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Advanced cervical cancer

Advanced cervical cancer is cancer that has spread outside of the pelvis or has come back after treatment. You may hear this called metastatic or recurrent cervical cancer.

You may be diagnosed with locally advanced cervical cancer. This is cervical cancer that has spread outside of the cervix to nearby areas of the body. This normally means stages 1B2 to 4A.  The information on this page is not about locally advanced cervical cancer. 

On this page:

What is advanced cervical cancer?

The language used for advanced cervical cancer can be confusing and it may not always be the same, depending on who you speak to. 

We define advanced cervical cancer as:

  • cervical cancer that has spread from the cervix to other parts of the body – this includes the stomach, liver, lungs and bones (metastatic).         
  • cervical cancer that has come back after treatment and spread outside of the pelvis (recurrent).  

Different doctors may use different words to describe this stage of cancer. It’s best to ask your healthcare team about the stage of cancer you have and what treatments may be available.

Symptoms of advanced cervical cancer

Advanced cervical cancer is more likely to cause symptoms than cervical cancers at an earlier stage. These symptoms can include:    

  • blood in your wee
  • leaking wee
  • bone pain
  • swollen ankles, legs and feet (oedema)
  • pain in your side or between your ribs and hips
  • other changes to your bladder or bowel habits
  • loss of appetite
  • weight loss
  • extreme tiredness (fatigue)
  • vaginal bleeding.

If you have any of the symptoms, it is important to let your GP or hospital healthcare team know straight away. These may not be a sign of the cervical cancer coming back, but you should have tests to check them out. 

Diagnosing advanced cervical cancer

If your healthcare team think your cancer has spread, they will use different tests to work out how big the cancer is, where it has spread and what treatments may help. These include:

  • PET-CT scan    
  • MRI scan
  • CT scan
  • surgery to remove the lymph nodes (lymphadenectomy).

Read about tests for cervical cancer > 

Understanding your diagnosis

Your healthcare team may call the type of cervical cancer you have ‘incurable’. Others may call your treatment palliative. And some might not use any of these words. This can be confusing and leave you feeling unsure about the future, so it is important to get them to explain the words they use. You might like to write down the definitions. 

You may want to know whether the cancer can be cured, how it will develop, or how long you have left to live. This is called the prognosis. The prognosis will be individual to you. It depends on several things, including how far the cancer has spread and what treatments you can have.  

Your healthcare team are the best people to speak with about your prognosis and any other questions about the cancer or treatment. They will be able to help make things clearer and support you if any of the news comes as a shock.

Your multidisciplinary team (MDT)

You should be cared for and treated by a multidisciplinary team (MDT). Your MDT may include: 

  • a clinical nurse specialist (CNS) nurse – your main contact if you have any questions or worries outside of your appointments
  • a consultant oncologist, consultant gynaeoncologist or consultant surgeon – a doctor who specialises in treating cancers, usually with surgery
  • a clinical oncologist or clinical gynaeoncologist – a doctor who specialises in treating cancer with radiotherapy, chemotherapy and other targeted therapies
  • a pathologist or histopathologist – an expert who specialises in how diseases affects the body
  • a radiologist – an expert who specialises in diagnosing and treating diseases using scans and images
  • a clinical psychologist – an expert who can help you manage the emotional impact of advanced cervical cancer.   

You may also be referred to other specialists, including dieticians, physiotherapists and research doctors or nurses.

You may also be referred to a palliative care team. Your palliative care team could include:

  • your GP or practice nurse
  • community or district nurses
  • a consultant – a doctor who may also specialise in giving palliative care
  • specialist palliative care nurses – experts in giving palliative care.

Many people think that the word ‘palliative’ means death, but this is not always the case. Palliative services aren’t just for people at the end of their life – they are available at any point during treatment or care. 

Palliative care teams can help you manage pain and other symptoms of advanced cervical cancer. They can also provide you with emotional and practical support.  .   .      

Your palliative care team can help you plan for the future and live as long and as comfortably as possible. They will also be able to support your family.

Making treatment decisions

Your MDT will discuss your test results, diagnosis and medical history to help decide which treatments are best for you. Treatment for advanced cervical cancer will be decided on a case-by-case basis. Your healthcare team will need to think about:

  • where the cervical cancer has spread 
  • which treatments you have had before  
  • your general health and fitness
  • your preferences.

It is important that you are involved in any decisions about your treatment. You need to know and understand all the information about the treatment, including the benefits and risks. 

It can be very difficult to make a decision about treatment when you have advanced cervical cancer. Your options may be limited or, if you have already had treatment, you may feel exhausted at the idea of going through it again. Remember that your MDT are there to offer you support with the emotional side of decision making, as well as the factual side. Don’t be afraid to open up about how you are feeling so they can factor this into discussions.

Read about making treatment decisions >

Clinical trials are carefully controlled medical research studies that involve patients. They are usually done to find out if a new treatment is safe and more effective than anything currently offered. 

Some clinical trials are randomised control trials (RCT). This means that:

  • some people in the trial are given the new treatment
  • some people in the trial are given a different treatment, a different dose of the same treatment, or nothing (placebo).

You may not know if you are having the new treatment or a placebo. It is important to know this as part of any decision about whether to take part in a clinical trial. You should also ask any other questions you have and find out exactly what the trial involves. Ask your healthcare team whether there are any clinical trials that you could take part in.

Researchers are currently looking at whether immunotherapy can help control advanced cervical cancer. Immunotherapy uses your own immune system to treat cancer.

Many clinical trials have been stopped or adapted because of coronavirus. You can find out more from your healthcare team.

You can search for clinical trials for cervical cancer on the Cancer Research UK database >

You may decide that you don’t want treatment for advanced cervical cancer. This may be for many different reasons and will be a very personal decision to you. 

Deciding not to have treatment does not mean you have to suffer or be uncomfortable. You can still have treatment and support to control any symptoms.

It is important to take some time to think about this decision and talk it through with your healthcare team. You will also want to speak with your loved ones, so they can understand how you are feeling and you can discuss the future.

Treatment for advanced cervical cancer

We talk through some possible treatment options below, but it’s best to speak with your healthcare team to find out what will happen for you.

Cervical cancer that has come back after treatment may not spread outside of the pelvis. It may be treated with radiotherapy or a combination of radiotherapy and chemotherapy (chemoradiation), depending on which treatments you have had before.

Read about chemoradiation >

Cervical cancer that has come back after treatment and spread outside of the pelvis may be treated with surgery. The surgery removes the organs in your pelvis as well as some of the surrounding areas. It is called pelvic exenteration.

Read about pelvic exenteration >

If the advanced cervical cancer can’t be treated with the aim of getting rid of it, you may have treatment to help control it or help with any symptoms.   

This treatment is usually chemotherapy that is given alongside a type of drug called Avastin (bevacizumab).   

Read about Avastin (bevacizumab) >

Living with advanced cervical cancer

Your diagnosis may have come as a shock, so take the time you need to process it. You can start to think about how your life might look moving forward whenever you are ready. 

We have detailed information about living with advanced cervical cancer, including suggestions for getting support, in a different section of our website. When you feel ready, it may help to read through it, perhaps with a loved one.

Read about living with advanced cervical cancer >

More information and support about advanced cervical cancer

We know that getting a diagnosis of advanced cervical cancer can be devastating. You may cycle through many emotions, from anger through to fear and sadness. It can also be a lonely time, if you feel that no one around you understands. 

We are here for you through all of this. Our Helpline volunteers can listen to what’s going on and talk through how you’re feeling. You can give them a call on 0808 802 8000

Check our Helpline opening hours >

Sometimes connecting with others who have gone through a similar experience can be helpful. Our online Forum lets our community give and get support. We have a private forum for those with advanced cervical cancer. If you would like to join, we ask for a few details – this is kept private, but means we can make sure this part of the forum is a safe space. You can read through the messages or post your own – whichever feels most comfortable.

Join our Forum >

If you have general questions about advanced cervical cancer, our panel of medical experts may be able to help. They can’t give you answers about your individual situation or health – it’s best to speak with your GP or healthcare team for that.

Use our Ask the Expert service >

Thank you to all the experts who checked the accuracy of this information, and the volunteers who shared their personal experience to help us develop it.

References

  • British Gynaecological Cancer Society (2020). Cervical Cancer Guidelines: Recommendations for Practice. Web: www.bgcs.org.uk/wp-content/uploads/2020/05/FINAL-Cx-Ca-Version-for-submission.pdf. Accessed October 2020.
  • Marshall, C. et al (2019). Overview of systemic treatment in recurrent and advanced cervical cancer: a primer for radiologists. Abdom Radiol. 44. pp.1506–1519.
  • Li, L. et al (2018). Pelvic Exenteration for Recurrent and Persistent Cervical Cancer. Chinese Medicine Journal (Engl). 131;13. pp.1541-1548. 
  • Boussios, S. et al (2016). Management of patients with recurrent/advanced cervical cancer beyond first line platinum regimens: Where do we stand? A literature review. Crit Rev Oncol Hematol. 108. pp.164-174.
  • Li, H. et al (2016). Advances in diagnosis and treatment of metastatic cervical cancer. Journal of Gynecological Oncology. 27;4. Epub. 

We write our information based on literature searches and expert review. For more information about the references we used, please contact [email protected]

Read more about how we research and write our information >

"Speaking to other people who have been through similar things has been the most helpful thing by far for me."
Read Alice's story
Date last updated: 
04 Nov 2020
Date due for review: 
04 Nov 2023
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