Cervical Cancer

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Follow-up visits. For the first three years after treatment, you should have follow-up visits every three to six months to ensure that changes in your health are monitored and problems are treated early. Your follow-up visits will include physical exams and pelvic exams and may include urine tests, blood tests, and X-rays. A Pap test may also be done to look for cancer cells in the vagina. If the cancer does not return within three to five years, visits can be scheduled less often.

Menopause. Some cervical cancer treatments cause immediate menopause. If your uterus and ovaries have been removed or you have had radiation therapy, the estrogen levels in your body will decrease sharply, which is a characteristic of menopause. The lack of estrogen can cause osteoporosis (brittle, thin bones) and menopausal symptoms such as hot flashes and insomnia. Several medicines and other treatments are available for preventing or treating osteoporosis and menopausal symptoms, so talk with your doctor about your options.

Fertility. Before you begin a treatment plan for cervical cancer, your doctor will discuss your fertility options. Depending on your age and the type of treatment you have, you may not be able to have children. Women who have undergone a hysterectomy or radiation for cervical cancer are infertile, meaning they will not be able to become pregnant. Your doctor may discuss "ovarian transposition" which is sometimes successful at protecting ovaries from radiation therapy. It involves surgically moving the ovaries away from the radiation area to minimize exposure. However, there is no guarantee that ovarian function can be preserved with this procedure.

This section includes information on:

  • Sexuality
  • Treatment and relationships
  • Treatment and family expectations
  • Spiritual well-being
  • End-of-life issues
  • Sexuality

    As cancer care has improved and survival rates have increased, issues that affect quality of life, such as sexual health, have become increasingly important. Often patients are not sure what to expect from healthcare providers in regard to talking about sexual health during and after cancer treatment.

    Cancer treatment, such as surgery, chemotherapy, or radiation therapy, can decrease your level of sexual desire by slowing down the production of sex hormones. Side effects of treatment, such as nausea or fatigue, may also decrease your desire. Negative emotions like depression, anger, fear, or guilt may keep you or your partner from wanting to have sex. Medications for pain, nausea, anxiety, or depression can also decrease desire. If you have experienced changes in your appearance as a result of treatment, you may feel self-conscious. All of these factors affect sexual desire.

    Surgery or radiation treatment to the abdomen or pelvis may cause physical changes in blood circulation or nerve supply to the sex organs. Women who experience vaginal dryness as a result of surgery or radiation may use water-soluble lubricants or moisturizing suppositories available at any drugstore without a prescription. Some women may experience some shrinkage of the vagina as a result of radiation or surgery. A combination of learning to relax the vaginal muscles and gentle, gradual stretching of the vagina with dilators can overcome this problem. Finding positions that give the woman control over movement and minimize deep penetration can also help. Your doctor can give you additional advice about sexual activity after radiation treatment or surgery. For more detailed information about positioning and sexual techniques, refer to Sexuality for Women and Their Partners by the American Cancer Society.

    If you are having chemotherapy, it is important to know what your platelet count is before engaging in sexual activity. If your platelet count is lower than 50,000 and you engage in sexual activity, you may be at risk for bleeding.

    During chemotherapy you are also at greater risk for getting an infection. For this reason, practice good personal hygiene and bathe daily. Wash your hands and genitals before and after sexual activity. If you are not in a monogamous sexual relationship (having only one partner) or you are not sure of your partner's faithfulness, you should practice safer sex, using latex condoms to avoid contact with your partner's body fluids. If you use a lubricant with latex condoms, choose a water-based lubricant, and not a lubricant that contains oil (i.e., baby oil or petroleum jelly), since such products can weaken the condom. Nonoxynol-9 is no longer recommended as an HIV preventive.

    If you are the spouse or partner of the patient, you need not worry about getting cancer from sexual intercourse. Cancer is not passed from one person to another. Sexual activity does not cause cancer, nor does sexual activity increase the risk that cancer will return. The causes of cancer are complex, such as exposure to certain toxic chemicals, tobacco use, or genetic factors. It is medically impossible to pass cancer from one person to another. However, some chemotherapy drugs can be present during treatment in semen or vaginal fluid. If your partner is receiving chemotherapy, use condoms for the first 72 hours after chemotherapy is finished to avoid any exposure to the drugs.

    Treatment and Relationships

    Cancer and cancer treatment can cause changes in your appearance. Side effects, such as hair loss, weight changes, scars, or changes in skin color may distress you. You may feel helpless and frustrated by changes beyond your control. The way you feel about your body and yourself can affect how you interact with others. Classes are available to help you look good and feel better. Contact your local chapter of the American Cancer Society to find out about classes near you.

    Anxiety about cancer and cancer treatment can cause a strain on any relationship. Anxiety can interfere with your ability to enjoy any activity, but it is a treatable condition. Worry and fear about the future may make it hard to share intimacy and affection. This commonly occurs when your need for closeness and intimacy are greater than ever. It is normal to experience these emotions during treatment, and it's healthy to talk about them.

    Your doctor, nurse, social worker, or chaplain is available to listen to your concerns and give you advice. Many people don't talk to healthcare professionals about their sexual relationships because they feel embarrassed, ashamed, or afraid. Discuss your concerns with one of your healthcare providers. Choose a doctor, nurse, social worker, chaplain, or therapist whom you trust and who cares about you. He or she can give you information and advice to help you maintain your sexual and emotional health during and after treatment.

    Treatment and Family Expectations

    You carry out different roles every day. You may be a friend, a parent, a daughter, a spouse, a lover, a sister, a worker, and a breadwinner all at once. Each of these roles makes demands upon your time and energy. Fatigue and stress caused by your treatment may prevent you from taking care of duties that you once took for granted. If you are not able to meet these demands, you may feel guilty and become frustrated. You may not be able to do as much for your family as before, but you still have a lot to offer through your love, your caring, and your friendship.

    Because of your illness, your family and loved ones may try to protect you. Even though they mean well, you may feel like they are taking away your independence or your rights as an adult. After treatment, when you start feeling better, your loved ones may have become used to you in the role of a patient. You may need to sit down together and discuss how to switch back from the caretaker and sick-person roles into your usual, more balanced roles.

    For more information about your cancer treatment and its impact on your sexuality, please talk with your doctor, nurse, social worker, chaplain, or family therapist.

    Spiritual Well-being

    A diagnosis of cancer may raise questions and spiritual concerns. Questions such as "Why did this happen to me?" and "Is God punishing me for past wrongs?" may come up over and over. It is not unusual for people to have feelings of shame or guilt as a result of having a cancer diagnosis. Scientists believe that a variety of factors cause cancer, such as toxic chemicals in the environment, the use of tobacco, or heredity. The medical community does not yet have all the answers.

    Your faith should inspire you and help you understand yourself. You may find it helpful to discuss your concerns with a priest, rabbi, minister, or other spiritual person whom you trust.

    End of Life Issues

    In certain instances, when the cancer can no longer be controlled with available therapies or when patients can no longer tolerate treatments, doctors turn their focus to making the patient comfortable. This is called palliative care. The patient receives medications and treatments to control pain and other symptoms, such as constipation, nausea, and shortness of breath. Some patients remain at home during this time, while others enter a hospital or other facility. Either way, services are available to help patients and their families with the medical, psychological, and spiritual issues surrounding dying. A hospice often provides such services.

    The time at the end of life is different for each person. Each individual has unique needs for information and support. The patient's and family's questions and concerns about the end of life should be discussed with the healthcare team as they arise.

    Last reviewed on 10/13/09

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