Treatment decisions for advanced cervical cancer

Deciding about treatment can be difficult when you have advanced cancer. Treatments such as chemotherapy or radiotherapy can help to reduce symptoms and might make you feel better. But they also have side effects that can make you feel unwell for a while.

It helps to understand:

• what treatment can do for you
• how it might affect your quality of life
• what side effects it has

Your doctor or specialist nurse can talk to you about the benefits and possible side effects. You can ask them questions.

You might also find it helps to talk things over with a close relative, a friend or a counsellor at the hospital.

Types of treatment

Treatment depends on:

• the size of the cancer and where it is in the body
• the treatment you have already had
• your general health

Treatment for cancer that has come back within the pelvis (local recurrence)

The pelvis is the lower part of your tummy, between your hips. Depending on the treatment you had before and exactly where the cancer has come back, you might have:

• surgery to remove your womb, cervix and top of the vagina (radical hysterectomy)
• an operation to remove the organs within your pelvis (pelvic exenteration)
• chemotherapy and radiotherapy together (chemoradiotherapy)

For some women, treatment for a local recurrence may still cure the cancer.

Treatment for cancer that has spread further away in the body

Chemotherapy

Chemotherapy can help to shrink a cancer down to reduce symptoms and help you feel more comfortable. It can sometimes help you live some time longer. 

Targeted cancer treatment

You might have a targeted cancer drug called bevacizumab (Avastin) with chemotherapy to help control the cancer for a while. 

Immunotherapy

You might be offered an immunotherapy drug as part of a trial, for example Pembrolizumab. You can ask your doctor whether there are any trials that may be suitable for you. 

Radiotherapy

Radiotherapy can help to shrink the cancer and improve your quality of life if the cancer has spread and is causing symptoms such as pain.

Surgery

Surgery is not often used. But your doctor might suggest an operation if the cancer is causing a blockage in the kidneys or bowel.

Your choices

Your doctor might offer you a choice of treatments. Discuss the advantages and disadvantages of each treatment with them and ask how they can control any side effects. This helps you make the right decision for you. You also need to think about the other factors involved in each treatment, such as:

• whether you need extra appointments
• if you need more tests
• the distance you need to travel to and from hospital

You might have to make further choices as your situation changes. It helps to find out as much as possible each time. You can stop a treatment whenever you want to if you find it too much to cope with.

If you decide not to have treatment

You may decide not to have cancer treatments, such as chemotherapy. But you can still have medicines to help control symptoms, such as sickness or pain.

Your doctor or nurse will explain what could help you. You can also ask them to refer you to a local symptom control team to give you support at home.