Radiation therapy for cervical cancer

Also known as radiotherapy, radiation therapy uses a controlled dose of radiation to kill or damage cancer cells. The radiation is usually in the form of x-ray beams. It is targeted at the parts of the body with cancer or areas the cancer cells might have spread to. Treatment is carefully planned to do as little harm as possible to healthy tissues.

Learn more about:

• How you have radiation therapy
• Chemoradiation
• External beam radiation therapy
• Internal radiation therapy
• Side effects of radiation therapy
• Video: What is radiation therapy?

How you have radiation therapy

You may have radiation therapy:

• in combination with chemotherapy as the main treatment for cervical cancer (chemoradiation)
• after surgery to help get rid of any remaining cancer cells and reduce the chance of the cancer coming back (adjuvant therapy).

There are two main ways of delivering radiation therapy: externally or internally. It’s common to have both types to treat cervical cancer.

External beam radiation therapy

In external beam radiation therapy (EBRT), a machine precisely directs radiation beams from outside the body to the cervix, lymph nodes and other organs that need treatment. You will have a planning session, including a CT scan, to work out where to direct the radiation beams. This may take up to 45 minutes. The actual treatment takes only a few minutes each time and is painless.

You will probably have EBRT as daily treatments, Monday to Friday, over 4–6 weeks as an outpatient. You will lie on a table under the radiation therapy machine. The radiation therapist will leave the room before turning the machine on. They will be able to talk to you through an intercom and watch you on a screen while you have treatment.

Internal radiation therapy

Also known as brachytherapy, this delivers radiation therapy directly to the tumour from inside your body, while reducing the amount of radiation delivered to nearby organs such as the bowel and bladder. Brachytherapy is usually given after the course of EBRT is finished.

The main type of internal radiation therapy used for cervical cancer is high-dose-rate (HDR) brachytherapy. With HDR brachytherapy, you only need a few treatments to receive the prescribed dose of radiation. You will usually have HDR brachytherapy as a day patient.

During treatment

You will probably have 3–4 sessions over 2–4 weeks. You will be given a general or spinal anaesthetic at each brachytherapy session.

Applicators are used to deliver the radiation source to the cancer. They are available in different sizes and your radiation oncologist will examine you to choose suitable applicators for your situation. Applicators are placed into the cervix under ultrasound guidance to make sure they are in the right place. To hold the applicators in place, you may have gauze padding put into your vagina, and a stitch or two in the area between the vulva and the anus (perineum). You will also have a small tube (catheter) inserted to empty your bladder of urine during treatment.

You will have a CT or MRI scan to check the position of the applicators. This scan helps your doctor deliver the brachytherapy to the correct area. Once your doctor has completed the treatment plan, the radiation source will be placed into the applicators for 10–20 minutes.

After treatment

The applicators are taken out after the radiation dose is delivered. As several sessions are needed, the applicators may need to be put in each time. Occasionally, you may stay in hospital with the applicators in place (no radiation inside), so that the radiation sessions can be given closer together. After brachytherapy, you may feel uncomfortable in the vaginal region or have a small amount of bleeding. Pain medicines can help if needed.

Radiation therapy after surgery (adjuvant therapy)

If you’ve had a hysterectomy, your doctor may recommend you also have radiation therapy. Usually, about 4–6 weeks after surgery, you will have EBRT in combination with chemotherapy. Occasionally, some women will have brachytherapy to deliver radiation to the top of the vagina.

Video: What is radiation therapy?

Learn more about radiation therapy in this short video.