Also known as radiotherapy, radiation therapy uses a controlled dose of radiation, such as x-rays, to kill or damage cancer cells. For more on this, see our general section on Radiation therapy.
Radiation therapy is a common treatment for vaginal cancer. Some people with vaginal cancer are treated with a combination of radiation therapy and chemotherapy. This is called chemoradiation or chemoradiotherapy. Radiation therapy can also be used to control symptoms of advanced cancer (palliative treatment).
Learn more about:
- How is it given?
- External radiation therapy
- Internal radiation therapy
- Short-term side effects of radiation therapy
- Long-term side effects of radiation therapy
- Video: What is radiation therapy?
How is it given?
There are two main ways of delivering radiation therapy: externally and internally. Most people with vaginal cancer have both types of radiation therapy. Your radiation oncologist will recommend the course of treatment most suitable for you.
External beam radiation therapy (EBRT)
This precisely delivers radiation to the cancer from outside the body. You will lie on a treatment table under a machine called a linear accelerator, which directs radiation towards the affected areas of the pelvis.
EBRT is usually given daily, Monday to Friday, over 4–6 weeks. The exact number of treatment sessions you have will depend on the type and size of the cancer, and whether it has spread to the lymph nodes. Each session takes about 20 minutes and is painless.
Internal radiation therapy
Also called brachytherapy, internal radiation therapy delivers radiation directly to the tumour from inside your body. It can be given in fewer treatment sessions because radiation doesn’t have to travel through the body.
What is the main type?
The main type of internal radiation therapy used for vaginal cancer is high-dose-rate (HDR) brachytherapy. You may have this after finishing a course of EBRT.
How is it given?
Brachytherapy can be delivered in a number of ways. The simplest way is through a vaginal cylinder, which is a hollow applicator with a rounded tip placed inside the vagina. The tube inside the cylinder is connected to a machine that delivers the radioactive seed.
Your vagina may feel stretched and uncomfortable, but the treatment is reasonably painless. You can take painkillers or you may be given a local anaesthetic to make you feel more comfortable when the cylinder is inserted. Treatment takes about 10–20 minutes. You may need to have 3–4 sessions to deliver the right amount of radiation to treat the cancer.
A more complex form of brachytherapy
A more complex form of brachytherapy may be used if the cancer is still quite thick and bulky after EBRT. You will be admitted to hospital to have this type of brachytherapy. Hollow needles are inserted in and around the cancer under anaesthetic. A radioactive seed travels inside the needle and delivers radiation directly to the cancer.
The needles stay in place for 2–3 days until treatment is completed. During that time, you will be connected to the brachytherapy machine for at least three treatments and you must lie flat on a special bed until the needles are removed. You will be given pain-relieving medicine while you are in hospital. You are not radioactive between treatments, so family and friends can visit you in hospital. There are only a few centres in Australia where this treatment is available.
After brachytherapy you may feel uncomfortable in the vaginal region. Painkillers can help if needed.
Short-term side effects of radiation therapy
The side effects you experience will vary depending on the dose of radiation and the areas treated. Many will be short-term side effects. These often get worse during treatment and just after the course of treatment has ended.
| skin reactions | The vulva may become sore and swollen, and feel like a bad sunburn. It may start by being pink or red and feeling itchy, and then peel, blister or weep. Your treatment team will recommend creams and pain relief to use until the skin heals. Wash the vulvar area with lukewarm, slightly salted water, and avoid perfumed products and talcum powder. |
| fatigue | Your body uses a lot of energy to recover and travelling to treatment can also be tiring. The fatigue may last for weeks after treatment ends. |
| bladder and bowel problems | Radiation therapy can irritate the bladder and bowel. You may pass urine more often or with a burning sensation. Bowel motions may be more frequent, urgent or loose (diarrhoea), and you may pass more wind. Less commonly, you may have some blood in your faeces (poo). Always tell your doctor about any bleeding. |
| vaginal discharge | Radiation therapy may cause or increase vaginal discharge. Let your treatment team know if it smells bad or has blood in it. Do not wash inside the vagina with douches as this may cause infection. |
Long-term side effects of radiation therapy
Side effects can take several weeks to get better, though some may continue longer. Some side effects from radiation therapy may not show up until many months or years after treatment. These are called late effects.
| hair loss | You may lose your pubic hair. Sometimes, this can be permanent. Radiation therapy will not affect the hair on your head or other body areas. |
| bladder, bowel and rectal changes | Bladder changes (e.g. frequent or painful urination) and bowel changes (e.g. diarrhoea or wind) can appear months or years after radiation therapy ends. In some cases, a bowel blockage can occur. In rare cases, you may experience some bleeding from the rectum. Let your doctor know if you have pain in the abdomen, have any bleeding or cannot open your bowels. |
| lymphoedema | Like surgery, radiation therapy can increase the risk of lymphoedema. If the lymph nodes and vessels have been removed during surgery or scarred during radiation therapy, lymph fluid can’t drain properly. Lymph fluid can become trapped, causing the legs, vulva or mons pubis to swell. |
| narrowing of the vagina | The vagina can become drier, shorter and narrower (vaginal stenosis), which may make having sex and follow-up pelvic examinations uncomfortable or difficult. Your treatment team will suggest ways to prevent this. |
| menopause | If you are premenopausal, radiation therapy to the pelvis can stop the ovaries producing hormones, which causes early menopause. Talk to your radiation oncologist about menopause or any fertility issues before starting treatment. |
Video: What is radiation therapy?
Watch this short video to learn more about radiation therapy.
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Key resource
Download a PDF booklet on this topic.
More resources
A/Prof Alison Brand, Director, Gynaecological Oncology, Westmead Hospital, NSW; Ellen Barlow, Clinical Nurse Consultant, Royal Hospital for Women, NSW; Jane Conroy-Wright, Consumer; Rebecca James, 13 11 20 Consultant, Cancer Council SA; Suparna Karpe, Clinical Psychologist, Gynaecological Oncology, Westmead Hospital, NSW; Dr Pearly Khaw, Consultant Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; Sally McCoull, Consumer; A/Prof Orla McNally, Gynaecological Oncologist and Director, Oncology/Dysplasia, The Royal Women’s Hospital, and Director, Gynaecology Tumour Stream,Victorian Comprehensive Cancer Centre, VIC; Haley McNamara, Social Worker and Project Manager, Care at End of Life Project, Queensland Health, QLD; Tamara Wraith, Senior Clinician – Physiotherapy, The Royal Women’s Hospital, VIC.
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