What are the side-effects of treatment for cervical cancer?

It is difficult 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.

Side-effects of surgery

Radical hysterectomy entails the removal of the womb and the cervix together with the additional removal of adjacent tissues, tubes, lymph nodes and sometimes also the ovaries. For a few days after the operation, the woman may have pain in her lower abdomen. Medicine to control the pain is very effective. 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. Sometimes the bladder problems may even be permanent. She may also 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, can usually be resumed in four to eight weeks.

Women who have had their uterus removed (total hysterectomy for precursors, radical hysterectomy for invasive cancer) no longer have menstrual periods. Sexual desire and the ability to have intercourse are usually not affected by total hysterectomy but may be affected by radical hysterectomy. After surgery, a woman's view of her own sexuality may change, and she may feel an emotional loss. 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.

Side-effects of radiotherapy and chemotherapy

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 tight clothes to prevent friction at 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. 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. This may also occur after surgery if a portion of the upper vagina has been removed together with the cervix and uterus. Patients may be taught how to use a dilator as well as a water-based lubricant to help minimise these problems.

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

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 that 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.

Follow-up care

Regular follow-up examinations - including a gynaecological examination, a Pap smear and other laboratory tests - are very important for any woman who has been treated for pre-cancerous lesions or for cancer of the cervix. The doctor will do these tests and examinations at regular intervals for several years to check for any signs that the condition has returned.

Cancer treatment may cause side-effects many years later. For this reason, patients should continue to have regular check-ups and should report any health problems that appear.

Support for cancer patients

Living with a serious disease is not easy. Cancer patients and those who care about them face many problems and challenges. Coping with these problems is often easier when people have helpful information and support services.

Patients with cancer may worry about holding their job, caring for their family, keeping up with daily activities, or starting a new relationship. Worries about tests, treatments, hospital stays, and medical bills are common. Doctors, nurses and other members of the health care team can answer questions about treatment, working or other activities. Also, meeting with a social worker, counsellor or member of the clergy can be helpful to patients who want to talk about their feelings or discuss their concerns. Friends and relatives can be very supportive.

It helps many patients to discuss their concerns with others who have cancer. Cancer patients often get together in support groups, where they can share what they have learnt about coping with cancer and the effects of treatment. It is important to keep in mind, however, that each patient is different. Treatments and ways of dealing with cancer that work for one person may not be right for another - even if they both have the same kind of cancer. It is always a good idea to discuss the advice of friends and family members with the doctor.

The Hospice Society of South Africa and CANSA (Cancer Association of SA) are two of the well-known organisations that work with cancer patients and their families. One of these organisations is usually represented in a town or district. The contact telephone numbers should be in the local telephone directory.

(Reviewed by Professor Lynette Denny, Gynaecology Oncology Unit, Department Obstetrics & Gynaecology, University of Cape Town/Groote Schuur Hospital)

We live in a world where facts and fiction get blurred
In times of uncertainty you need journalism you can trust. For only R75 per month, you have access to a world of in-depth analyses, investigative journalism, top opinions and a range of features. Journalism strengthens democracy. Invest in the future today.
Subscribe to News24
Voting Booth
Have you entered our Health of the Nation survey?
Please select an option Oops! Something went wrong, please try again later.
31% - 9520 votes
69% - 20876 votes