Living with itCervical cancer

Back to the Cervical cancer hub →36 questions · 6 red cards

The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask.

Living with it

top

The first 60 days →Appointment prep sheet →Side effects →Help with costs →

Decisions you may face

11 with more than one option · full decision page →

One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.

Prevention Locally advanced3 Recurrent/metastatic2 Primary prevention2 Screening3 Precancer (HSIL / CIN2-3, AIS)2 Stage IA1-IB1 (≤2 cm)2 Stage IB2-IIA (surgical candidates)2 Locally advanced (IB3, IIB-IVA), standard3 Locally advanced, high risk (node-positive IB2-IIB, III-IVA)Persistent, recurrent, or metastatic, first line4 Second line and beyond5 Pelvic recurrence after radiation3

Red cards

From the labels and guidelines behind the standard of care. Your team's thresholds win.

Emergency services now
Hypophysitis or adrenal crisis
Persistent headache with extreme tiredness, nausea, dizziness on standing or low blood pressure. Vomiting, severe weakness or collapse is adrenal crisis.
Atezolizumab Cadonilimab Cemiplimab Pembrolizumab source
Emergency services now
Skin reaction
Blisters, peeling, or sores in the mouth or eyes with a rash. Enfortumab vedotin carries a boxed warning for Stevens-Johnson syndrome and toxic epidermal necrolysis, mostly in the first cycle.
Sacituzumab tirumotecan Tisotumab vedotin Trastuzumab deruxtecan source
Emergency services now
Bleeding or bruising
Bleeding that will not stop, black or bloody stools, or unexplained bruising when platelets are expected to be low.
Cisplatin source
Emergency services now
Bowel perforation
Sudden severe abdominal pain, a hard or very tender abdomen, or abdominal pain with vomiting and fever. Boxed warning for gastrointestinal perforation on bevacizumab.
Bevacizumab source
Call the 24-hour line now
Interstitial lung disease or pneumonitis
Any new or worsening cough, breathlessness or fever. The label says to interrupt treatment for any suspected ILD and to permanently discontinue for grade 2 or higher.
Trastuzumab deruxtecan source
Check before combining
Food and drink: Pembrolizumab
No pharmacokinetic interactions expected (antibody). See the irAE guide for toxicity management.
Pembrolizumab source

See all on the product pages:Atezolizumab Bevacizumab Cadonilimab Cemiplimab Cisplatin Pembrolizumab Sacituzumab tirumotecan Tisotumab vedotin Trastuzumab deruxtecan·Printable cards in the navigator

Questions to ask

Bring to your appointment

Questions to ask your oncologist about Cervical cancer

Generated from this cancer's standard of care, biomarkers, and pipeline · 36 questions

Newly diagnosed

What is my exact diagnosis, stage, and grade, and which tests established them?
Why: Everything else follows from an accurate stage and subtype.
Which biomarkers have been tested on my tumour (for example HPV type, PD-L1 CPS, Tissue factor, High-risk HPV typeand HPV status, PD-L1 CPS), and what were the results?
Why: These results decide eligibility for targeted therapy, immunotherapy, and trials.
Which subtype is my cancer, and does that change the recommended treatment?
Why: Recognised subtypes for this cancer include Squamous cell carcinoma, Adenocarcinoma, Adenosquamous carcinoma.
Is germline (inherited) genetic testing recommended for me or my family?
Why: Inherited variants can change treatment and matter for relatives.

Prevention

For my situation (prevention), which of the standard options do you recommend and why?
Why: Guideline options include: HPV vaccination age 9-14; HPV primary screening.

Locally advanced

For my situation (locally advanced), which of the standard options do you recommend and why?
Why: Guideline options include: Cisplatin chemoradiation + brachytherapy + pembrolizumab.
Am I a candidate for Pembrolizumab, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Recurrent/metastatic

For my situation (recurrent/metastatic), which of the standard options do you recommend and why?
Why: Guideline options include: Pembrolizumab-chemotherapy-bevacizumab; tisotumab vedotin.
Am I a candidate for Pembrolizumab, Tisotumab vedotin, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Primary prevention

For my situation (primary prevention), which of the standard options do you recommend and why?
Why: Guideline options include: HPV vaccination of girls (and boys) at 9-14, one or two doses per WHO; catch-up to 26 (US label to 45). Reduces invasive cancer ~90% when given before exposure.
Am I a candidate for Nonavalent HPV vaccine, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
How do the results of KEN SHE (single-dose HPV vaccine) apply to someone like me?
Why: Trial populations differ from individual patients; ask how closely you match.

Screening

For my situation (screening), which of the standard options do you recommend and why?
Why: Guideline options include: HPV primary testing every 5 years from 25-30 (self-sampling accepted), or cytology every 3 years; VIA or HPV screen-and-treat in low-resource settings; WHO target 70% screened twice in a lifetime.

Precancer (HSIL / CIN2-3, AIS)

For my situation (precancer (hsil / cin2-3, ais)), which of the standard options do you recommend and why?
Why: Guideline options include: Colposcopy-directed biopsy then LEEP/LLETZ or cone excision; thermal ablation or cryotherapy where eligible; HPV test of cure at 6-12 months.

Stage IA1-IB1 (≤2 cm)

For my situation (stage ia1-ib1 (≤2 cm)), which of the standard options do you recommend and why?
Why: Guideline options include: Simple hysterectomy is non-inferior to radical for low-risk IA2-IB1 ≤2 cm (SHAPE trial, 2024); cone or trachelectomy for fertility preservation; sentinel node mapping in trials (SENTICOL III).
How do the results of SENTICOL III apply to someone like me?
Why: Trial populations differ from individual patients; ask how closely you match.

Stage IB2-IIA (surgical candidates)

For my situation (stage ib2-iia (surgical candidates)), which of the standard options do you recommend and why?
Why: Guideline options include: Open radical hysterectomy with pelvic lymphadenectomy (minimally invasive approach inferior in LACC); adjuvant radiation or chemoradiation for intermediate/high-risk pathology (Sedlis, Peters criteria).
Am I a candidate for Cisplatin, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
How do the results of LACC (Laparoscopic Approach to Cervical Cancer) apply to someone like me?
Why: Trial populations differ from individual patients; ask how closely you match.

Locally advanced (IB3, IIB-IVA), standard

For my situation (locally advanced (ib3, iib-iva), standard), which of the standard options do you recommend and why?
Why: Guideline options include: Weekly cisplatin 40 mg/m² with external-beam IMRT/IGRT followed by image-guided brachytherapy to ≥85 Gy EQD2, completed within 56 days.
Am I a candidate for Cisplatin, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Locally advanced, high risk (node-positive IB2-IIB, III-IVA)

For my situation (locally advanced, high risk (node-positive ib2-iib, iii-iva)), which of the standard options do you recommend and why?
Why: Guideline options include: Add pembrolizumab during chemoradiation and for 15 maintenance cycles (KEYNOTE-A18, approved 2024 for FIGO III-IVA), or induction carboplatin-paclitaxel weekly × 6 before chemoradiation (INTERLACE). Adjuvant chemotherapy after chemoradiation is not recommended (OUTBACK).
Am I a candidate for Pembrolizumab, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
How do the results of KEYNOTE-A18 / ENGOT-cx11 / GOG-3047 and INTERLACE apply to someone like me?
Why: Trial populations differ from individual patients; ask how closely you match.

Persistent, recurrent, or metastatic, first line

For my situation (persistent, recurrent, or metastatic, first line), which of the standard options do you recommend and why?
Why: Guideline options include: Pembrolizumab + cisplatin/carboplatin-paclitaxel ± bevacizumab (KEYNOTE-826, CPS ≥1 in the US); atezolizumab + chemotherapy + bevacizumab (BEATcc, region-dependent); cadonilimab + chemotherapy in China (COMPASSION-16).
Am I a candidate for Pembrolizumab, Bevacizumab, Atezolizumab or related drugs, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
How do the results of KEYNOTE-826 and BEATcc / ENGOT-Cx10 / GOG-3030 apply to someone like me?
Why: Trial populations differ from individual patients; ask how closely you match.

Second line and beyond

For my situation (second line and beyond), which of the standard options do you recommend and why?
Why: Guideline options include: Tisotumab vedotin (innovaTV 301, OS benefit); cemiplimab if immunotherapy-naive (EU); T-DXd for HER2 IHC 3+; pembrolizumab for MSI-H/TMB-high; single-agent chemotherapy; trials of sac-TMT and TIL therapy.
Am I a candidate for Tisotumab vedotin, Cemiplimab, Trastuzumab deruxtecan or related drugs, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
How do the results of innovaTV 301 / ENGOT-cx12 / GOG-3057 and EMPOWER-Cervical 1 / GOG-3016 / ENGOT-cx9 apply to someone like me?
Why: Trial populations differ from individual patients; ask how closely you match.

Pelvic recurrence after radiation

For my situation (pelvic recurrence after radiation), which of the standard options do you recommend and why?
Why: Guideline options include: Pelvic exenteration in selected patients with central recurrence; re-irradiation with brachytherapy or proton therapy in specialised centres.

Any stage

Are there clinical trials I could join, for example of Sacituzumab tirumotecan, Lifileucel, SHR-8068, SHR-A2102?
Why: Trials are how the next standard of care is set; asking early keeps options open.
Would a second opinion at a high-volume centre change anything, and can you help arrange it?
Why: Rare or high-stakes decisions benefit from a centre that treats many similar patients.
What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
Why: Supportive care improves quality of life and helps patients complete treatment.
I read that “Vaccine and screening access in LMICs”. How does that affect my plan?
Why: Open problems are where trials and second opinions matter most.
I read that “Brachytherapy capacity”. How does that affect my plan?
Why: Open problems are where trials and second opinions matter most.

Newly diagnosed? Read the first 60 days with Cervical cancer, then print the one-page appointment sheet with room for the answers.

Print this page for your appointment (your browser's print command). These prompts are for discussion; your clinical team knows your case.

Model panel1 model

Machine commentary by named AI models on a date, not clinical review. Claims are tied to the record's own sources; check them before relying on anything here.

FableAnthropic · v5.12026-09-17low confidence

The record's global burden figures, its account of HPV causation and the WHO elimination threshold and 90-70-90 targets are consistent with the Wikipedia and WHO sources it lists. Its description of treatment by stage is coherent but the summary is out of step with its own standard-of-care table on early-stage surgery (SHAPE), and the record contains duplicated history, biomarker and standard-of-care entries. The claim of 'near-zero' invasive cancer in vaccinated cohorts is stronger than the ~88-90% reductions the record cites elsewhere. HIV co-infection, which the WHO strategy highlights, is absent. Most specific trial statistics, approval dates and 2025-2026 events cannot be verified from the four sources, one of which is mislabelled as NCCN when it points to a PMC article and another of which is an access-controlled landing page.

Right 2Disputed 1Missing 1Unclear 3Show verdicts

Right
Around 660,000 women are diagnosed and 350,000 die each year, nine in ten of them in low- and middle-income countries; it is the fourth most common cancer in women worldwide.
These figures match the GLOBOCAN-derived incidence and mortality estimates and the fourth-place ranking given in the Wikipedia article, which also attributes the large majority of deaths to lower-income countries.
Wikipedia
Right
WHO elimination threshold (4 per 100,000) and the 90-70-90 targets by 2030.
The WHO global strategy document defines elimination as an incidence below 4 per 100,000 women and sets the 90% vaccination, 70% screening and 90% treatment targets for 2030, as the record states.
Guideline (Primary prevention)
Unclear
Cohorts vaccinated at 12-13 show near-zero invasive cancer (Sweden, Scotland, Australia).
The record is not consistent with itself: the summary and burden say 'near-zero', the stateOfArt says '~90% to near-total reduction', and the linked Swedish registry paper is summarised as an 88% reduction. 'Near-zero' may hold for the Scottish report but not for Sweden as described. None of the four listed sources settles the country-by-country figures.
Wikipedia
Unclear
Recurrent/metastatic: Pembrolizumab-chemotherapy-bevacizumab; tisotumab vedotin (guideline labelled NCCN Guidelines: Cervical Cancer, ESMO-MCBS 2 from innovaTV 204, single-arm).
The URL given for this row is a PMC article, not the NCCN guideline it is labelled as, so the label and source do not match. The ESMO-MCBS grade quoted is for the single-arm innovaTV 204 study, yet the record elsewhere relies on the phase 3 innovaTV 301 overall-survival result; the grading appears outdated relative to the record's own evidence base.
NCCN Guidelines: Cervical Cancer (Recurrent/metastatic)
Missing
Cervical cancer is almost entirely caused by persistent infection with high-risk human papillomavirus.
The record names HPV as the cause but never mentions HIV co-infection, which the WHO strategy treats as a central risk multiplier and reason for adapted screening intervals in women living with HIV, nor smoking, parity or immunosuppression as cofactors. A burden-focused record on a disease concentrated in sub-Saharan Africa should cover the HIV link.
Guideline (Primary prevention)
Unclear
INTERLACE, 5-year OS 80% vs 72%; KEYNOTE-A18, 36-month OS 82.6% vs 74.8%; KEYNOTE-826 26.4 months; BEATcc 32.1 months.
These precise trial figures, and the 2025-2026 history entries (at-home self-test approval, World Health Assembly call), cannot be checked against any of the four listed sources, none of which is a trial report or a dated regulatory record. The NCCN landing page cited is access-controlled and gives no figures.
NCCN Guidelines: Cervical Cancer (Prevention)
Disputed
Early disease is treated with open radical hysterectomy or, for the smallest tumours, fertility-sparing surgery.
The record's own standardOfCare table states that simple hysterectomy is non-inferior to radical hysterectomy for low-risk tumours of 2 cm or less (SHAPE), and the stateOfArt lists this as a headline advance, but the summary omits it and presents radical hysterectomy as the default for early disease. The record also duplicates several entries (Pap smear 1943, HPV vaccine 2006, tisotumab 2021 in history; HPV type, PD-L1 CPS and tissue factor in biomarkers; overlapping prevention and locally advanced rows), which should be consolidated.
NCCN Guidelines: Cervical Cancer (Prevention)

Human reviews sit on top of the panel. Add a clinical review or see the review queue.

ProvenanceLast edited 2026-09-18 · Jude Gomila · Merge worktree-agent-a92b346da6e5b3a8a (orphan trials con… · diff · file · history

Wikipedia

Cervical cancer

Sources & links

Wikipedia