Treatment plan for recurrent cervical cancer

What are the treatment options for recurrent cervical cancer? Recurrence in the cervix or vagina often causes irregular vaginal bleeding or foul-smelling leucorrhea. Recurrence in the pelvic wall or paracervix may cause pain and edema in the affected lower limb, pain in the lumbosacral region or lower abdomen. Pelvic examination may show a paracervical mass or a fixed mass in the sacral fossa. Metastasis to the rectum or bladder often causes blood in the stool or hematuria. Bone metastasis often causes local pain. Lung metastasis may cause cough and chest pain.

When the above symptoms and signs appear after treatment of cervical cancer, the possibility of recurrence should be considered. Local recurrence of the cervix and vagina can be diagnosed easily by vaginal smear cytology and biopsy. However, recurrence of the paracervix and pelvic wall is difficult to diagnose mainly by clinical symptoms and pelvic examination. Attention should be paid to the differentiation of pelvic masses from lymphocele after radical surgery, pelvic wall inflammation, and paracervical connective tissue fibrosis after radiotherapy. Local fine needle puncture for cell smear and pathological examination can help to clarify the diagnosis. B-ultrasound, pyelography, isotope renal imaging and CT pelvic examination have certain reference value for diagnosing recurrent cancer.
Experts remind that when the above symptoms and signs appear after treatment of cervical cancer, the possibility of recurrence should be considered. Local recurrence of the cervix and vagina can be easily diagnosed by vaginal smear cytology examination and biopsy. However, recurrence of the paracervix and pelvic wall is difficult to diagnose mainly by clinical symptoms and pelvic examination.
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