Booklet: What You Need to Know about Cervical Cancer

Side Effects of Treatment

It is hard to limit the effects of therapy so that only cancer cells are removed or destroyed. Because treatment also damages healthy cells and tissues, it often causes unpleasant side effects.

The side effects of cancer treatment depend mainly on the type and extent of the treatment. Also, each patient reacts differently. Doctors and nurses can explain the possible side effects of treatment, and they can help relieve symptoms that may occur during and after treatment. It is important to let the doctor know if any side effects occur. The booklets Radiation Therapy and You and Chemotherapy and You also have helpful information about cancer treatment and coping with side effects.

Surgery

Methods for removing or destroying small cancers on the surface of the cervix are similar to those used to treat precancerous lesions. Treatment may cause cramping or other pain, bleeding, or a watery discharge.

Hysterectomy is major surgery. For a few days after the operation, the woman may have pain in her lower abdomen. The doctor can order medicine to control the pain. A woman may have difficulty emptying her bladder and may need to have a catheter inserted into the bladder to drain the urine for a few days after surgery. She also may have trouble having normal bowel movements. For a period of time after the surgery, the woman's activities should be limited to allow healing to take place. Normal activities, including sexual intercourse, usually can be resumed in 4 to 8 weeks.

Women who have had their uterus removed no longer have menstrual periods. However, sexual desire and the ability to have intercourse usually are not affected by hysterectomy. On the other hand, many women have an emotionally difficult time after this surgery. A woman's view of her own sexuality may change, and she may feel an emotional loss because she is no longer able to have children. An understanding partner is important at this time. Women may want to discuss these issues with their doctor, nurse, medical social worker, or member of the clergy. They also may find it helpful to read the National Cancer Institute booklet called Taking Time.

Radiation Therapy

Patients are likely to become very tired during radiation therapy, especially in the later weeks of treatment. Resting is important, but doctors usually advise patients to try to stay as active as they can.

With external radiation, it is common to lose hair in the treated area and for the skin to become red, dry, tender, and itchy. There may be permanent darkening or "bronzing" of the skin in the treated area. This area should be exposed to the air when possible but protected from the sun, and patients should avoid wearing clothes that rub the treated area. Patients will be shown how to keep the area clean. They should not use any lotion or cream on their skin without the doctor's advice.

Usually, women are told not to have intercourse during radiation therapy or while an implant is in place. However, most women can have sexual relations within a few weeks after treatment ends. Sometimes, after radiation treatment, the vagina becomes narrower and less flexible, and intercourse may be painful. Patients may be taught how to use a dilator as well as a water-based lubricant to help minimize these problems.

Patients who receive external or internal radiation therapy also may have diarrhea and frequent, uncomfortable urination. The doctor can make suggestions or order medicines to control these problems.

Chemotherapy

The side effects of chemotherapy depend mainly on the drugs and the doses the patient receives. In addition, as with other types of treatment, side effects vary from person to person. Generally, anticancer drugs affect cells that divide rapidly. These include blood cells, which fight infection, help the blood to clot, or carry oxygen to all parts of the body. When blood cells are affected by anticancer drugs, patients are more likely to get infections, may bruise or bleed easily, and may have less energy. Cells in hair roots and cells that line the digestive tract also divide rapidly. When chemotherapy affects these cells, patients may lose their hair and may have other side effects, such as poor appetite, nausea, vomiting, or mouth sores. The doctor may be able to give medicine to help with side effects. Side effects gradually go away during the recovery periods between treatments or after treatment is over.

Biological Therapy

The side effects caused by biological therapies vary with the type of treatment the patient receives. These treatments may cause flu-like symptoms such as chills, fever, muscle aches, weakness, loss of appetite, nausea, vomiting, and diarrhea. Sometimes patients get a rash, and they may bleed or bruise easily. These problems can be severe, but they gradually go away after the treatment stops.

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