Systemic chemotherapy uses anti-cancer drugs that are injected into a vein or given by mouth. These drugs enter the bloodstream and reach all areas of the body, making this treatment potentially useful for cancers that have spread to distant organs (metastasized).
Drugs most often used to treat cervical cancer include cisplatin, paclitaxel (Taxol®), topotecan, ifosfamide (Ifex®), and 5-fluorouracil (5-FU). Other drugs are used as well. If chemotherapy is chosen, you may receive a combination of drugs. Chemotherapy drugs kill cancer cells but also damage some normal cells, which can lead to side effects.
Chemotherapy side effects depend on the type of drugs, the amount taken, and the length of time you are treated. Temporary side effects of chemotherapy might include:
- Nausea and vomiting
- Loss of appetite
- Loss of hair
- Mouth sores
Because chemotherapy can damage the blood-producing cells of the bone marrow, the blood cell counts might become low. This can result in:
- An increased chance of infection (from a shortage of white blood cells)
- Bleeding or bruising after minor cuts or injuries (because of a shortage of blood platelets)
- Shortness of breath (due to low red blood cell counts)
Fatigue is also quite common and may be caused by low red blood cell counts, by other reasons related to the chemotherapy, or by the cancer itself.
Most side effects of chemotherapy (except premature menopause and infertility) disappear once treatment is stopped. Hair will grow back after treatment ends. Premature menopause can be treated with hormones.
If you have problems with side effects, talk with your cancer care team. There are remedies for many of the temporary side effects of chemotherapy. For example, there are very good drugs that can prevent or reduce nausea and vomiting.
Chemoradiation
For some stages of cervical cancer, chemotherapy is given to help the radiation work better. When chemotherapy and radiation therapy are given together, it is called concurrent chemoradiation. One option is to give a dose of cisplatin every week during radiation. This drug is given into a vein (IV) about 4 hours before the radiation appointment. Another choice is to give cisplatin along with 5-FU every 4 weeks during radiation. Other drug combinations are also used. Giving chemotherapy with radiation can improve the patient’s chance for survival, but giving them together also tends to have worse side effects. The nausea and fatigue are often worse. Diarrhea can also be a problem if chemotherapy is given at the same time as radiation. Problems with low blood counts can also be worse. Your health care team will watch for side effects and can give you medicines to help you feel better.
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