Cervical Cancer - Resources

Chemotherapy

Chemotherapy uses cell-killing drugs called cytotoxic drugs to destroy widespread cancer cells that have spread from the primary tumor and can no longer be treated with surgery or radiation alone. Chemotherapy is usually used along with radiation (a combination called “chemoradiation”) for treatment of stages IB1 - IVB cervical cancer. Chemotherapy can help increase the effectiveness of radiation therapy. In the most advanced cancer stage, IVB, chemotherapy is used palliatively to help relieve symptoms.

Platinum-Based Drugs. Platinum-based drugs are the main chemotherapy treatment for cervical cancer. Cisplatin is the primary drug used. Carboplatin is an alternative platinum drug that is used for treating more advanced cervical cancer.

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Other drugs. Other drugs may be given alone or in combination with a platinum-based drug. They include paclitaxel, topotecan, gemcitabine, 5-FU, vinorelbine, and others.

Administration. Chemotherapy is typically given intravenously at a medical center or doctor's office. The drugs are given in cycles with a period of rest following a period of treatment, to allow recovery from the side effects.

Side Effects. Chemotherapy affects all fast-growing cells, including healthy ones. So, side effects are inevitable. Side effects occur with all chemotherapeutic drugs. They are more severe with higher doses and increase over the course of treatment. Side effects also tend to be more severe when chemotherapy is given along with radiation.

Common side effects may include:

• Nausea and vomiting. Drugs can help relieve these side effects.
• Diarrhea
• Temporary hair loss
• Loss of appetite and weight
• Fatigue

Complications. Serious short- and long-term complications can also occur and may vary, depending on the specific drugs used. They include:

• Severe drop in white blood cell count (neutropenia). The reduction in white blood cells suppresses the immune system and makes patients more susceptible to infections.
• Reduction of blood platelets (thrombocytopenia), which can lead to bruising
• Anemia, reduction in red blood cells, is a common side effect of chemotherapy. Chemotherapy-induced anemia is usually treated with erythropoiesis-stimulating drugs, which include epoietin alfa (Epogen, Procrit) and darberpetin alfa (Aranesp). Recent studies have shown that these drugs may contribute to rapid tumor growth in patients with cervical cancer. Doctors need to follow strict dosing guidelines when administering these drugs. Patients should discuss the risks and benefits of erythropoiesis-stimulating drugs with their oncologists. [For more information, see In-Depth Report #57: Anemia ]
• Premature menopause
• Liver and kidney damage
• Problems with concentration, motor function, and memory

Review Date: 10/21/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).