Cervical Cancer (cont.)
In this Article
- Cervical cancer facts*
- What is the cervix?
- What is cancer?
- What are the risk factors and causes of cervical cancer?
- What are the symptoms of cervical cancer?
- How is cervical cancer diagnosed?
- How is staging of cervical cancer determined?
- What is the treatment for cervical cancer?
- What are methods of treatment for cervical cancer?
- How do I go about getting a second opinion?
- What follow-up care is involved after cervical cancer treatment?
- What support, research, and clinical trials information is available for cervical cancer patients?
- Find a local Oncologist in your town
What are methods of treatment for cervical cancer?
Surgery is an option for women with Stage I or II cervical cancer. You and your surgeon can talk about the types of surgery and which may be right for you.
If you have a small tumor, the type of surgery may depend on whether you want to get pregnant and have children later on. Some women with very early cervical cancer may decide with their surgeon to have only the cervix, part of the vagina, and the lymph nodes in the pelvis removed (radical trachelectomy).
Other women may choose to have the cervix and uterus removed (complete hysterectomy). The surgeon may also remove some tissue around the cervix, part of the vagina, the fallopian tubes, or the ovaries. In addition, the surgeon may remove lymph nodes near the tumor.
It's common to feel tired or weak for a while after surgery for cervical cancer. The time it takes to heal is different for each woman. You'll probably be able to leave the hospital within a couple of days. Most women return to their normal activities within 4 to 8 weeks after surgery.
You may have pain or discomfort for the first few days after surgery. Medicine can help control your pain. Before surgery, you should discuss the plan for pain relief with your health care team. After surgery, they can adjust the plan if you need more pain control.
After a trachelectomy, some women need to have a tube put into the bladder to drain urine. It usually can be removed a few days after surgery.
After a hysterectomy, some women become constipated or have nausea and vomiting. In addition, some women lose control of their bladder or have trouble emptying their bladder. These effects are usually temporary. After a hysterectomy, you'll stop having menstrual periods, and you won't be able to become pregnant.
After the ovaries are removed, menopause occurs at once. You may have hot flashes, vaginal dryness, and night sweats. These symptoms are caused by the sudden loss of female hormones. Talk with your health care team about your symptoms so that you can develop a treatment plan together. There are drugs and lifestyle changes that can help, and most symptoms go away or lessen with time.
Surgery to remove lymph nodes may cause swelling (lymphedema) in one or both legs. Ask your health care team about how you may prevent or control the swelling. Information about lymphedema is available on NCI's website at http://www.cancer.gov/cancertopics/coping.
For some women, surgery to remove the cervix and nearby tissues can affect sexual intimacy. You may have feelings of loss that make intimacy difficult. Sharing these feelings with your partner may be helpful. Sometimes couples talk with a counselor to help them express their concerns.
You may want to ask the doctor these questions before having surgery:
- Do you recommend surgery for me? If so, which kind? Will my ovaries be removed? Do I need to have lymph nodes removed?
- What is the goal of surgery?
- What are the risks of surgery?
- How will I feel after surgery? If I have pain, how will it be controlled?
- How long will I have to be in the hospital?
- Will I have any lasting side effects?
- When will I be able to resume normal activities?
Radiation therapy uses high-energy rays to kill cancer cells. It's an option for women with any stage of cervical cancer. Women with early cervical cancer may choose radiation therapy instead of surgery. It also may be used after surgery to destroy any cancer cells that remain in the area. Women with cancer that extends beyond the cervix may have radiation therapy and chemotherapy.
Doctors use two types of radiation therapy to treat cervical cancer. Some women receive both types:
- External radiation therapy: A large machine directs radiation at your pelvis or other areas with cancer. The treatment usually is given in a hospital or clinic. You may receive external radiation therapy 5 days a week for several weeks. Each treatment takes only a few minutes.
- Internal radiation therapy (also called brachytherapy): A narrow cylinder is placed inside your vagina, and a radioactive substance is loaded into the cylinder. Usually, a session of internal radiation therapy lasts only a few minutes. The cylinder and substance are removed, and you can go home. The short session may be repeated two or more times over several weeks. When the radioactive substance is removed, no radioactivity is left in your body. With a less common method of internal radiation therapy, you may stay in the hospital for several days during treatment.
Although radiation therapy is painless, it may cause side effects. The side effects depend mainly on how much radiation is given and which part of your body is treated. Radiation to the abdomen and pelvis may cause nausea, vomiting, diarrhea, or urinary problems. You may lose hair in your genital area. Also, skin on the abdomen and pelvis may become red, dry, and tender.
You may have dryness, itching, or burning in your vagina. Your doctor may advise you to wait until a few weeks after radiation treatment ends to have sex.
You are likely to become tired during radiation therapy, especially in the later weeks of treatment. Resting is important, but doctors usually advise patients to try to stay as active as they can.
Although the side effects of radiation therapy can be upsetting, they can usually be treated or controlled. Talk with your doctor or nurse about ways to relieve discomfort.
It may also help to know that most side effects go away when treatment ends. However, you may want to discuss with your doctor the possible long-term effects of radiation therapy. For example, radiation therapy may make the vagina narrower. A narrow vagina can make sex or follow-up exams difficult. There are ways to prevent this problem. If it does occur, however, your health care team can tell you about ways to expand the vagina.
Another possible long-term effect is damage to the ovaries. Menstrual periods usually stop, and women may have hot flashes and vaginal dryness. Menstrual periods may return for some women, especially younger women. Women who may want to get pregnant after radiation therapy should ask their health care team about ways to preserve their eggs before treatment starts.
You may want to ask the doctor these questions before having radiation therapy:
- What is the goal of this treatment?
- How will the radiation be given?
- Will I need to stay in the hospital? If so, for how long?
- When will the treatments begin?
- How often will I have them? When will they end?
- How will I feel during treatment? Are there side effects?
- How will we know if the radiation therapy is working?
- Will I be able to continue my normal activities during treatment?
- How will radiation therapy affect my sex life?
- Are there lasting side effects?
Chemotherapy uses drugs to kill cancer cells. For the treatment of cervical cancer, chemotherapy is usually combined with radiation therapy. For cancer that has spread to distant organs, chemotherapy may be used alone.
Most drugs for cervical cancer are given directly into a vein (intravenously) through a thin needle. Some drugs can be taken by mouth. Most women receive chemotherapy in a clinic or at the doctor's office. Drugs that are swallowed may be taken at home instead. Some women need to stay in the hospital during treatment.
The side effects depend mainly on which drugs are given and how much. Chemotherapy kills fast-growing cancer cells, but the drugs can also harm normal cells that divide rapidly:
- Blood cells: When chemotherapy lowers the levels of healthy blood cells, you're more likely to get infections, bruise or bleed easily, and feel very weak and tired. Your health care team will check for low levels of blood cells. If the levels are low, your health care team may stop the chemotherapy for a while or reduce the dose of drug. They may also give you medicines that can help your body make new blood cells.
- Cells in hair roots: Chemotherapy may cause hair loss. If you lose your hair, it will grow back, but it may change in color and texture for a while. Ultimately it will return to being naturally as it was before.
- Cells that line the digestive tract: Chemotherapy can cause a poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Your health care team can give you medicines and suggest other ways to help with these problems.
Other side effects include skin rash, tingling or numbness in your hands and feet, hearing problems, loss of balance, joint pain, or swollen legs and feet. Your health care team can suggest ways to control many of these problems. Most go away when treatment ends.
You may want to ask the doctor these questions before having chemotherapy:
- Why do I need this treatment?
- Which drug or drugs will I have?
- How do the drugs work?
- What are the expected benefits of the treatment?
- What are the risks and possible side effects of treatment? What can we do about them?
- When will treatment start? When will it end?
- How will treatment affect my normal activities?
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