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Chemotherapy treatment

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. They work by disrupting the growth of cancer cells. The drugs circulate in the bloodstream around the body.

When you have chemotherapy

Whether you have chemotherapy depends on the stage of your cervical cancer and what is best for you. 

You are likely to have chemotherapy at the same time as radiotherapy (chemoradiotherapy) if you have anything from a stage 1B2 cancer to a stage 4A cancer.

Or you might have chemotherapy:

  • for cancer that has come back
  • before surgery as part of a clinical trial

Doctors are looking at whether it is useful to use chemotherapy to shrink a cancer before surgery or before chemoradiotherapy. This is called neo adjuvant therapy. If it works, it can mean that you have a smaller operation or radiotherapy to a smaller area. This is a research treatment and so you would only have it as part of a clinical trial.

Chemotherapy is also used to treat cervical cancer that has spread to another part of the body (advanced or metastatic cancer).

How often you have chemotherapy

If you have chemotherapy alongside radiotherapy you usually have it once a week for about 5 weeks while you have your course of radiotherapy. Or you might have different chemotherapy drugs every 2 or 3 weeks.

Types of chemotherapy

Cisplatin is the most common drug for early or locally advanced cervical cancer. Other drugs that might be used include:

  • carboplatin
  • paclitaxel (Taxol)
  • paclitaxel and carboplatin
  • topotecan

How you have chemotherapy

You usually have the chemotherapy as a drip into your vein (intravenously). Topotecan is given as capsules that you swallow but this is not a common treatment. 

Into your bloodstream

You have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take newspapers, books or electronic devices to help to pass the time. You can usually bring a friend or family member with you. 

Before you start chemotherapy

COVID swab test

Due to coronavirus, you need to have a test to check for coronavirus before you have treatment. The test is called a COVID swab test.

To have the test your nurse takes a sample from the inside of your nose and the back of your throat. They use a long cotton bud to take the sample. Or the sample might be saliva or other fluid. Depending on which test your hospital uses, it can take from 90 minutes to a few days to get a result.

At most hospitals, you have a COVID swab test 48 to 72 hours (up to 3 days) before going for your treatment in the chemotherapy unit.

This means you might have the swab test on the same day that you visit the hospital for blood tests and your doctor’s clinic appointment. If you have treatment weekly or more often, some hospitals will ask you to have the swab test on the day of treatment.

Check with your team about when you’ll have the test as there are some differences between hospitals.

Blood tests

You need to have blood tests to make sure it’s safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you take any supplements or if you’re prescribed them by an alternative or complementary therapy practitioner.

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • a lower resistance to infections
  • bleeding and bruising easily
  • diarrhoea or constipation
  • hair loss
Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C, or generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

  • which drugs you have
  • how much of each drug you have
  • how you react

Tell your treatment team about any side effects that you have.

Most side effects only last for a few days or so. Your treatment team can help to manage any side effects that you have.

When you go home

Chemotherapy for cervical cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.