Cervical Cancer: Chemotherapy

Finding out you have cervical cancer can be overwhelming. And if you're advised to get chemotherapy, you may have questions. You may want to know how it works and what to expect. Or maybe you're wondering why chemotherapy is the right treatment for you.

No matter what you're feeling, know that your health care team will be by your side every step of the way. Their job is to support you and help you learn as much as you'd like about your treatment.

Ask your team any questions you have. Your doctors can give you specific details about your treatment plan. In the meantime, here are answers to some common questions:

Chemotherapy, often called chemo, uses strong medicine to kill cancer cells. These medicines kill cells that grow quickly, like cancer cells.

But you also have healthy, noncancer cells that grow quickly. Unfortunately, chemo can damage those cells, too. This can cause side effects. For instance, chemo may affect cells on the inside of your mouth and stomach. (See below for more information about side effects.)

It's common for doctors to give you both radiation therapy and chemotherapy to treat cervical cancer. Radiation uses beams of energy to kill cancer cells. Using the two therapies together is called chemoradiation. This method may make your chemo treatment more effective.

You may get chemotherapy on its own if cervical cancer has grown beyond the cervix, spread to other parts of your body, or returns after treatment.

There are several ways for your doctor to give you chemo:

• Through an I.V. This way is the most common. Your doctor puts a small tube (I.V. catheter) into your vein. The medicine is then slowly infused into the I.V. catheter where it enters your bloodstream right away.
• As an injection
• As a pill

You can get chemotherapy at your doctor's office, a chemo clinic, or a hospital infusion center. Chemo is often given every 3 to 4 weeks. When you have chemo along with radiation, the chemo is often given once a week.

Your doctor will make a schedule that says when you get each medicine for your treatment. Together, you can go over your plan so you can feel prepared and more comfortable before each appointment. You should be able to go home the same day. It's rare to stay in the hospital for chemo.

You might get a prescribed number of cycles of chemo over a set timeframe. This means you'll get the medicine for a certain amount of time and then rest before having chemo again. Each round of treatment and rest period is called one cycle.

Having chemotherapy in cycles helps to:

• Kill more cancer cells. Cancer cells in your body divide quickly. But they don't all do it at the same time. So getting chemo treatments in cycles lets the medicine get rid of more cells over time.
• Give your body rest. Chemo can be hard on your body, causing side effects that may make you feel sick. Rest between chemo cycles helps your body heal.
• Give your mind a break. Getting chemo can be very stressful, both physically and mentally. Resting between cycles can bring you much-needed mental and emotional rest. Taking care of your mind is just as important as keeping your body healthy during your chemo treatment.

Chemo for cervical cancer often combines a couple of medicines. Here are some of the most common ones:

• Cisplatin
• Carboplatin
• Docetaxel
• Paclitaxel
• Topotecan
• Fluorouracil (5-FU)

Talk with your doctor to learn more about your specific treatment and how it works.

Sometimes getting chemo can cause unpleasant things to happen in your body. These symptoms are called side effects. You might have them when you take some medicines.

Common side effects of chemotherapy include:

• Bruising and bleeding easily
• Anemia (low red blood cell counts)
• Nerve damage causing numbness, tingling, and pain (peripheral neuropathy)
• Diarrhea
• Fatigue or low energy
• Hair loss
• Increased chance of infections
• Sores or pain in the mouth, tongue, or throat
• Loss of appetite
• Nausea and vomiting
• Skin and nail changes (dry skin and color change)
• Shortness of breath
• Kidney damage
• Hearing problems
• Menstrual changes
• Infertility
• Chemo brain, which can affect concentration and focus
• Mood changes

Whether you have side effects can depend on which medicine you take and how much. Symptoms tend to be worse when you get radiation and chemo at the same time. Some side effects may get worse after each cycle of chemo. Still, side effects can be different for each person. Many side effects go away fairly quickly when treatment ends. But some may take months or even years to go away completely. Some side effects last a lifetime and may cause damage to certain organs.

It's important to tell your doctor about any changes or side effects that you notice. If you're bothered by pain or any other problem, don't feel like you're on your own. There are often ways to reduce your symptoms with medicine or other types of treatment.

Ask your doctor questions about your medicine's side effects, such as:

• Which side effects can be treated?
• Which side effects go away over time?
• Which side effects will last or be permanent?

Keep a list of your medicines. Bring the list to your appointments and use it as a guide to ask your doctor questions, like how the medicines work and what you may notice after taking them.

It's important to stay in touch with your health care team while you get chemo. Ask what signs you should look for during your treatment and when you should call your team. And always let your doctor know about changes in your symptoms.

Reach out to your doctor if you have any of the following symptoms during chemo treatment:

• Burning feeling when you go to the bathroom
• Fever of 100.4°F (38°C) or higher, or as advised by your doctor
• New cough
• Redness, swelling, and warmth at the site of an I.V. or injury
• Shaking or intense chills
• Sore throat
• Bloody stool or blood in your urine
• Bleeding or unexplained bruising
• Unusual pain, including intense headaches
• Rash
• Long-lasting diarrhea or vomiting

Call 911 right away if you have shortness of breath or trouble breathing.

Make sure you know what number to call to reach your doctor if you have any questions. Find out ahead of time if there's a different number to use on evenings, holidays, and weekends.

You may find it helpful to keep a diary of your side effects. You can write down any changes you go through, whether they're physical, mental, or emotional. All three areas are important to discuss with your health care team.

Keeping a written list will help you remember your questions at your next visit. It will also make it easier to work with your health care team to manage your side effects and stay on track for your next treatment. Remember, they're there to help you through this.