Treatments for recurrent cervical cancer

Recurrent cervical cancer means that the cancer has come back after it has been treated. The following are treatment options for recurrent cervical cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Cervical cancer can come back in the cervix. It can also recur close to where it first started, such as in the uterus or other organs in the pelvis. It can also come back in distant sites.

Chemoradiation

You may be offered chemoradiation for recurrent cervical cancer. Chemotherapy is given during the same time period as radiation therapy to make the radiation therapy more effective. 5-fluorouracil (Adrucil, 5-FU) plus cisplatin or mitomycin (Mutamycin) or other chemotherapy drugs may be used.

Radiation therapy

You may be offered radiation therapy for recurrent cervical cancer. Radiation therapy may be external radiation therapy, brachytherapy or both. For recurrent cervical cancer, radiation therapy is often given with chemotherapy, but in some cases it may be used alone as the main treatment.

For recurrent cervical cancer, radiation therapy may be used to relieve pain, stop bleeding or control other symptoms of advanced cervical cancer (called palliative therapy).

Chemotherapy

Chemotherapy may be offered for recurrent cervical cancer to relieve pain or control the symptoms of advanced cervical cancer.

Chemotherapy drugs used to treat recurrent cervical cancer are used alone or in combination and include:

  • cisplatin
  • carboplatin (Paraplatin, Paraplatin AQ)
  • paclitaxel (Taxol)
  • topotecan (Hycamtin)
  • gemcitabine (Gemzar)
  • 5-fluorouracil (Adrucil, 5-FU)
  • ifosfamide (Ifex)
  • docetaxel (Taxotere)
  • irinotecan (Camptosar)
  • mitomycin (Mutamycin)
  • vinorelbine (Navelbine)
  • epirubicin (Pharmorubicin)
  • doxorubicin (Adriamycin)

The most common chemotherapy drug combinations used to treat cervical cancer are:

  • cisplatin and ifosfamide
  • cisplatin and paclitaxel
  • cisplatin and gemcitabine
  • cisplatin and topotecan
  • paclitaxel and topotecan

Targeted therapy

You may be offered targeted therapy for recurrent cervical cancer. The most common targeted therapy drug used to treat cervical cancer is bevacizumab (Avastin). It is usually given in combination with chemotherapy.

Immunotherapy

Immunotherapy helps to strengthen or restore the immune system's ability to fight cancer. You may be offered immunotherapy for recurrent cervical cancer.

If chemotherapy was used to treat metastatic cervical cancer but it didn't respond or the cancer comes back, then you may be offered cemiplimab (Libtayo).

Pembrolizumab (Keytruda) may also be offered for recurrent cervical cancer in combination with chemotherapy. It is sometimes given with the targeted therapy drug bevacizumab (Avastin). Pembrolizumab is only used for cervical cancer tumours that have the PD-L1 checkpoint protein.

Find out more about immunotherapy for cervical cancer.

Surgery

You may be offered one of the following types of surgery for recurrent cervical cancer.

A pelvic exenteration may be used to treat recurrent cervical cancer that comes back in the pelvis but has not spread to the side wall of the pelvis. A pelvic exenteration is not used if cancer comes back in another part of the body.

Find out more about a pelvic exenteration.

A radical hysterectomy may be offered for a small recurrence in the cervix or uterus if you were previously treated with radiation therapy.

Find out more about a hysterectomy.

If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Clinical trials

Talk to your doctor about clinical trials open to women with cervical cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Expert review and references

  • Guideline Resource Unit (GURU). Cancer of the Uterine Cervix. Edmonton: Alberta Health Services; 2021: Clinical Practice Guideline GYNE-004 Version: 6. https://www.albertahealthservices.ca/info/cancerguidelines.aspx.
  • American Cancer Society. Treating Cervical Cancer. 2021: https://www.cancer.org/.
  • Chuang LT, Temin S, Berek JS. Management and care of patients with invasive cervical cancer: ASCO Resource-Stratified Guideline Rapid Recommendation Update. JCP Global Oncology. 8:1-4.
  • Cibula D, Raspollini MR, Planchamp F, Centeno C, Chargari C, et al. ESGO/ESTRO/ESP Guidelines for the management of patients with cervical cancer – Update 2023. International Journal of Gynecological Cancer. 2023: 33:649-666.
  • Hacker N, Jackson M, Vermorken J. Cervical cancer. Berek JS, Hacker NF (eds.). Berek and Hacker's Gynecologic Oncology. 7th ed. Philadelphia: Wolters Kluwer; 2021: Kindle version, [Chapter 9].
  • Jorgensen K, Rauh-Hain JA, Klopp AH. Cancer of the cervix. DeVita VT Jr, Lawrence TS, Rosenberg S. eds. DeVita Hellman and Rosenberg's Cancer: Principles and Practice of Oncology. 12th ed. Philadelphia, PA: Wolters Kluwer; 2023: Kindle version, [chapter 48], https://read.amazon.ca/?asin=B0BG3DPT4Q&language=en-CA.
  • National Comprehensive Cancer Network . NCCN Clinical Practice Guidelines in Oncology: Cervical Cancer Version 1.2023. 2023.

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

We do our best to make sure that the information we provide is accurate and reliable but cannot guarantee that it is error-free or complete.

The Canadian Cancer Society is not responsible for the quality of the information or services provided by other organizations and mentioned on cancer.ca, nor do we endorse any service, product, treatment or therapy.


1-888-939-3333 | cancer.ca | © 2024 Canadian Cancer Society