Cervical cancer survivors suffer from fatigue, insomnia and hot flushes

May 4, 2017, European Society for Radiotherapy and Oncology
High grade dysplasia (carcinoma in situ) in the uterine cervix. The abnormal epithelium is extending into a mucus gland to the left of centre. This disease can progress to invasive cancer (squamous cell carcinoma) of the cervix. Credit: Haymanj/public domain

Around half of women who have been treated for locally advanced cervical cancer suffer from symptoms of insomnia, fatigue or hot flushes at some point, according to new research presented at the ESTRO 36 conference.

Cervical affects more than 500,000 women around the world each year, with an average age at diagnosis of 50. Survival rates, even in women where the cancer has begun to spread to nearby tissue, have increased meaning women are living with side-effects for longer.

Dr Stéphanie Smet, a resident in at the Medical University of Vienna, Austria, who presented the research, says that these symptoms may have a substantial impact on ' daily lives and they need to be better recognised and treated when necessary.

The study involved 1,176 patients with locally advanced cervical cancer, treated at 22 centres around the world between 2008 and 2015. All received the gold-standard of radiotherapy combined with chemotherapy, followed by brachytherapy, where an MRI scanner is used to guide a radioactive implant to the site of the cancer to deliver a high dose of radiotherapy. Patients were followed up for an average of 27 months.

They were assessed for symptoms by their doctors and filled in questionnaires themselves. The results show that 64% of women were experiencing fatigue to some degree at least once during their regular follow-up examinations in the years after treatment. For insomnia, the figure was 43% and for hot flushes it was 50%. These symptoms were mainly in the mild to moderate range. Severe or disabling symptoms were rare at 4%, 3% and 2% respectively.

Patients were on average 49 years old, ranging from 22 to 91, and the results show that younger women were more likely to experience these symptoms.

Dr Smet told the congress: "Our study shows that around half of women with locally advanced cervical cancer are, at some point, suffering from mild to moderate fatigue, insomnia and hot flushes. These symptoms could have a serious impact on patients' daily life, possibly influencing how they feel in their professional, social and family life.

"More and more diagnosed with this type of cancer are surviving for longer, thanks to advances in radiotherapy. This is a relatively young group of patients, so many will possibly face decades of coping with their symptoms.

"It is important to realise that these symptoms can already exist before patients start the treatment, sometimes even before they are diagnosed with cancer. It is difficult to distinguish whether and to what extent these symptoms are caused by the cancer itself, by the treatment or by other factors. In most cases, it is probably a combination."

Until now, research in this area of radiotherapy has primarily focused on symptoms related to nearby organs at risk such as the bladder, bowel, rectum or vagina. Dr Smet continued: "We hope that by presenting our report we will create more awareness for these under-recognised symptoms.

"There has been a great deal of research on treating cancer-related fatigue and insomnia, and include drugs, physical exercise and psychological counselling. Hormone replacement therapy can be a safe and effective treatment for hot flushes, if it administered as soon as the menopause begins and for a period of four to five years."

Dr Smet told the congress that more work is needed to decipher which patients are most at risk of developing these symptoms and to tailor support accordingly.

She also said that the study could help understand the symptoms experienced by other cancer patients who are treated with pelvic radiotherapy. This includes other gynaecological cancers as well as rectal and prostate cancer.

President of ESTRO, Professor Yolande Lievens, head of the department of radiation oncology at Ghent University Hospital, Belgium, said: "Thanks to advances in treatment, cancer survival is improving, which makes us aware of the fact that besides the loco-regional side effects we are typically focusing on, we should also be vigilant for more general side effects. These results highlight how important it is to follow cancer survivors in the long term. Medical teams who look after patients treated for cancer of the cervix, and by extension other gynaecologic and pelvic cancers, need to be aware of symptoms such as fatigue, insomnia and , and be able to advise on management and treatment options."

Explore further: Untreated effects of breast cancer care increase depression and anxiety among survivors

More information: Abstract no: OC-0051, "Fatigue, insomnia, hot flashes (CTCAE) after definitive RCHT+IGABT for cervical cancer (EMBRACE)", in the "Joint clinical - GEC ESTRO on cervix cancer" proffered papers session, 10:30-11.30 hrs (CEST) on Saturday, 6 May, Auditorium.

Related Stories

Untreated effects of breast cancer care increase depression and anxiety among survivors

December 9, 2016
Treatment advances have increased the five-year survival rate for breast cancer to 90 percent. But, for many of the 2.8 million survivors in the United States, the price of survival includes severe physical and psychosocial ...

Study finds not all women get appropriate care for cervical cancer

March 2, 2017
Women with locally advanced cervical cancer whose treatment follows national guidelines for care have better survival, regardless of race, ethnicity or stage of cancer.

Cervical cancer is preventable, but still a leading cancer

January 11, 2017
At the beginning of the year, many women (and men) set resolutions around health and fitness, often focusing on weight loss. But one of the most important habits women can form revolves around regular health checks, particularly ...

Naturally occurring symptoms may be mistaken for tamoxifen side-effects

December 9, 2016
Women taking tamoxifen to prevent breast cancer were less likely to continue taking the drug if they suffered nausea and vomiting, according to new data presented at the San Antonio Breast Cancer Symposium today (Friday).

Some older cancer patients can avoid radiotherapy, study finds

January 28, 2015
Some older women with breast cancer could safely avoid radiotherapy, without harming their chances of survival, a study has shown.

Less than half of cervical cancer patients receive standard-of-care treatment

October 31, 2016
Standard-of-care treatment for locally advanced cervical cancer includes radiation, chemotherapy and brachytherapy (in which radiation is implanted internally). A University of Colorado Cancer Center study published in the ...

Recommended for you

Pregnant? Eating broccoli sprouts may reduce child's chances of breast cancer later in life

August 16, 2018
Researchers at the University of Alabama at Birmingham have found that a plant-based diet is more effective in preventing breast cancer later in life for the child if the mother consumed broccoli while pregnant. The 2018 ...

PARP inhibitor improves progression-free survival in patients with advanced breast cancers

August 15, 2018
In a randomized, Phase III trial led by researchers at The University of Texas MD Anderson Cancer Center, the PARP inhibitor talazoparib extended progression-free survival (PFS) and improved quality-of-life measures over ...

Scientists discover chemical which can kill glioblastoma cells

August 15, 2018
Aggressive brain tumour cells taken from patients self-destructed after being exposed to a chemical in laboratory tests, researchers have shown.

Three scientists share $500,000 prize for work on cancer therapy

August 15, 2018
Tumors once considered untreatable have disappeared and people previously given months to live are surviving for decades thanks to new therapies emerging from the work of three scientists chosen to receive a $500,000 medical ...

New clues into how 'trash bag of the cell' traps and seals off waste

August 15, 2018
The mechanics behind how an important process within the cell traps material before recycling it has puzzled scientists for years. But Penn State researchers have gained new insight into how this process seals off waste, ...

RUNX proteins act as regulators in DNA repair, study finds

August 15, 2018
A study by researchers from the Cancer Science Institute of Singapore (CSI Singapore) at the National University of Singapore has revealed that RUNX proteins are integral to efficient DNA repair via the Fanconi Anemia (FA) ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.