Treatment of Recurrent Cervical Cancer

If you had surgery but no radiation therapy to the pelvis when your cancer was first treated, you might be treated with external beam radiation therapy (EBRT) directed to the area where the cancer came back.

• External beam radiation therapy (EBRT) - Radiation from outside the body is focused on the cancer. Most people are treated with EBRT 5 days a week for 5 to 7 weeks as an outpatient. This schedule helps protect healthy cells and tissues by spreading out the total dose of radiation.

If you were treated with radiation therapy for your first cervical cancer, you might be treated with a pelvic exenteration for recurrent cancer, especially if no cancer can be detected anywhere else in the body and all of the cancer can be removed by the surgery.

• Pelvic exenteration - In addition to removing the entire uterus, cervix, and pelvic lymph nodes, the surgeon removes the vagina, ovaries, lower colon, rectum, and bladder. This operation is used to treat recurrent cervical cancer. Artificial openings (stomas) are made to allow urine and stool to flow from the body to a collection bag. Plastic surgery may be needed to make an artificial vagina after this operation.

Patients whose cancer has recurred in the pelvis only or in other parts of the body are sometimes given palliative treatment (treatment to relieve symptoms, but that is not likely to cure the cancer) with radiation or chemotherapy. Some of the chemotherapy drugs that might be used, either alone or in combination, are:

• Platinol^® (cisplatin) - Cisplatin is a platinum compound chemotherapy drug that acts like an alkylating agent. It stops cancer cells from growing, which kills them. Cisplatin is given by an injection into the vein over at least 1 hour. Your dose depends upon the type of cancer you have, your size, and how well your kidneys work.
• Camptosar ^® (irinotecan) - Irinotecan belongs to a group of chemotherapy drugs known as topoisomerase inhibitors. Irinotecan stops cancer cells from growing by preventing the development of elements necessary for cell division. Irinotecan is given by an injection in a vein over 90 minutes weekly for 3 weeks and then one off or once every 3 weeks. The dose depends on your size, your age, whether you have had radiation to your abdomen/pelvis, how well your liver is working, your blood counts, and whether you have had any side effects such as diarrhea.
• Gemzar ^® (gemcitabine) - Gemcitabine belongs to a group of chemotherapy drugs known as antimetabolites. Gemcitabine prevents cells from making DNA and RNA, which stops cancer cells from growing; this kills the cancer cells. Gemcitabine is given as an injection in a vein over 30 minutes. It is usually given once a week for 3 weeks, followed by 1 week off. The dose depends on your size, your blood counts, and the cancer being treated.
• Ifex ^® (ifosfamide) - Ifosfamide belongs to a group of chemotherapy drugs known as alkylating agents. Ifosfamide stops cancer cells from growing and kills them. Ifosfamide is given as an injection in a vein over 1 to 24 hours for a few days. The dose depends on your size, how well your kidneys are working, your blood counts, and the type of cancer being treated.
• Taxol^® or Onxol^® (paclitaxel) - Paclitaxel belongs to a group of chemotherapy drugs known as taxanes. It is also called a mitotic inhibitor because it affects cells during mitosis (cell division). It stops cells from dividing, which kills them. Paclitaxel is given by an injection into a vein, usually over a 3-hour period, every 3 weeks. Sometimes, smaller doses are given once a week over shorter periods. The dose depends on your weight, how well your liver works, the side effects you have, and how often the medicine is given.

This content has been reviewed and approved by Myo Thant, MD.