Palliative care for women with advanced cervical cancer: A literature review
DOI:
https://doi.org/10.37800/RM.3.2026.735Keywords:
symptoms, quality of life , screening, home care, emotional well-being, stressAbstract
Relevance: Women with advanced cervical cancer often experience pain, fatigue, emotional distress, social isolation, and financial strain, particularly in settings where palliative care remains difficult to access. Comprehensive palliative care integrates symptom management with psychological, social, and spiritual support.
The study aimed to review evidence on the epidemiology and symptoms of advanced cervical cancer, examine current palliative care approaches and barriers to access, and identify measures that may improve patients’ quality of life.
Materials and Methods: The research methodology used content analysis, systematization, generalization, deduction, and comparative analysis of data.
Results: The reviewed literature indicates that multidisciplinary palliative care may improve symptom management and support the quality of life of women with advanced cervical cancer. The most frequently reported components of care include pain control, psychosocial and spiritual support, and home-based services. Early involvement of palliative care teams may also promote regular symptom assessment and better coordination between oncology and supportive care. Home-based care and caregiver education contributed to emotional support, reduced care fragmentation, and improved accessibility in resource-limited settings. In low- and middle-income countries, access to palliative care remains substantially limited because of shortages of trained personnel, medications, equipment, and funding. Standardized symptom assessment tools, such as the Edmonton Symptom Assessment Scale, supported more individualized and timely supportive interventions.
Conclusions: Based on the results, recommendations were developed for early integration of palliative care, establishment of regional centers, caregiver training, and expansion of access to medications in low- and middle-income countries. The practical value lies in implementing these measures to ensure patient dignity and comfort.
References
1. World Health Organization. Cervical cancer. [Internet]. 2025. Available from:
https://www.who.int/news-room/fact-sheets/detail/cervical-cancer
2. Yordanov A, Vasileva-Slaveva M, Galai N, Faraggi D, Kubelac MP, Tripac-Iacovleva I, Calleja N, Di Fiore R, Calleja-Agius J. Cancer of the cervix in Bulgaria: Epidemiology of a crisis. Healthcare. 2023;11(3):318.
https://doi.org/10.3390/healthcare11030318
3. Bruni L, Albero G, Serrano B, Mena M, Collado JJ, Gómez D, Muñoz J, Bosch FX, de Sanjosé S. Human papillomavirus and related diseases report. 2023;1:113-127. Available from:
https://hpvcentre.net/statistics/reports/BGR.pdf
4. Shuftan N, Dayan M, Scobie S, Wee B, Dimova A, Atanasova E, Murauskiene L, Gandré C, Or Z, Augusto GF, Habicht T, Köhler K, Kahur K, Axelsson B, Kroneman M, De Jong J, De Veer A, Bemelmans W, Pereira C, Aggarwal A, Davies J, Van Ginneken E, Panteli D. The variation of coverage and access to palliative care for cancer patients in eight European countries: An exploratory vignette approach. BMC Palliative Care. 2025;24(1):188.
https://doi.org/10.1186/s12904-025-01831-1
5. Karcheva M, Yordanov A, Kostadinov S. An overview of cervical cancer epidemiology and prevention in Bulgaria. Germs. 2020;10(4):322-327.
https://doi.org/10.18683/germs.2020.1224
6. Lebanova H, Stoev S, Naseva E, Getova V, Wang W, Sabale U, Petrova E. Economic burden of cervical cancer in Bulgaria. International Journal of Environmental Research and Public Health. 2023;20(3):2746.
https://doi.org/10.3390/ijerph20032746
7. Kebebew T, Mosalo A, Mavhandu-Mudzusi AH. Hospital-based evaluation of palliative care among patients with advanced cervical cancer: A cross-sectional study. BMC Palliative Care. 2022;21(1):140.
https://doi.org/10.1186/s12904-022-01030-2
8. Chona EZ, Msengi EA, Gosse RA, Ambikile JS. The lived experiences and caring needs of women diagnosed with cervical cancer: A qualitative study in Dar es Salaam, Tanzania. PLoS ONE. 2023;18(8):e0289925.
https://doi.org/10.1371/journal.pone.0289925
9. Wall JA, Nix-Parker T, Klein K, Bakitas MA. Cervical cancer patients’ knowledge and experiences with palliative care – a qualitative study. Gynaecologic Oncology Reports. 2025;59:101774.
https://doi.org/10.1016/j.gore.2025.101774
10. National Cancer Institute. Cervical cancer treatment – patient version. [Internet]. 2025. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK65985/
11. American Cancer Society and American Society of Clinical Oncology. Palliative care. [Internet]. 2025. Available from:
https://www.cancer.org/cancer/supportive-care/palliative-care.html
12. Sanders JJ, Temin S, Ghoshal A, Alesi ER, Ali ZV, Chauhan C, Cleary JF, Epstein AS, Firn JI, Jones JA, Litzow MR, Lundquist D, Mardones MA, Nipp RD, Rabow MW, Rosa WE, Zimmermann C, Ferrell BR. Palliative Care for Patients With Cancer: ASCO guideline update. J Clin Oncol. 2024;42(19):2336-2357.
https://doi.org/10.1200/JCO.24.00542
13. Dans M, Kutner JS, Agarwal R, Baker JN, Bauman JR, Beck AC, Campbell TC, Carey EC, Case AA, Dalal S, Doberman DJ, Epstein AS, Fecher L, Jones J, Kapo J, Lee RT, Loggers ET, McCammon S, Mitchell W, Ogunseitan AB, Portman DG, Ramchandran K, Sutton L, Temel J, Teply ML, Terauchi SY, Thomas J, Walling AM, Zachariah F, Bergman MA, Ogba N, Campbell M. NCCN Guidelines® Insights: Palliative Care, Version 2.2021: Featured Updates to the NCCN Guidelines. J Nat Comprehensive Cancer Network. 2021;19(7):780-788.
https://doi.org/10.6004/jnccn.2021.0033
14. Ooko F, Mothiba T, Van Bogaert P, Wens J. Access to palliative care in patients with advanced cancer of the uterine cervix in low- and middle-income countries: A systematic review. BMC Palliative Care. 2023;22(1):140.
https://doi.org/10.1186/s12904-023-01263-9
15. Allende-Perez S, Dominguez-Ocadio G, Velez-Salas V, Isla-Ortiz D, Peña-Nieves A, Verastegui E. Snapshot of symptoms of advanced cervical cancer patients referred to the palliative care service in a cancer centre in Mexico. International Journal of Gynecology & Obstetrics. 2020;153(2):335-339.
https://doi.org/10.1002/ijgo.13479
16. Krakauer EL, Kane K, Kwete X, Afshan G, Bazzett-Matabele L, Bien-Aimé DDR, Borges LF, Byrne-Martelli S, Connor S, Correa R, Devi CRB, Diop M, Elmore SN, Gafer N, Goodman A, Grover S, Hasenburg A, Irwin K, Kamdar M, Kumar S, Nguyen Truong QX, Randall T, Rassouli M, Sessa C, Spence D, Trimble T, Varghese C, Fidarova E. Essential package of palliative care for women with cervical cancer: Responding to the suffering of a highly vulnerable population. JCO Global Oncol. 2021;7:873-885.
https://doi.org/10.1200/GO.21.00026
17. Council of Europe. Recommendation Rec(2003)24 of the Committee of Ministers to member states on the organisation of palliative care (Adopted by the Committee of Ministers on 12 November 2003 at the 860th meeting of the Ministers’ Deputies). [Internet]. 2003. Available from:
http://www.hospiz.at/wordpress/wp-content/uploads/2017/06/Europarat_recommendations2003.pdf
18. Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, Snijders PJF, Peto J, Meijer CJLM, Muñoz N. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. Journal of Pathology. 1999;189(1):12-19.
https://doi.org/10.1002/(sici)1096-9896(199909)189:1%3C12::aid-path431%3E3.0.co;2-f
19. Gouldthorpe C, Power J, Taylor A, Davies A. Specialist palliative care for patients with cancer: More than end-of-life care. Cancers. 2023;15(14):3551.
https://doi.org/10.3390/cancers15143551
20. Xie S, Liu W, Xie S, Zhang Y, Wu Y. The formation of palliative treatment intentions among patients with advanced gynaecological cancer in China: A grounded theory study. Asia-Pacific J Oncol Nurs. 2025;12:100776.
https://doi.org/10.1016/j.apjon.2025.100776
21. Paschen C, Ecker F, Haider P, Wenzel C, Masel EK. Determinants of time to first palliative care consultation in hospitalized patients with advanced or terminal illness – a retrospective analysis. Eur J Int Med. 2025;140:106384.
https://doi.org/10.1016/j.ejim.2025.06.013
22. Ngo K, Casserly D, Sheehy-Skeffington B, Colleran M. EV351/#907 A review of the palliative care of patients with advanced gynaecological cancers admitted to a specialist palliative care unit. Int J Gynaecol Cancer. 2024;34(4):A266.
https://doi.org/10.1136/ijgc-2024-igcs.472
23. Reinius MA, Kingdon AD. Principles of palliative care for advanced gynaecological cancers. Obstet Gynaecol Reprod Med. 2025;35(4):111-118.
https://doi.org/10.1016/j.ogrm.2025.01.004
24. Lee MW, Sriprasert I, Phung PG, Pino C, Woll SM, Vallejo A, Furey KB, Muderspach LI, Roman LD, Wright JD, Matsuo K. Trends and comparisons of palliative care utilization for patients with metastatic gynecologic malignancy. Int J Gynecol Cancer. 2025;35(4):101631.
https://doi.org/10.1016/j.ijgc.2025.101631
25. Lippitt M, Wethington S, Feger D, Rositch A. Trends and guideline-related changes in provision of palliative care in older women with gynecologic malignancies. Gynecol Oncol. 2021;162:S314.
https://doi.org/10.1016/s0090-8258(21)01247-6
26. Holmes C, Mitchell A, Downham E. Palliative care in gynaecological oncology. Obstet Gynaecol Reprod Med. 2021;31(3):77-83.
https://doi.org/10.1016/j.ogrm.2021.01.002
27. Hicks-Courant K, Graul A, Ko E, Giuntoli R, Martin L, Morgan M, Haggerty A. Sources of palliative care knowledge among patients with advanced or metastatic gynaecologic cancer. J Pain Symptom Manag. 2020;61(3):566-570.
https://doi.org/10.1016/j.jpainsymman.2020.09.019
28. Hoppenot C. Palliative care is a critical part of gynecologic oncologic care. Ann Palliative Med. 2023;12(1):25-27.
https://doi.org/10.21037/apm-22-1343
29. Dey T, Mukerjee A, Rai B, Arora M, Kumar D, Srinivasa G, Ghoshal S. Early integration of palliative care in cervical cancer: Experiences from a pilot study. J Fam Med Primary Care. 2023;12(2):366-370.
https://doi.org/10.4103/jfmpc.jfmpc_1569_22
30. Crawford GB, Dzierżanowski T, Hauser K, Larkin P, Luque-Blanco AI, Murphy I, Puchalski CM, Ripamonti C. Care of the adult cancer patient at the end of life: ESMO clinical practice guidelines. ESMO Open. 2021;6(4):100225.
https://doi.org/10.1016/j.esmoop.2021.100225
31. Fowler JR, Maani EV, Dunton CJ, Gasalberti DP, Jack BW. Cervical cancer. 2023;4:16-23.
https://www.ncbi.nlm.nih.gov/books/NBK431093/
32. Salyer C, Littell RD, Pearl ML, Brown AJ, Popowich S, Lefkowits C, Spoozak L. Palliative care in gynecologic oncology: A narrative review of current literature and vision for the future. Ann Palliative Med. 2022;11(11):3542-3554.
https://doi.org/10.21037/apm-22-708
33. Mah SJ, Ramirez DM, Schnarr K, Eiriksson LR, Gayowsky A, Seow H. Timing of palliative care, End-of-Life quality indicators, and health resource utilization. JAMA Netw Open. 2024;7(10):e2440977.
https://doi.org/10.1001/jamanetworkopen.2024.40977
34. Vestergaard AH, Neergaard MA, Fokdal LU, Christiansen CF, Valentin JB, Johnsen SP. Utilisation of hospital-based specialist palliative care in patients with gynaecological cancer: Temporal trends, predictors and association with high-intensity end-of-life care. Gynecol Oncol. 2023;172:1-8.
https://doi.org/10.1016/j.ygyno.2023.02.019
35. Islam JY, Saraiya V, Previs RA, Akinyemiju T. Health care access measures and palliative care use by race/ethnicity among metastatic gynaecological cancer patients in the United States. Int J Environ Res Public Health. 2021;18(11):6040.
https://doi.org/10.3390/ijerph18116040
36. Paulsen T, Liland H, Myklebust TÅ, Lindemann K. Early referral to a palliative team improves end-of-life care among gynecological cancer patients: A retrospective, population-based study. Int J Gynecol Cancer. 2022;32(2):181-188.
https://doi.org/10.1136/ijgc-2021-002898
37. Persenaire C, Spinosa DL, Brubaker LW, Lefkowits CJ. Incorporation of palliative care in gynecologic oncology. Cur Oncol Rep. 2023;25(11):1295-1305.
https://doi.org/10.1007/s11912-023-01457-7
38. Vetter VJ. Palliative care screening tools in the gynecologic oncology population: A narrative review. Ann Palliative Med. 2022;11(10):3263-3272.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 М. Сабри
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The articles published in this Journal are licensed under the CC BY-NC-ND 4.0 (Creative Commons Attribution – Non-Commercial – No Derivatives 4.0 International) license, which provides for their non-commercial use only. Under this license, users have the right to copy and distribute the material in copyright but are not permitted to modify or use it for commercial purposes. Full details on the licensing are available at https://creativecommons.org/licenses/by-nc-nd/4.0/.
