Chemotherapy for cervical cancer

You may have chemotherapy with radiotherapy (chemoradiation) after surgery. This is to help reduce the risk of the cancer coming back. Having chemotherapy after surgery is called adjuvant treatment. 

Not everyone needs adjuvant treatment after surgery. You may only need it if:

• the cervical cancer has spread to your lymph nodes
• the cervical cancer was larger and more likely to spread.

You may have chemotherapy with radiotherapy (chemoradiation) if you have locally advanced cervical cancer that can’t be treated with surgery. This is called radical treatment. 

You may have chemotherapy if:

• the cervical cancer is advanced and is causing symptoms
• the cervical cancer has come back after other treatments. 

This is sometimes called palliative treatment. You may have the chemotherapy on its own or alongside other drug treatments, such as Avastin (bevacizumab).   

Read about Avastin >

Less commonly, you may have chemotherapy with radiotherapy (chemoradiation) before surgery. It is done as part of a clinical trial  and is called neoadjuvant treatment. The idea is that chemoradiation may help shrink the tumour and make surgery easier.  

There is a current clinical trial offering chemotherapy alone, ahead of chemoradiation. It is for cervical cancer that cannot be removed with surgery. You can ask your healthcare team if you are eligible.

Read more about the clinical trial on the Cancer Research UK website >

Chemotherapy can damage your ovaries. As it is also often given along with radiotherapy, this means you almost definitely won’t be able to get pregnant and have a child or more children after treatment.

Read more about fertility and cervical cancer > 

You will probably feel very emotional about this, which can make it hard to think about some practical steps you could take. But it is important to discuss these options with your healthcare team before you start treatment. Before treatment, you may be able to:

• freeze and store eggs
• freeze and store embryos – these are eggs that have been fertilised .

This may delay treatment, so you will need to consider any risks of doing that. Your healthcare team can explain how it might affect your individual situation. Unfortunately, egg and embryo freezing is not always possible and these services are not available in every hospital.

Read about fertility preservation on the Macmillan Cancer Support website >

Your immune system protects the body from infection by finding and killing germs, bacteria or viruses. Chemotherapy can affect your immune system. This means that chemotherapy may mean you have a higher risk of becoming ill with coronavirus.     

Your hospital is doing as much as possible to reduce this risk. When your healthcare team are supporting you to make treatment decisions, they will consider the risk of COVID-19 as part of this. In most hospitals we have spoken to, chemotherapy is continuing as usual for cervical cancer patients. But your healthcare team may talk to you about:    

• delaying your treatment
• changing how often you have treatment – so you visit the hospital less 
• changing to oral chemotherapy  – topotecan can be given as tablets, although this is not a common drug for treating cervical cancer
• changing to a different treatment
• using telephone calls and video calls to avoid face-to-face appointments where possible
• having a test to check for COVID-19 before each treatment cycle. 

Your healthcare team will probably ask you to self-isolate for about 2 weeks before and after chemotherapy. They will let you know what you should and shouldn’t do during this time. When you are having chemotherapy, you are considered extremely clinical vulnerable by government standards – this means you should follow specific guidance in your area:

• England > 
• Scotland > 
• Wales > 
• Northern Ireland > 

Read about COVID-19 and healthcare >