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
- 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.
When radiation therapy is combined with chemotherapy, it is known as chemoradiation. The chemotherapy drugs make the cancer cells more sensitive to radiation therapy.
If you have chemoradiation, you will usually receive chemotherapy once a week a few hours before the radiation therapy appointment.
Side effects of chemoradiation include fatigue; diarrhoea; needing to pass urine more often or in a hurry; cystitis (irritation of the bladder); dry and itchy skin in the treatment area; and nausea.
Chemoradiation can also affect the blood, increasing the risk of anaemia (due to low levels of red blood cells), infections (due to low levels of white blood cells) and bleeding problems (due to lower number of platelets).
Talk to your treatment team about ways to manage the side effects of chemoradiation.
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.
External beam radiation therapy and HDR brachytherapy will not make you radioactive. It is safe for you to be with both adults and children after your treatment sessions.
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.
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.
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.
Podcast: Making Treatment Decisions
Dr Pearly Khaw, Lead Radiation Oncologist, Gynae-Tumour Stream, Peter MacCallum Cancer Centre, VIC; Dr Deborah Neesham, Gynaecological Oncologist, The Royal Women’s Hospital and Frances Perry House, VIC; Kate Barber, 13 11 20 Consultant, VIC; Dr Alison Davis, Medical Oncologist, Canberra Hospital, ACT; Krystle Drewitt, Consumer; Shannon Philp, Nurse Practitioner, Gynaecological Oncology, Chris O’Brien Lifehouse and The University of Sydney Susan Wakil School of Nursing and Midwifery, NSW; Dr Robyn Sayer, Gynaecological Oncologist Cancer Surgeon, Chris O’Brien Lifehouse, NSW; Megan Smith, Senior Research Fellow, Cancer Council NSW; Melissa Whalen, Consumer.
We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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