Radiotherapy for vaginal cancer
Radiotherapy for vaginal cancer can be given from outside the body (external radiotherapy) or from inside the body (internal radiotherapy). You may have external followed by internal radiotherapy.
External beam radiotherapy is given from a radiotherapy machine outside the body. You have it as an outpatient once a day from Monday to Friday, with a rest at the weekend. Each session of treatment takes a few minutes. It usually takes about 5 to 6 weeks to have the full course of treatment.
Internal radiotherapy (brachytherapy) is used to give an extra dose of radiation to the tumour after external radiotherapy. This can be done in 2 ways.
This treatment may be used for cancers in the lower part of the vagina. During an operation, the doctor places radioactive needles, tubes or seeds into the cancer. These then release a dose of radiation to the surrounding area. You may have it under general anaesthetic, so you are asleep during the treatment. Or you may have a spinal anaesthetic or epidural, which means you are awake but will not feel anything.
The doctor gently inserts an applicator (similar to a plastic tampon) into the vagina. It is connected to a machine, which sends radiation into the applicator. The treatment may last several minutes or a few hours, depending on the equipment used.
Chemotherapy is often given with radiotherapy. This is called chemoradiation. The chemotherapy drugs make the cancer cells more sensitive to radiotherapy. The combination of treatments can be more effective than radiotherapy on its own.
The chemotherapy drug most commonly used is cisplatin. You usually have it once a week throughout your radiotherapy.
Your cancer doctor, nurse or radiographer will tell you about the likely side effects of pelvic radiotherapy. They can give you advice on how to manage them and tell you about the treatments that can help.
Most side effects are temporary. They may get worse for a couple of weeks after treatment. After this, side effects usually improve slowly over a few weeks.
Changes in your blood
You may have a light vaginal discharge after treatment has finished. If it continues or becomes heavy, tell your cancer doctor or specialist nurse.
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Radiotherapy to the pelvic area can sometimes cause late effects. These are side effects that do not go away, or that develop months or years after treatment. If these happen, there are lots of ways they can be managed or treated. We have more detailed information about coping with late effects of pelvic radiotherapy.
These are some of the late effects of vaginal cancer treatment.
Bowel and bladder changes
Effects on the vagina
Radiotherapy can make your vagina narrower and less stretchy. The vaginal walls may be dry and thin, and can stick together. This can make penetrative sex and internal examinations uncomfortable. Your doctor or nurse may suggest tampon shaped dilators that you gently put inside the vagina to help with this.
This can feel uncomfortable. Creams, gels, lubricants or pessaries (small tablets that are put inside the vagina) can help.
After pelvic radiotherapy, the blood vessels in the lining of the vagina can become fragile. This means they can bleed more easily, especially after sex.
We also have more information about female pelvic side effects and your sex life.
Below is a sample of the sources used in our vaginal cancer information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
Adams T, Cuello M. Cancer of the Vagina: FIGO cancer report 2018. International journal of gynaecology and obstetrics. p14-21.
Royal College of Radiotherapy: Clinical Oncology. Radiotherapy dose fractionation, third edition. 2019.
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.
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