Cervical Cancer Radiation Therapy

Radiation therapy (also called radiotherapy) is an option for women with any stage of cervical cancer. Women with early stage cervical cancer may choose radiation therapy instead of surgery. It also may be used after surgery to destroy any cancer cells that remain in the area. Women with cancer that extends beyond the cervix may have radiation therapy and chemotherapy

Radiation therapy uses high-energy rays to kill cancer cells. It affects cells only in the treated area.

Doctors use two types of radiation therapy to treat cervical cancer. Some women receive both types:

• External radiation therapy: A large machine directs radiation at your pelvis or other tissues where the cancer has spread. The treatment usually is given in a hospital or clinic. You may receive external radiation 5 days a week for several weeks. Each treatment takes only a few minutes.
• Internal radiation therapy: A thin tube is placed inside the vagina. A radioactive substance is loaded into the tube. You may need to stay in the hospital while the radioactive source is in place (up to 3 days). Or the treatment session may last a few minutes, and you can go home afterward. Once the radioactive substance is removed, no radioactivity is left in your body. Internal radiation may be repeated two or more times over several weeks.

Side effects depend mainly on how much radiation is given and which part of your body is treated. Radiation to the abdomen and pelvis may cause nausea, vomiting, diarrhea, or urinary problems. You may lose hair in your genital area. Also, your skin in the treated area may become red, dry, and tender.

You may have dryness, itching, or burning in your vagina. Your doctor may advise you to wait to have sex until a few weeks after radiation treatment ends.

You are likely to become tired during radiation therapy, especially in the later weeks of treatment. Resting is important, but doctors usually advise patients to try to stay as active as they can.

Although the side effects of radiation therapy can be upsetting, they can usually be treated or controlled. Talk with your doctor or nurse about ways to relieve discomfort.

It may also help to know that most side effects go away when treatment ends. However, you may wish to discuss with your doctor the possible long-term effects of radiation therapy. For example, the radiation may make the vagina narrower. A narrow vagina can make sex or follow-up exams difficult. There are ways to prevent this problem. If it does occur, however, your health care team can tell you about ways to expand the vagina.

Another long-term effect is that radiation aimed at the pelvic area can harm the ovaries. Menstrual periods usually stop, and women may have hot flashes and vaginal dryness. Menstrual periods are more likely to return for younger women. Women who may want to get pregnant after radiation therapy should ask their health care team about ways to preserve their eggs before treatment starts.

You may want to ask the doctor these questions before having radiation therapy:

• What is the goal of this treatment?
• How will the radiation be given?
• Will I need to stay in the hospital? If so, for how long?
• When will the treatments begin? How often will I have them? When will they end?
• How will I feel during treatment? Are there side effects?
• How will we know if the radiation therapy is working?
• Will I be able to continue my normal activities during treatment?
• How will radiation therapy affect my sex life?
• Are there lasting side effects?
• Will I be able to get pregnant and have children after my treatment is over?