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Complications of cervical cancer

Complications of cervical cancer can occur as a side effect of treatment and as the result of advanced cervical cancer.

Pain

Having cancer does not always mean having pain. Pain is hardly ever a symptom of early cancer. Even people with advanced cancer do not always have pain. If the cancer spreads into your nerve endings, bones or muscles it can often cause severe pain. It is important to manage your pain effectively and you should speak to your doctor if your pain medication is not helping. However, a number of effective painkilling medications can usually be used. Depending on the levels of pain, they can range from paracetamol and the non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to more powerful opiate-based painkillers, such as codeine and morphine.

Kidney failure

Your kidneys remove waste material from your blood. The waste is passed out of your body in urine through tubes called the ureters. Kidney function can be monitored by a simple blood test called 'serum creatinine level'.

In some cases of advanced cervical cancer, the cancerous tumour (abnormal tissue growth) can press against the ureters, blocking the flow of urine out of the kidneys. The build-up of urine inside the kidneys is known as 'hydronephrosis' and can cause the kidneys to become swollen and stretched.

Severe cases of hydronephrosis can cause the kidneys to become scarred, which can lead to loss of most or all of the kidney's functions. This is known as 'kidney failure'.

Kidney failure can cause a wide range of symptoms, including:

  • tiredness
  • swollen ankles, feet or hands (due to water retention)
  • shortness of breath
  • feeling sick
  • blood in your urine (haematuria).

Treatment options for kidney failure that's associated with cervical cancer include draining urine out of the kidneys using a tube that's inserted through the skin and into each kidney (percutaneous nephrostomy). Another option is to widen each of the ureters by placing a small metal tube called a 'stent' inside them.

Blood clots

Cervical cancer, like any other cancer, can make the blood 'more sticky' and make it more prone to forming clots. Bed rest after surgery and chemotherapy can also increase the risk of developing a clot.

Advanced cervical cancer can spread to your blood vessels directly, which can also increase your risk of developing a blood clot.

A type of blood clot known as 'deep venous thrombosis' (DVT) can occur in cases of cervical cancer. DVT is a blood clot that develops in one of the deep veins in the body, usually in the leg.

Symptoms of a DVT include:

  • pain, swelling and tenderness in one of your legs (usually your calf)
  • a heavy ache in the affected area
  • warm skin in the area of the clot
  • redness of your skin, particularly at the back of your leg, below the knee.

A major concern in cases of DVT is that the blood clot from the leg vein will travel up to the lungs and block the supply of blood into the lungs. This is known as a 'pulmonary embolism', and it can be fatal.

DVT is usually treated by using a combination of blood-thinning medication, such as heparin or warfarin, and compression garments that are specially designed to help encourage the flow of blood through the limbs.

Bleeding

If the cancer spreads into your vagina, bowel or bladder, it can cause significant damage, resulting in bleeding. Bleeding can occur in your vagina, rectum (back passage), or you may pass blood when you urinate.

Minor bleeding can often be treated using a medication called 'tranexamic acid', which encourages the blood to clot and stop the bleeding.

Major bleeding can be treated using a combination of medications that are designed to lower blood pressure. This should help to stem the flow of blood.

Fistula

A fistula is an abnormal channel that develops between two sections of the body. In most cases involving cervical cancer, the fistula develops between the bladder and the vagina. This can lead to a persistent discharge of fluid from the vagina.

Sometimes a fistula develops between the vagina and rectum.

Surgery is usually required to repair a fistula, although it's often not possible in people with advanced cervical cancer because they're usually too frail to withstand the effects of surgery.

In such cases, treatment often involves using medication, creams and lotions to reduce the amount of discharge and protect the vagina and surrounding tissue from damage and irritation.

Vaginal discharge

Another uncommon but distressing complication of advanced cervical cancer is an unpleasant smelling discharge from your vagina.

The discharge can occur for a number of reasons, such as the breakdown of tissue, the leakage of bladder or bowel contents out of the vagina, or a bacterial infection of the vagina.

Treatment options for vaginal discharge include an anti-bacterial gel called 'metronidazole', and wearing clothing that contains charcoal. Charcoal is a chemical compound that's very effective in absorbing unpleasant smells.

Palliative care

If your doctors can't do any more to treat your cancer, your care will focus on controlling your symptoms and helping you to be as comfortable as possible. This is called 'palliative care'.

Palliative care also includes psychological, social and spiritual support for you and your family or carers.

There are different options for terminal care in the late stages of cancer. You may want to think about whether you would like to be cared for in hospital, in a hospice, or at home, and to discuss these issues with your doctor.

Sources: Cancer Australia, NHS Choices, UK (Complications of cervical cancer)

Last reviewed: October 2015

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