Symptoms of recurrent cervical carcinoma may include vaginal bleeding or discharge, pain in the pelvis, back or legs, leg swelling (edema), chronic cough and weight loss.
• If radiation was not given previously, recurrences that are confined to the pelvis may be treated with external
beam radiation and intracavitary or interstitial radiation therapy .
• If radiation therapy was already given, the only option is the removal of the vagina, uterus and the bladder
and/or rectum with the creation of an artificial bladder— a pelvic exenteration. However, this operation is
feasible only for those patients who have no spread of their cancer to the lymph nodes or elsewhere beyond
the pelvis. The five-year survival rate on carefully selected patients after a pelvic exenteration is about 50
percent.
• Women with recurrent tumors that can't be surgically removed or with metastatic disease are treated with
palliation in mind. The aim of therapy is to alleviate symptoms with treatment that has the minimal side
effects. For metastatic bony disease, local radiation therapy is used to relieve pain. For lung and liver
metastases, chemotherapy may be tried. Commonly used drugs include single agent cisplatin or carboplatin .
Other agents include cisplatin or carboplatin and ifosfamide , vincristine and mitomycin-C + bleomycin +
cisplatin and bleomycin + mitomycin-C + 5-fluorouracil.
• Those with unresectable pelvic disease may be given further radiation to alleviate local pain symptoms or
