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Treating advanced cervical cancer

Women discussing cervical cancer

This page is an overview of the treatments your specialist may suggest if you have advanced cervical cancer. You can find information below on

 

A quick guide to what's on this page

Curing advanced cervical cancer

Advanced cervical cancer means cancer that has started to spread into nearby tissues or further.  Doctors calls this stage 2B or above. It is sometimes possible to cure advanced cervical cancer even if it has come back after treatment (recurrent cervical cancer). Whether your cancer can be cured will depend on how much cancer there is, and where it has spread to. Unfortunately, it is not usually possible to cure cervical cancer that has spread to a body organ further away from the cervix, such as the lungs or liver (stage 4B).

Which treatments are available

Doctors usually treat advanced cervical cancer with chemotherapy and radiotherapy together. Surgery may sometimes be an option afterwards. If you have already had radiotherapy for cervical cancer, you may not be able to have any more. Your specialist will discuss which treatment is best for your individual situation.
 

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

 

 

What advanced cancer is

Advanced cervical cancer means cancer that has grown into tissues around the cervix (stage 2B), or spread further. It is sometimes possible to cure advanced cervical cancer even if it has come back after your first phase of treatment (recurrent cervical cancer). Whether your cancer can be cured will depend on

  • How much cancer there is
  • How widespread the cancer is
  • Exactly where it has spread to

Unfortunately, it is not usually possible to cure cervical cancer that is stage 4B. That is cervical cancer that has spread to another body organ further away from the cervix, such as the lungs or liver. If you are looking for information about treating this stage of cancer, go to the section on controlling symptoms of advanced cervical cancer.

 

The main treatments

Doctors now usually treat advanced cervical cancer with combined chemotherapy and radiotherapy (chemoradiation). Some women may have surgery after this.

Treatment often depends on whether you have had treatment before. If you have already had radiotherapy for cervical cancer, you may not be able to have any more. There is a maximum amount of radiotherapy normal body tissues can take. So you may have chemotherapy on its own, or with surgery.

 

If it's spread to nearby tissues

Cancer that has spread to nearby tissues is called stage 2B or stage 3 cervical cancer. If your cancer is at this stage when you are diagnosed, you will usually have internal and external radiotherapy along with chemotherapy. There is more about radiotherapy and about combined chemoradiation in this section.

 

If it's spread to nearby organs

If your cancer has spread to your bladder or bowel it is called stage 4A. If your cancer is this stage when you are diagnosed, you may have internal and external radiotherapy, along with chemotherapy (chemoradiation) or radical surgery

Radical surgery means removing the womb and vagina as well as any part of the bladder, bowel or rectum that is affected by the cancer. Or you may have a smaller operation to stage your cancer. This means finding out exactly which areas are affected. 

After surgery, if this is your first phase of treatment, you would then have external radiotherapy to the affected areas. There is more about the operations you may have in this section.

 

If cancer has come back

Cervical cancer can grow and spread locally, within the pelvis. It can also spread to nearby lymph nodes. There are lymph nodes in a chain running up from both groins. It is these lymph nodes that can be a common site of cervical cancer spread.

Diagram of the lymph nodes in the pelvis

If you have cervical cancer that has come back after previous radiotherapy treatment, you may be able to have surgery if the cancer has not spread too far. The extent of the surgery depends on how much cancer there is and where exactly it has come back. 

Your specialist will usually ask you to have a CT scan to see where the cancer is. Or you may have a PET scan if your specialist thinks that you need a large operation (radical surgery). You will usually need to have an examination under anaesthetic as well. You will probably need to have your womb and cervix removed as well as any part of the bladder or bowel that is affected. You will also need to have any lymph nodes removed that are linked to the areas where the cancer has come back.

 

Chemoradiation

You may have chemotherapy to treat any stage of advanced cervical cancer, usually alongside radiotherapy or possibly surgery.

Chemotherapy and radiotherapy together (chemoradiation) is a good option for many cervical cancers. You don't have chemotherapy every day. So some days you'll have both treatments, and others you'll just have radiotherapy. There are different ways of giving this treatment and it depends partly on the drugs your doctor chooses. You may have chemotherapy once a week throughout your 5 week radiotherapy course. Or you may have it every 2 or 3 weeks during your radiotherapy course. 

The combined treatment has more side effects, mainly affecting your bone marrow or bowel, but these generally only last a short time. There is more information about combined chemoradiation and the side effects in this section.

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Updated: 17 June 2014