Symptoms of recurrent cervical carcinoma may include vaginal bleeding or discharge, pain in the pelvis, back or legs, leg swelling (edema), chronic cough and weight loss. • If radiation was not given previously, recurrences that are confined to the pelvis may be treated with external beam radiation and intracavitary or interstitial radiation therapy . • If radiation therapy was already given, the only option is the removal of the vagina, uterus and the bladder and/or rectum with the creation of an artificial bladder—a pelvic exenteration. The five-year survival rate after a pelvic exenteration is about 50 percent. • Women with recurrent tumors that can't be surgically removed or with metastatic disease are usually treated with chemotherapy . Commonly used drugs include single agent cisplatin or carboplatin . Other regimens include cisplatin or carboplatin + ifosfamide , vincristine + mitomycin-C + bleomycin + cisplatin and bleomycin +mitomycin-C + 5-fluorouracil. • Those with unresectable pelvic disease may be re-irradiated with or without heat or given pelvic arterial chemotherapy.