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Controlling advanced cervical cancer symptoms

Women discussing cervical cancer

This page is about treatment you can have for symptoms of advanced cancer of the cervix. You can find information on

 

A quick guide to what's on this page

Controlling advanced cervical cancer symptoms

If your cervical cancer can't be cured, there is treatment available to control your symptoms. This treatment may also shrink the cancer and slow it down.

Which treatments are available

Surgery, chemotherapy and radiotherapy can all be used to treat cervical cancer that has spread or cannot be cured. Which treatment you have will depend on where your cancer has spread to, the size and number of secondary tumours you have, your symptoms, the treatment you have had before, and how well you are. 

Deciding about treatment

It can be difficult to decide which treatment to try, or whether to have treatment at all, when you have advanced cancer. You will need to consider how the treatment will affect you. This means finding out about side effects as well as thinking about travelling back and forth to the hospital for appointments and treatment.

Most importantly, you will need to understand what can be achieved with the treatment you are being offered. Your doctor will discuss the options for treatment with you. There may be a counsellor or specialist nurse you could chat to. You may also wish to talk things over with a close relative or friend.
 

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

 

 

What advanced cervical cancer means

Sometimes cervical cancer can't be cured. This may be because it keeps coming back in the pelvis and abdomen despite all the treatment you have had. Or because it has spread from where it started in the cervix to another part of the body. This is called a secondary cancer or metastasis. Some of the cervical cancer cells have travelled through the lymphatic system or bloodstream and lodged in another part of the body. They have then started to grow there. If cervical cancer does spread to another part of the body it most often spreads to the

Click on the links to find out more about secondary cancers.

It can also spread to the ureters (these are the tubes that run from each kidney to the bladder).

Even if your cervical cancer can't be cured, there is treatment available to control your symptoms. This treatment may also shrink the cancer and slow it down, even if it cannot get rid of it altogether.

 

Which treatments are available

Surgery, chemotherapy and radiotherapy can all be used to treat cervical cancer that has spread or cannot be cured. Which treatment you have will depend on

  • Where your cancer has spread
  • The size and number of secondaries you have
  • The symptoms the cancer is causing
  • The treatment you have already had
  • How well you are - whether you are strong enough to have a particular treatment

There may be trials of experimental treatments going on which you could take part in. These could be trials for new chemotherapy drugs or new types of treatment. Look in the page on cervical cancer research in this section.

We also have a trials and research section which includes a database of clinical trials. Choose 'cervical' from the drop down menu of cancer types. You can choose to search for trials that are open and recruiting patients, trials that have finished recruiting and are following up the patients who took part, and trials that have produced results.

 

Deciding about treatment

It can be difficult to decide which treatment to try, or whether to have treatment at all, when you have advanced cancer. You will need to consider how the treatment will affect you. This means finding out about side effects as well as thinking about travelling back and forth to the hospital for appointments and treatment.

Most importantly, you will need to understand what can be achieved with the treatment you are being offered. Your doctor will discuss the options for treatment with you. There may be a counsellor or specialist nurse you could chat to. You may also wish to talk things over with a close relative or friend.

It can be helpful to talk over difficult decisions with someone who is outside your own circle of family and friends. If you would like to talk to someone else, contact our cancer information nurses. Or look for a cervical cancer organisation that can help put you in touch with a support group. We also have information about counselling oganisations who can help you to find sources of emotional support and counselling in your area.

 

Radiotherapy

Doctors can use radiotherapy to

  • Shrink lung secondaries
  • Control pain

Radiotherapy can control pain by shrinking tumours that are pressing on nerves or are growing inside the bones. When you have radiotherapy to control symptoms, you usually only have a short course. You may only have one or two treatments and you'd very rarely have more than 10. So you should not have many side effects. There is more about radiotherapy in our section on treating cervical cancer with radiotherapy. And there is general information about radiotherapy for symptoms in the radiotherapy section.

 

Surgery for a blockage

Surgery is used in particular situations in advanced cervical cancer that cannot be cured. It can only be used if you are fit enough to have an operation. And it is important to think about how getting over an operation will make you feel. In other words, the benefits of the surgery should be more than the discomfort you will have to go through.

If your cancer begins to grow into or around your bowel, there is a risk that it may cause a blockage. This means that the waste that normally passes through the bowel cannot get through. This does not happen to everyone. But if it happens to you, you may

  • Feel bloated
  • Be constipated
  • Feel sick
  • Have griping pains in your abdomen
  • Vomit large amounts

Your doctor may suggest surgery to clear a blocked bowel. It may be possible to operate to remove the blockage, or in some cases, bypass it by making a colostomy. There is more information about having a colostomy operation in our section about colorectal cancer: if you need a colostomy.

No one can say how much you will benefit from this operation. The cancer may not come back quickly. And it may not come back to block the bowel again. On the other hand, it may be quite a big operation to have when you are feeling low.

Sometimes, instead of a colostomy, it is possible to have a tube called a stent put in, to allow motions (poo) to pass along the bowel. The specialist will use X-rays to guide the stent into place.

Sometimes doctors use a drug called octreotide to help control the symptoms of a blocked bowel instead of an operation. The drug works by reducing the amount of fluid that builds up in your stomach and digestive system. Unfortunately this treatment is only a temporary measure.

 

Experimental surgery

With some types of cancer, doctors have had limited success in removing secondary cancers from the liver or lungs. This can only be done if there are just one or two small and isolated areas of secondary cancer in either the liver or lungs. It is not often tried with cervical cancer secondaries, usually because the secondary cancer is too widespread. Or because other treatments are tried instead. When deciding whether this treatment is possible for you, your doctor will have to think about

  • Your general health
  • How advanced your cancer was when it was diagnosed
  • How quickly your cancer came back before

There is more information about this type of treatment in the section on treating cervical cancer with surgery.

 

Treating a waterlogged kidney

You may hear this called hydronephrosis. In cervical cancer, one (or sometimes both) of the tubes from the kidney to the bladder can get blocked by the tumour. This means that the urine made by that kidney cannot drain away and the kidney becomes overloaded with it. If not treated this can make you feel extremely ill and can cause that kidney to fail. Obviously, it is even more serious if both your kidneys are affected.

To treat this, your doctor will put in a tube to drain the urine. This can be done in two ways

  • Your doctor may be able to put a tube through the blockage. The tube is entirely inside your body. It allows the urine to get past the blockage and drain into the bladder. The tube is called a stent.
  • It isn't always possible to put a stent in straight away, or at all. If it can't be done straight away, your doctor will put in a tube called a nephrostomy tube. This allows urine to drain out of the body into a bag. The bag has a tap on it so you can empty it. After this type of surgery, you will have a district nurse visit you at home to help you manage the tube and drainage bag. You may be able to have a stent put in after things have settled down a bit with that kidney.
 

Chemotherapy

This treatment is still being researched for advanced cervical cancer. This means doctors cannot be sure how much help it will be. But good results have been reported in some cases. It is sometimes possible to stop the spread and growth of the cancer for some months (in rare cases, even years). Particularly if the cancer has only spread to one part of the body.

Treatment is usually with a combination of chemotherapy drugs. Using more than one drug generally increases the chances of shrinking the tumour. You will almost certainly have some side effects with chemotherapy treatment. The side effects vary depending on the drugs that are being used to treat you. So ask your doctor or nurse what the side effects are likely to be. This will help you decide whether to have the treatment or not.

There is more information about this type of treatment in the section on chemotherapy and also in the section on treating cervical cancer with chemotherapy. There is information about specific chemotherapy drugs in our cancer drug section.

 

Treatment for particular symptoms

As well as having treatment to control symptoms by shrinking your cancer, there are treatments that are directed straight at the symptoms. If you are having any troublesome symptoms, such as pain or sickness, make sure that your doctor and specialist nurse know. They will be able to suggest ways of making you more comfortable, and so improve the quality of your day to day life.

Your hospital doctor, nurse or GP may suggest referring you to a team of symptom control specialists. These doctors and nurses specialise in relieving symptoms of cancer and other chronic diseases. You may hear them called Macmillan teams, palliative care teams or symptom control teams. Some are hospital based and some are community based. They may be based at your local hospice.

The community based teams are able to come and see you in your own home. The nurse or doctor who visits will ask you questions about your symptoms - how bad they are, whether anything makes them better or worse, for example. It may take a while to get good control of your symptoms, but there is very little that they can't help you with. You may also find them a source of emotional support. They have experience of working with people in your situation and will be sensitive to how you are feeling.

There is such a wide range of possible symptoms, and ways of helping them, that we can't go into them all here. We have a large section on coping physically with cancer. It includes information about pain control and controlling sickness.

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Updated: 2 June 2014