When someone hears the words “you have cervical cancer,” it’s like the world stops for a moment. The next thing you’re faced with? Decisions—big ones. One of the most important is figuring out the best treatment path. Should it be radiation? Chemotherapy? Or maybe both?
Let’s walk through what each treatment means, how they work, and what you can truly expect from the experience—not just in a clinical sense, but from a human perspective.
What’s the Difference Between Radiation and Chemotherapy?
It’s easy to confuse the two. After all, both aim to destroy cancer cells. But how they go about it? Totally different.
- Radiation therapy targets specific areas. Think of it like a sniper—it delivers high-energy beams directly to the tumour.
- Chemotherapy, on the other hand, is more like a fog—it spreads throughout your whole body, attacking cancer cells wherever they may be hiding.
Radiation is local. Chemo is systemic. That one key difference influences everything else about your treatment.
When Is Radiation Therapy Recommended?
Radiation is often used when the cancer is still within the cervix or nearby tissues. For example, in stage IB to IIB, doctors often recommend external beam radiation and brachytherapy (a form of internal radiation). It can also be given after surgery to make sure any remaining cancer cells are wiped out.
In later stages, radiation is often combined with chemo to increase effectiveness—a combo known as chemoradiation. But more on that soon.
When Is Chemotherapy Used for Cervical Cancer?
Chemotherapy isn’t always a solo act when it comes to cervical cancer. It usually plays two key roles:
- As part of chemoradiation: A low dose of chemo makes cancer cells more sensitive to radiation.
- For advanced or recurrent cancer: In later stages (like stage IV), chemo may be used to shrink tumours, control symptoms, or slow progression.
Drugs like cisplatin, carboplatin, and paclitaxel are the usual suspects. Some are given alone, others in combinations.
Can You Have Both Radiation and Chemotherapy Together?
Yes—and in many cases, it’s the gold standard.
This combo, known as concurrent chemoradiation, is often used for locally advanced cervical cancer. The idea? Use low-dose chemo to boost the power of radiation. Think of it as softening up the enemy before sending in the main attack.
It’s more intense, no doubt, and the side effects can stack up. But for many patients, it offers the best chance of control or even cure.
What Does a Typical Radiation Treatment Involve?
Radiation therapy isn’t just one-and-done. It’s a journey.
- External Beam Radiation Therapy (EBRT) is the most common. You’ll lie on a table while a machine delivers beams to your pelvis. It’s painless and takes just minutes, but you might do this 5 days a week for 5–6 weeks.
- Brachytherapy is a bit more intimate. A device is placed inside the vagina to deliver radiation close to the cervix. This happens a few times during your treatment course.
Don’t worry—you’ll have planning scans beforehand, and the team will work hard to make sure everything is precisely targeted.
What to Expect During Chemotherapy Sessions
Chemotherapy often means spending a few hours at a hospital or infusion centre. You’ll be hooked up to an IV drip, possibly with some pre-meds to help with nausea.
Each cycle may last a few hours and be repeated every 3–4 weeks, depending on the drug. Some women bring a book, others nap, and a few just chat with the nurses—it all depends on how you feel.
You won’t lose your hair with every chemo drug, but fatigue and a bit of queasiness are common. And if you’re wondering, yes, you can usually go home the same day.
Side Effects of Radiation Therapy
Radiation is powerful—but with power comes a price.
Common side effects include:
- Fatigue – the kind that doesn’t go away with a nap.
- Diarrhoea or bladder irritation – because your bowels and bladder sit near the cervix.
- Vaginal dryness or narrowing – this can affect intimacy and pelvic exams.
- Skin irritation – especially in the pelvic area.
These side effects usually fade after treatment ends, but some (like vaginal changes) can be long-term. Your team may recommend dilators, creams, or physical therapy to help.
Side Effects of Chemotherapy
Chemotherapy hits fast-growing cells—and sadly, that includes some healthy ones too. This is why side effects happen.
You might experience:
- Nausea and vomiting
- Hair thinning or loss
- Weakened immune system – leading to more infections
- Neuropathy – tingling in hands and feet
Some side effects go away quickly. Others linger. But your medical team will do everything they can to help manage them—don’t be afraid to speak up.
How Do These Treatments Affect Fertility and Menstrual Cycles?
Here’s a tough one: both radiation and chemo can affect fertility.
- Radiation to the pelvis can damage the ovaries and uterus.
- Chemo, especially certain types, can stop ovulation.
This means you may go into early menopause. If you’re still planning to have children, talk to your doctor about options like egg or embryo freezing before starting treatment.
And remember—it’s okay to grieve the loss of fertility. It’s a deeply personal and emotional journey.
Coping Strategies During Treatment
Treatment isn’t just hard on the body—it takes a toll on the heart and mind, too. So how can you stay grounded?
- Lean on your support circle – whether it’s family, friends, or a cancer support group.
- Eat nourishing foods, even if you don’t feel hungry.
- Stay hydrated and rest – your body is working overtime.
- Ask for help – with chores, childcare, or just a listening ear.
And on the really tough days? Be kind to yourself. Survival isn’t just about fighting—it’s also about resting.
Talking to Your Doctor: Questions to Ask Before Starting Treatment
Feeling overwhelmed? One way to reclaim control is by asking questions. Lots of them.
Here are a few to start with:
- What’s the goal of this treatment—cure or control?
- What are the likely side effects? How can I prepare?
- Will I need time off work?
- Can I still be intimate with my partner?
- Are there clinical trials available?
No question is too small. Your healthcare team is there to guide you—don’t hesitate to speak your mind.
Which Treatment is Right for You?
So, radiation or chemo—which one wins?
The truth is, there’s no one-size-fits-all answer. Your treatment plan depends on:
- The stage of your cancer
- Your general health
- Whether you’ve had surgery already
- Your goals, including fertility and quality of life
It’s not just about medicine—it’s about you. That’s why shared decision-making matters. Don’t be afraid to ask for second opinions or more time to consider your options.
Final Thoughts
Choosing between radiation and chemotherapy can feel overwhelming—but knowing what to expect makes the road a little less scary. With the right support, medical care, and self-compassion, you can walk this path one step at a time.
You’re not alone in this.
References
- Radiation Therapy for Cervical Cancer – American Cancer Society, 2023. https://www.cancer.org/cancer/cervical-cancer/treating/radiation.html
- Chemotherapy for Cervical Cancer – National Cancer Institute, 2022. https://www.cancer.gov/types/cervical/patient/cervical-treatment-pdq
- Cervical Cancer Treatment (PDQ®)–Health Professional Version – National Cancer Institute, 2024. https://www.cancer.gov/types/cervical/hp/cervical-treatment-pdq
- Coping with Cancer – Macmillan Cancer Support, 2023. https://www.macmillan.org.uk/cancer-information-and-support