Radiotherapy for vaginal cancer

Radiotherapy uses high-energy x-rays to destroy cancer cells. You may have radiotherapy as a treatment for vaginal cancer.

What is radiotherapy?

Radiotherapy treats cancer using high-energy rays (radiation). It destroys the cancer cells, while doing as little harm as possible to normal cells. This is the most common treatment for vaginal cancer.

Using radiotherapy to treat cancer in the pelvic area is called pelvic radiotherapy.

How is radiotherapy given?

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 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

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.

  • Interstitial radiotherapy 

    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.

  • Intracavity brachytherapy

    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.

Chemoradiation

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.

Possible side effects of radiotherapy for vaginal cancer

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.

  • Early menopause

    Radiotherapy to the pelvis affects the ovaries. If you are still having periods, radiotherapy will cause an early menopause.

  • Skin changes

    The skin in the area being treated sometimes gets dry and irritated. You will be given advice on how to look after your skin.

  • Tiredness

    Tiredness is a common side effect and may continue for months after treatment has finished.

  • Bladder changes

    Radiotherapy can irritate the bladder. You may feel like you need to pass urine (pee) more often. You may also have a burning feeling when you pass urine.

  • Bowel changes

    Radiotherapy to the pelvis may irritate your bowel and cause tummy (abdominal) cramps. You may need to empty your bowels more often and you may have diarrhoea.

  • Changes in your blood

    External radiotherapy can reduce the number of blood cells your body makes. This is more likely to happen if you are having chemoradiation.

  • Vaginal discharge

    You may have a light vaginal discharge after treatment has finished. If it continues or becomes heavy, tell your cancer doctor or specialist nurse.

Support from Macmillan

Macmillan is here to support you. If you would like to talk, you can:

Late effects of radiotherapy

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

    After radiotherapy, you may have changes to your bowel or bladder. These are sometimes permanent.

  • 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.

  • Vaginal dryness

    This can feel uncomfortable. Creams, gels, lubricants or pessaries (small tablets that are put inside the vagina) can help.

  • Vaginal bleeding

    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.

  • Lymphoedema

    Pelvic radiotherapy may increase the risk of swelling in one or both legs. This is called lymphoedema. There are different ways to help manage lymphoedema.

We also have more information about female pelvic side effects and your sex life.

About our information

  • References

    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 cancerinformationteam@macmillan.org.uk

    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.

  • Reviewers

    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.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We try to make sure our information is as clear as possible. We use plain English, avoid jargon, explain any medical words, use illustrations to explain text, and make sure important points are highlighted clearly.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected. Our aims are for our information to be as clear and relevant as possible for everyone.

You can read more about how we produce our information here.