Side effects of cervical cancer chemoradiotherapy
Having chemotherapy with radiotherapy (chemoradiotherapy) can cause more severe side effects. This is compared with having these treatments on their own.
Everyone is different, and the side effects vary from person to person. You might not have all of the effects mentioned. Side effects depend on the type of chemotherapy you have. They also depend on the radiotherapy treatment area.
The side effects gradually get worse during the treatment. They can continue to get worse after your treatment ends. Side effects will improve, but some might take a few weeks to months.
Contact your doctor or nurse if any of the side effects are severe or if your temperature goes above 37.5°C.
Tests
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
Possible side effects
Tell your doctor or nurse if you have any side effects so they can help you manage them. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Signs of an infection include headaches, aching muscles, a cough, a sore throat, pain passing urine, or feeling cold and shivery.
Chemotherapy reduces the number of white blood cells in the blood. This increases your risk of infections. White blood cells help fight infections.
When the level is very low it is called neutropenia (pronounced new-troh-pee-nee-ah).
You have antibiotics if you develop an infection. You might have them as tablets or as injections into the bloodstream (intravenously). To have them into your bloodstream you need to go into hospital.
You might notice you:
- bruise more easily
- have nosebleeds
- have bleeding gums when you brush your teeth
This is due to a drop in the number of platelets that help clot your blood.
If your platelets get very low you may have lots of tiny red spots or bruises on your arms or legs called 
.
Tell your doctor or nurse straight away if you have this.
You have a platelet transfusion if your platelet count is very low. It is a drip of a clear fluid containing platelets. It takes about 15 to 30 minutes. The new platelets start to work right away.
Radiotherapy can inflame the lining of your bowel. This can cause diarrhoea. You may also have:
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griping or cramping pain
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an increase in wind
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feeling you need to go to the toilet urgently
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some mucus or blood in your poo (stool)
It’s important to drink plenty if you have diarrhoea, so you don't become dehydrated. Your doctor might prescribe tablets to help slow down your bowel if you need them. This should help to reduce the number of times you have diarrhoea. Changing your diet might also help lessen the number of times you need to go, such as reducing the amount of fibre if you have been following a diet very high in fibre. Ask your nurse or doctor about this.
Ask your nurse or radiographer for soothing creams to apply around your back passage (anus). The skin in that area can get very sore and might break if you have severe diarrhoea.
Diarrhoea should gradually get better a few weeks after your treatment has finished. Let your doctor or nurse know if it continues.
Feeling or being sick can be severe. It can start a few hours after treatment and last for a few days. Anti-sickness injections and tablets can control it. Tell your doctor or nurse if you feel sick. You might need to try different anti-sickness medicines to find one that works.
Contact your doctor or nurse straight away if you’ve been sick more than once in a day.
Tips
- Avoid eating or preparing food when you feel sick.
- Avoid fried foods, fatty foods or foods with a strong smell.
- Drink plenty of liquid to stop you from getting dehydrated.
- Relaxation techniques help control sickness for some people.
- Ginger can help – try it as crystallised stem ginger, ginger tea or ginger ale.
- Fizzy drinks help some people when they are feeling sick.
You are likely to feel very tired during your treatment. It tends to get worse as the treatment goes on. You might also feel weak and lack energy.
After a while you may need to sleep for some time during the day. Rest when you need to.
Tiredness gets better once you finish treatment but it can carry on for some months or years.
Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.
For a while after having the treatment you might feel that you have to pass urine more often than usual. And you may have a burning feeling when you do. Or you might feel that you can’t wait then you need to go. This is called cystitis.
The treatment temporarily inflames the lining of your bladder. It helps to drink plenty of fluids. You might find that some drinks increase the soreness, such as tea and coffee. You can experiment for yourself and see what works for you.
Tell your doctor or nurse if you have bladder soreness. They can prescribe medicines to help.
'Just can’t wait' card
You can get a card to show to staff in shops or pubs. It allows you to use their toilets without them asking awkward questions. You can get the cards from Disability Rights UK or the Bladder and Bowel Community. They also have a map of all the public toilets in the UK.
Disability Rights UK can also give you a key for disabled access toilets so that you don't have to ask for a key when you are out.
Long term side effects
Most side effects gradually go away in the weeks or months after treatment. But some radiotherapy side effects can continue or might start some months or years later.
