About radiotherapy for vaginal cancer
Radiotherapy uses high energy x-rays to kill cancer cells. You might have external radiotherapy, internal radiotherapy, or both.
This is a common treatment for vagina cancer.
How radiotherapy works
Radiotherapy works by damaging the DNA within cancer cells so they can no longer divide and grow. DNA is the genetic code that controls how the body's cells behave
External radiotherapy
This directs radiation at the cancer from a machine outside of your body. You have external radiotherapy in the hospital radiotherapy department each day, from Monday to Friday. Your appointment usually lasts up to 25 minutes each time.
The treatment itself takes only a few minutes. But it takes time to get you into the correct position and make sure you are comfortable.
You usually have a type of external radiotherapy called Intensity modulated radiotherapy (IMRT). It is a type of conformal radiotherapy. Conformal radiotherapy shapes the radiation beams to closely fit the area of cancer. This means that the tumour receives a high dose of radiation and normal healthy cells nearby receive a much lower dose.
Internal radiotherapy (brachytherapy)
You have internal radiotherapy in different ways. Depending on the type of cancer and your treatment plan, you might stay in hospital for a few days. Or you might have 2 or more treatments as an outpatient.
When you might have radiotherapy
Radiotherapy can be used in a number of different situations to treat vaginal cancer.
As your main treatment
Radiotherapy is the main treatment for many people with vaginal cancer.
You usually have radical radiotherapy if you have stage 1, 2, 3, or 4a vaginal cancer. Radical radiotherapy is intensive treatment to try to cure your cancer.
The area treated includes the vagina and the nearby lymph nodes in the 
. The lymph nodes in the are included if the cancer is in the lower part of the vagina.
To treat a cancer if you can't have surgery
You can have radiotherapy instead of surgery. You might have this if you can’t have an anaesthetic for some reason. For example, you have another health condition, such as heart or lung problems.
To help stop the cancer coming back after surgery
You might have radiotherapy after surgery if there is a risk that the cancer might come back. This may be either in the vaginal area or in the nearby lymph nodes.
Treating cancer that couldn't be completely removed
You might have radiotherapy after surgery if it wasn’t possible to remove all your vaginal cancer. The cancer may have been too close to other important parts of your body, such as the tube that drains your bladder (the urethra).
When you have cancer surgery, the surgeon sends the tissue they remove to the laboratory. Here the pathologist checks the tissue for cancer cells. There should be a border of cancer free tissue all around the edge. Doctors call this a clear margin. This helps your surgeon to be sure all the cancer is removed.
If there isn't a clear margin of tissue your specialist might suggest a course of radiotherapy. This is to kill off any possible cancer cells that may be left. Or they might recommend more surgery.
Combined radiotherapy and chemotherapy
Your doctor might suggest chemotherapy alongside your radiotherapy treatment (chemoradiotherapy).
Chemoradiotherapy seems to work better than these treatments alone. Researchers think this is because chemotherapy makes cancer cells more sensitive to radiotherapy.
For this treatment, you have radiotherapy as normal and chemotherapy one day every week. You usually have a chemotherapy drug called cisplatin.
Controlling symptoms of advanced cancer
Radiotherapy treatment can help to relieve symptoms of advanced cancer. This is palliative radiotherapy.
The treatment can shrink the cancer for a time and helps relieve symptoms such as pain and bleeding. You usually have treatment as a short course over a few days.
Radiotherapy can also be used to treat an ulcerating cancer or fungating wound. This does not happen very often. But sometimes with an advanced vaginal cancer, the area breaks down and forms a wound. This might be painful and the wound could produce a smelly liquid (discharge).
Dressings are available and your nurse will help you manage the wound. These can absorb the discharge and they contain charcoal to control any smell. But it’s better if the wound is treated.
Radiotherapy can often shrink the cancer. It can help stop the discharge and make the area more comfortable. The wound might even heal completely.
How many treatments do you have?
Your treatment plan depends on your individual case. It is designed specifically for you. Your radiotherapy team will explain everything to you. The information below is for guidance, so your treatment plan might be different.
You might have 5 weeks of external beam radiotherapy. You might then have:
- internal radiotherapy (brachytherapy) or
- continue with external beam treatment for another two weeks
To control symptoms of advanced cancer you usually have a shorter course of radiotherapy. For example, one treatment daily Monday to Friday for 1 to 2 weeks. But remember your treatment plan may be different.
Side effects of radiotherapy
Radiotherapy can have side effects. The skin in the vaginal area and groin is delicate so can become very sore and painful. This can continue for a few weeks after treatment has finished.
It can be hard to cope with the side effects but they do gradually improve. Your radiographer and nurse will help you manage any side effects you have.
