Chemotherapy (chemotherapy) uses anticancer medications that are pumped into a vein or delivered by mouth. These medications penetrate the bloodstream and can reach almost all regions of the body making this therapy effective in most parts of the body to kill cancer cells.

Not all women with Cervical Cancer require chemo, but a few circumstances when it can prescribed are:

As part of the main treatment for cervical cancer

The recommended therapy for some stages of Cervical Cancer is radiation and chemo (called combined chemoradiation) given together.

The chemo can work better with radiation. Concurrent chemoradiation methods include:

Cisplatin given weekly during radiation. This medication is injected into a vein (IV) before appointment for radiation. (If cisplatin is not a good choice, carboplatin may be used.)

Cisplatin plus 5-fluorouracil (5-FU) given on radiation every 3 weeks.

For Cervical Cancer that has spread or come back after treatment

Chemo can be used to treat Cervical Cancer that has spread (advanced cervical cancer) to other organs and tissues. This can also help if Cervical Cancer returns after chemoradiation (recurring cervical cancer) diagnosis.

The Chemotherapy most widely used for treating Cervical Cancer that has returned or spread to other areas include:

• Cisplatin
• Carboplatin
• Paclitaxel
• Topotecan

Combinations of these drugs are often used.

Some other drugs can be used as well, such as docetaxel, ifosfamide, 5-fluorouracil, irinotecan, gemcitabine and mitomycin. Bevacizumab, a targeted drug, may be added to chemo.

How is Chemotherapy given?

Chemotherapy for Cervical Cancer is typically administered into a vein (IV), either as an injection over a few minutes or as a vein infusion over a longer period of time. It can be done in the office of a doctor, in the infusion center, or in a hospital setting.

Chemo is administered in cycles, followed by a rest period to give you time to recover from the drug effects. Cycles usually last weekly or for 3 weeks. Timing varies according to the medications used. Of example, the chemo is given only on the first day of the cycle, for other medications. It is given, together with others, in a row for a few days, or once a week. Then the chemo schedule repeats at the end of the cycle, in order to continue the next cycle.

Often giving chemo needs a slightly larger and sturdier IV. These are known as CVCs, Central Venous Access Devices (CVADs), or Central Lines. They are used right into your blood to put medicines, blood products, nutrients, or fluids. These can also be used for blood testing.

Numerous different types of central venous catheters (CVCs) exist. The most common types are the PICC line and the port.

Side effects of Chemotherapy for cervical cancer

Chemotherapy destroys cancer cells but also damages some normal cells, which may contribute to certain side effects. Side effects depend on the form and dosage of the medications and how long you are being treated. Many side effects are short-term and go away after treatment has been completed, but some can last a long time, or even be permanent. If you have some side effects, it is important to inform your health care team, because there are many ways to reduce them.

Common short-term Chemotherapy side effects may include

• Nausea and vomiting
• Loss of appetite
• Hair loss
• Mouth sores
• Fatigue (tiredness)

Because Chemotherapy can damage the bone marrow’s blood-producing cells, the counts of blood cells may become low. This might lead to:

• An increased risk of infection from white blood cell deficiencies (called neutropenia)
• Bleeding or bleeding following minor wounds or fractures due to a lack of Platelets in the blood (called thrombocytopenia)
• Breath shortening or weakness due to low rates of red blood cells (called anaemia)

The side effects are also more severe when chemo is combined with radiation. Nausea, tiredness, Diarrhoea and low blood issues also get worse.

Your health care staff will be monitoring for side effects and will be able to give you medications to help avoid or treat them so that you feel better. You can be given medications for example to help avoid or reduce Nausea and Vomiting.

Long-term Chemotherapy side effects can include:

Menstrual changes: Changes in menstrual periods are a common side effect of chemo for younger women who have not had their uterus removed as part of the treatment. Yet even though you interrupt your cycles while on chemo, you may still be able to get pregnant. It is not safe to get pregnant while receiving chemo, as this could lead to birth defects and interfere with treatment. Patients who have finished treatment (such as chemo) and also want to have kids, it is important to speak to the doctor about what this is safe to do.

Premature menopause (with no more menstrual periods) and infertility (without being able to become pregnant) can occur and can continue. Some chemo-drugs are more likely than others to cause this. The older a woman gets chemo, the more likely she will become infertile as a result, or go into menopause. There is an increased chance of bone loss and osteoporosis if this occurs. Medicines are available which can cure or help prevent bone loss problems.

Neuropathy: Some drugs used in the treatment of cervical cancer, including paclitaxel and cisplatin, can damage nerves outside the brain and spinal cord; Sometimes the injury can lead to symptoms such as numbness, pain, burning or tingling sensations, cold or heat sensitivity, or weakness, mostly in the hands and feet. This was known as Peripheral Neuropathy. In most cases this gets easier or even goes away until the medication is stopped, but in some women it through last a long time.

Nephrotoxicity: Cisplatin, the primary chemo drug to treat cervical cancer, can damage the kidneys (also called nephrotoxicity). The damage is avoidable and reversible at times, but the damage can be long lasting at times. There are often no symptoms but the damage can be seen on routine blood work done while chemo is given. Cisplatin is typically stopped when kidney damage occurs, and carboplatin can be used instead.

Additional side effects are likely, too. Some of these are more common in other chemotherapies. Ask the cancer care team to tell you about the potential side effects of the medications that you get. Source: www.cancer.org/cancer/cervical-cancer/treating/chemotherapy.html