is not very clear but researchers think it may be because the chemotherapy makes cancer cells more sensitive to radiotherapy.

Many clinical trials have compared different ways of giving this treatment. A review in 2010 of these trials reported that chemoradiation helped women with cervical cancer to live longer. Chemoradiation also lowered the risk of the cancer coming back or spreading to other parts of the body.

Some trials have shown that cisplatin works best alongside radiotherapy for cervical cancer, but this review reported that other chemotherapy drugs worked as well as cisplatin.

Combination chemotherapy and radiotherapy is not suitable for you if

  • You have very early stage cervical cancer (stage 1A and 1B1), because this can be successfully treated with surgery or radiotherapy alone
  • You are not healthy enough – for example because your kidneys don’t work as well as they should
  • You have very advanced stage cervical cancer (stage 4B) that has spread to other parts of your body, such as the lungs or liver.

Unfortunately very advanced cervical cancer is unlikely to be cured by the radiotherapy and cisplatin combination. Instead, you may have surgery, radiotherapy, chemotherapy or a combination of these, depending on what best suits your particular circumstances.

 

How you have chemoradiation

There are different ways of having chemoradiation treatment and it depends partly on the chemotherapy drugs that you have. Cisplatin is one of the most common chemotherapy drugs that doctors use.

You may have chemotherapy once a week throughout a 5 week radiotherapy course. Or you may have chemotherapy every 2 or 3 weeks during your radiotherapy course.

 

Side effects of chemoradiation

The side effects of combined chemotherapy and radiotherapy are the same as if you had each treatment separately. But some side effects are likely to be more severe. In particular, there is a risk of developing a very low white blood cell count. This means you are at risk of getting an infection. If you have any signs of infection, such as a raised temperature, a sore throat, or pain when passing urine, you must contact your doctor.

You may also have a low platelet count. Platelets help your blood to clot. So if your platelets are low, this may cause symptoms such as nosebleeds, bleeding gums, or a rash of red spots caused by bleeding under the skin. If you have any of these symptoms, let your doctor know as soon as possible. If your blood counts fall very low, you may need to stop chemotherapy for a while until they recover.

Women having this treatment may be more likely to have digestive side effects, such as diarrhoea, during their radiotherapy treatment. Again, do tell your doctor, nurse or radiographer. They may not be able to get rid of the problem, but they may be able to give you something to lessen it. Or they can help you to cope in other ways.

Cisplatin chemotherapy doesn't generally cause hair loss.

Most side effects are temporary and manageable. There is information in this section about the particular side effects of radiotherapy and the side effects of chemotherapy for cervical cancer.

 

Getting information and support

We have detailed information about chemotherapy and about radiotherapy on our website. You can ask your doctor or specialist nurse for written information.

You could also email our cancer information nurses or call them from Monday to Friday, 9am to 5pm on freephone 0808 800 4040. They will be happy to help.

Our cervical cancer organisations page has details of organisations that can put you in touch with a cancer support group. The cervical cancer reading list has information about books, leaflets and CDs on cervical cancer treatments.

If you want to find people to share experiences with online, you could use CancerChat, our online forum.

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Updated: 2 June 2014