Radiation therapy for vulvar cancer

Also known as radiotherapy, this treatment uses a controlled dose of radiation, such as x-rays, to kill or damage cancer cells. Whether you have radiation therapy will depend on the stage of the cancer, its size, whether it has spread to the lymph nodes and, if so, how many nodes are affected. You can have radiation therapy:

  • before surgery to shrink the cancer and make it easier to remove (neoadjuvant treatment)
  • after surgery to get rid of any remaining cancer cells and reduce the risk of the cancer coming back (adjuvant treatment)
  • instead of surgery
  • to control symptoms of advanced cancer (palliative treatment).

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External beam radiation therapy (EBRT) 

This is the most common type of radiation therapy for vulvar cancer. You will lie on a treatment table while a machine, called a linear accelerator, directs radiation towards the areas of the vulva that are affected or at risk. EBRT is usually given daily, Monday to Friday, over 5–6 weeks. The exact number of sessions you have will depend on the type and size of the cancer. Each session takes about 20 minutes.

Radiation therapy to the vulva and groin is painless, but it can cause side effects. External beam radiation therapy will not make you radioactive. It is safe for you to be with other people, including children, after your treatment.


Internal radiation therapy

Also called brachytherapy, this delivers radiation therapy to the tumour from inside your body. It is not used often for vulvar cancer. For more on this, see Radiation therapy for vaginal cancer.


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.

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.

Common side effects

Short-term side effects

fatigue

Your body uses a lot of energy to heal itself after the treatment, 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 have a burning sensation when you pass urine. Bowel motions may be more frequent, urgent or loose (diarrhoea), or you may pass more wind than normal. Less commonly, women may have some blood in the stools (faeces). Always tell your doctor about any bleeding.

nausea and vomiting

Because the radiation therapy is directed near your abdomen, you may feel sick (nauseous), with or without vomiting, for several hours after each treatment. Your doctor may prescribe anti-nausea medicine to help prevent this.

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.

skin redness, soreness and swelling

The vulva may become sore and swollen. It may start by being pink or red and feeling itchy, and progress to peeling, blistering or weeping. Your treatment team will recommend creams and pain relief to use until the skin heals. Wash the area  with lukewarm water or weak salt baths, and avoid perfumed products and talcum powder.

Long-term side effects

hair loss

You may lose your pubic hair. For some women, this can be permanent. It will not affect the hair on your head or other parts of your body.

bladder and bowel changes

Bladder changes, such as frequent or painful urination, and bowel changes, such as diarrhoea or wind, can also be late effects, appearing months or years after radiation therapy finishes. In rare cases, blockage of the bowel can occur. It is important to let your doctor know if you have pain in the abdomen and cannot open your bowels.

lymphoedema

Radiation can scar the lymph nodes and vessels and stop them draining lymph fluid properly from the legs, making the legs swollen. This can occur months or years after radiation therapy, and it is easier to treat if diagnosed early.

narrowing of the vagina

The vagina can become drier, shorter and narrower (vaginal stenosis), which may make sex and follow-up pelvic examinations uncomfortable or difficult. Your treatment team will suggest strategies to prevent this.

menopause

In premenopausal women, radiation therapy to the pelvis can stop the ovaries producing hormones, and this causes early menopause. Your periods will stop, you will no longer be able to become pregnant and you may have menopausal symptoms. Talk to your radiation oncologist about menopause or any fertility issues before treatment.


Video: What is radiation therapy?

Learn more about radiation therapy in this short video.


This information was last reviewed in October 2018
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