Care and mobility considerations
The majority of women will receive curative treatment for early stage disease and return to health with no disabling effects. Some may develop long term side effects of treatment.
Stage 1 and 2 disease
- Five year survival from stage 1 disease is about 80-95%. Five year survival from stage 2 disease is 60-90%. Long term side effects of treatment are infertility and early menopause. Because this group has good long term survival they are likely to develop proportionately more of the long term side effects from their radiotherapy treatment.
- There are unlikely to be any long term care and mobility needs after initial treatment. The exception to this is the enduring but rare side effects of chemotherapy and long term effects of pelvic radiotherapy. Needs are likely to arise when disease recurs.
Stage 3 disease
- Five year survival from stage 3 disease is 30-50%. Long term disabling effects include the side effects of radiotherapy particularly on the bladder and bowel which may develop some years after treatment. Recurrent disease is common and may occur quite soon after treatment of initial disease – up to date medical evidence from the treating hospital will be important.
Stage 4 disease
- Stage 4A disease means the cancer has spread to other organs in the pelvis, there are likely to be disabling effects including problems with the bowel and bladder related to invasion by cancer. Treatment is likely to include chemotherapy, radical radiotherapy and/or major surgery. Radical treatment for advanced disease typically has more side effects than treatment of early disease. Long term survival is poor.
- Stage 4B disease means metastases have occurred, any of the disabling effects of metastatic disease may be present, she may be terminally ill. 5 year survival is about 16%.
Metastatic disease and recurrent disease after treatment of any stage of cervical cancer.
This person is likely to be terminally ill although the expected survival may be longer than six months.
There may be disabling effects from metastatic disease anywhere in the body including-:
- Liver metastases – these may cause fatigue and in the later stages, mental confusion, abdominal swelling or pain and jaundice
- Lung metastases or malignant pleural effusion – may cause very disabling breathlessness reducing mobility to a few yards.
- Brain metastases – these may cause fits, personality change, confusion, difficulties with balance, walking and self care
- Bone metastases – pain and pathological fractures
Problems specifically related to advanced cervical cancer or its treatment may include:
- Lymphoedema of the lower limbs, this is likely to affect ability to walk.
- Pelvic pain syndromes
- Problems with the bowel or bladder following radiotherapy treatment, including urinary and faecal incontinence; women who have had pelvic exenteration may have one or two stomas to care for.
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Amended February 2009
