Controlling symptoms of advanced cervical cancer

Tiredness (fatigue) is a common symptom of advanced cancer. You may feel that you lack energy, and this can be overwhelming. 

Let your doctor or nurse know if you’re very tired, as they can prescribe medicine to help or other treatments to help. For example, a blood transfusion can give you more energy if you’re tired due to anaemia (low red blood cell levels).

Resting

It’s important to rest a few times throughout the day. Resting regularly can help you feel less tired and more able to cope. You don't have to sleep during these times. Just sitting or lying down will help. 

Exercise

Exercising can be hard when you feel very tired. But, research shows that daily light to moderate exercise can give you more energy. You can try a short walk if you can manage it. Gentle exercises in bed or standing up can help if you can’t move around easily. 

Your hospital physiotherapist might be able to help you plan an exercise programme that suits your needs.  

Sleeping

You might feel more tired if you have trouble sleeping at night. It can help to change a few things about when and where you sleep.

You might not feel like eating and may lose weight. It is important to eat as much as you can.

Tips:

• Eating several small meals and snacks throughout the day can be easier to manage.
• Ask your doctor to recommend high calorie drinks to sip if you are worried about losing weight.
• Eat whatever you feel like eating rather than what you think you should eat.
• Eat plenty of calories when you can to make up for times when you don’t feel like eating.
• Drink plenty of fluids even if you can't eat.
• Don't fill your stomach with a large amount of liquid before eating.
• Try to eat high calorie foods to keep your weight up.

Sometimes cancer can grow so that it completely blocks the bowel. This is called a bowel obstruction. The waste from the food you have digested can't get past the blockage. This causes quite a few symptoms such as:

• feeling bloated and full
• vomiting large amounts
• feeling sick
• constipation
• being unable to pass wind
• pain

It's sometimes possible to unblock the bowel to relieve symptoms by putting in a tube called a stent. The surgeon puts a flexible tube with a light at the end (called an endoscope) into the bowel through your back passage. This is called a colonoscopy.

The surgeon uses the endoscope to see where the blockage is and pushes the stent through it. The stent expands and holds the bowel open so that bowel motions can pass through again. The surgeon leaves the stent in the bowel to keep it open. As well as relieving symptoms, this procedure gives doctors time to plan an operation to remove the blocked part of the bowel.

If you are well enough, you can have surgery to remove the blocked part of the bowel. It might be possible to close up the cut ends of the bowel again during this operation. Or the surgeon might need to bring the upper end of the bowel out into an opening made in the skin of your tummy (abdomen). The opening is called a stoma or colostomy.

Treatment for sickness depends on what is causing it. Some painkillers or cancer treatments can cause sickness. You might also feel sick if you are constipated.

Talking this over with a doctor or nurse is a good idea. Then, you can get the treatment you need.

Some people find that ginger is a good natural remedy for sickness. Try eating stem ginger or crystallised ginger if you like it. Or drinking boiled water with a small piece of fresh ginger in it. Some people find sipping fizzy ginger drinks can help. 

You may hear this called hydronephrosis. In cervical cancer, one (or sometimes both) of the tubes from the kidney to the bladder (the ureters) can get blocked by the tumour. This means the urine that the kidney makes cannot drain away and builds up inside the kidney.

If not treated, this can make you feel extremely ill and can cause that kidney to fail. It is even more severe if both your kidneys are affected.

To treat this, your doctor may be able to put a small tube inside the ureter to help drain the urine from the kidney into the bladder. The tube is called a stent.

If it isn't possible to put a stent in straight away or at all, your doctor will put a tube into your kidney through your skin. This tube is called a nephrostomy tube. It allows urine to drain out of the body into a bag. The bag has a tap on it so you can empty it.

After this type of surgery, a district nurse visits you at home to help you manage the tube and drainage bag. You may be able to have a stent put in after things have settled down a bit with that kidney.

Vaginal discharge can be a distressing symptom of advanced cervical cancer. It can make you feel very self conscious, anxious and depressed. Coping with it can be hard, but depending on what’s causing the problem, several things can help.

An infection is a common cause of vaginal discharge. Some women are more prone to getting infections during treatment with radiotherapy or chemotherapy for cervical cancer.

Depending on the type of infection, antibiotics or antifungal medications can help clear it up. Although it can be embarrassing, tell your doctor about your symptoms. If it is an infection, they can prescribe the right medications for you.

The unpleasant smelling discharge may also be a symptom of the cancer itself. If your cancer is very advanced, it may be difficult to get rid of the symptom completely.

To help control the smell and discharge, try to:

• Keep the area around the vagina clean and dry.
• Wear cotton underwear and loose clothes to keep the area cool.
• Change sanitary pads frequently.
• Use a deodorising spray, essential oils or an air filter around your bed or in the toilet before changing pads.
• Avoid using bubble bath and perfumed soaps around the vaginal area.
• Use scented disposable bags for used sanitary pads.
• Wipe from front to back after going to the toilet.

Ask your nurse about where you can find charcoal panty liners or underwear - this can help reduce the smell from the vaginal discharge