Reads are getting slower while writes are still fast
The cluster's IO capacity is not enough to handle the write load it is receiving.
Check the SSTable counts in cfstats. If the count is continually growing, the cluster's IO capacity is not enough to handle the write load it is receiving. Reads have slowed down because the data is fragmented across many SSTables and compaction is continually running trying to reduce them. Adding more IO capacity, either via more machines in the cluster, or faster drives such as SSDs, will be necessary to solve this.
If the SSTable count is relatively low (32 or less) then the amount of file cache available per machine compared to the amount of data per machine needs to be considered, as well as the application's read pattern. The amount of file cache can be formulated as (TotalMemory – JVMHeapSize) and if the amount of data is greater and the read pattern is approximately random, an equal ratio of reads to the cache:data ratio will need to seek the disk. With spinning media, this is a slow operation. You may be able to mitigate many of the seeks by using a key cache of 100%, and a small amount of row cache (10000-20000) if you have some hot rows and they are not extremely large.