Chemotherapy is used to shrink cervical cancer and decrease tumor growth. Chemotherapy may be used to treat later stages (stages II, III, and IV) of cervical cancer. It may be used alone or in combination with radiation (chemoradiation). Compared with radiation alone, chemoradiation improves survival.⁷ It is usually used as the primary therapy or after a hysterectomy.

Chemotherapy medicines may be taken by mouth (orally) or injected into a vein (intravenous, or IV). Chemotherapy is called a systemic treatment because the medicines enter the bloodstream and travel through the body to kill cancer cells.

Extensive research and clinical trials have studied the different chemotherapy medicines used to treat cervical cancer. Some medicines are used routinely, and some are used in combination with others for greater effectiveness. Your oncologist will discuss and recommend chemotherapy treatment specific to your condition.

Medication Choices

The most common chemotherapy medicines used for initial treatment or with radiation treatment in stage IIA, IIB, IIIA, IIIB, and IVA include:

• Cisplatin.
• Fluorouracil (5-FU).

For advanced stage (stage IVB) cervical cancer or recurrent cervical cancer, the most common chemotherapy medicines used are:

• Mitomycin.
• Paclitaxel.
• Ifosfamide.

Topotecan has been approved to use with cisplatin for advanced cervical cancer. These drugs may be used when surgery or radiation cannot be done or are not likely to work. They can also be used for cervical cancer that has returned or spread to other organs.

What To Think About

Most chemotherapy will cause some side effects.

Chemotherapy may be given after surgery to try to kill any cancer cells that may remain, which is called adjuvant therapy.

Studies show that chemotherapy given at the same time as radiation treatment (chemoradiation) improves survival rates in stages IIB, IIIA, IIIB and IVA cervical cancer without significantly increasing the side effects of either treatment. Chemoradiation may also improve survival rates in stages IB and IIA for women with large tumors.^{6, 1} Compared with radiation alone, chemoradiation improves survival.⁷ It is usually used as the primary therapy or after a hysterectomy.

Cisplatin is the medicine most often used in chemoradiation for cervical cancer.