Radiation therapy for cervical cancer
Also called radiotherapy, radiation therapy for cervical cancer uses x-rays to kill or damage cancer cells. The radiation 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.
You may have radiation therapy on its own as the main treatment for cervical cancer, or you may have it after surgery to help get rid of any remaining cancer cells. Women with cervical cancer that has spread to the tissues or lymph nodes surrounding the cervix will usually have radiation therapy in combination with chemotherapy (chemoradiation) to reduce the chance of the cancer coming back.
There are two main ways of delivering radiation therapy: externally or internally. Most women who have radiation therapy for cervical cancer will have both types.
Learn more about:
- External beam radiation therapy
- Internal radiation therapy
- Side effects of radiation therapy
- Video: What is radiation therapy?
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In external beam radiation therapy, a machine precisely directs radiation beams from outside the body to the cervix, lymph nodes and other organs that need treatment. The initial planning session will include a CT scan to work out where to direct the radiation beams, and may take up to 45 minutes. The actual treatment takes only a few minutes each time.
You will probably have external radiation therapy as daily treatments, Monday to Friday, over 4–6 weeks as an outpatient. You will lie on a table under the radiation therapy machine. Before the machine is turned on, the radiation therapist will leave the room, but they will be able to talk to you through an intercom and they will watch you on a screen while you have treatment. The treatment itself is painless.
|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.|
Internal radiation therapy is known as brachytherapy. It is a way of delivering radiation therapy from inside your body directly to the tumour, while reducing the amount of radiation delivered to nearby organs such as the bowel and bladder. The main type of internal radiation therapy used for cervical cancer is high-dose-rate (HDR) brachytherapy. With HDR, bigger doses are given in a few treatments.
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 a suitable applicator for your situation. The applicator is placed into the cervix under the guidance of an ultrasound to make sure it is in the right place.
To hold the applicator 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 applicator. 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 applicator for 10–20 minutes. If you have a general anaesthetic, this will happen while you are asleep.
If you’ve had surgery to remove the cervix and uterus (hysterectomy), your doctor may want to deliver some extra radiation to the top of the vagina. An applicator will be placed into your vagina. You will not need to have a general anaesthetic or gauze padding.
The applicator is taken out after the radiation dose is delivered. If several sessions are needed, the applicator will be reinserted each time.
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; dry and itchy skin in the treatment area; nausea; and low blood counts. Low numbers of bloods cells may cause anaemia, infections or bleeding problems. Talk to your treatment team about ways to manage the side effects of chemoradiation.
Video: What is radiation therapy?
A/Prof Penny Blomfield, Gynaecological Oncologist, Hobart Women’s Specialists, and Chair, Australian Society of Gynaecological Oncologists, TAS; Karina Campbell, Consumer; Carmen Heathcote, 13 11 20 Consultant, Cancer Council Queensland; Dr Pearly Khaw, Consultant Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; A/Prof Jim Nicklin, Director, Gynaecological Oncology, Royal Brisbane and Women’s Hospital, and Associate Professor Gynaecologic Oncology, The University of Queensland; Prof Martin K Oehler, Director, Gynaecological Oncology, Royal Adelaide Hospital, SA; Dr Megan Smith, Program Manager – Cervix, Cancer Council NSW; Pauline Tanner, Cancer Nurse Coordinator – Gynaecology, WA Cancer & Palliative Care Network, WA; Tamara Wraith, Senior Clinician, Physiotherapy Department, The Royal Women’s Hospital, VIC. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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