Radiotherapy treats cancer by using high-energy x-rays. These destroy the cancer cells while doing as little harm as possible to normal cells. Radiotherapy is often given with chemotherapy. This is called chemoradiation.

When radiotherapy is used

You may have radiotherapy:

• if you have early or locally advanced cervical cancer
• after surgery if there is a high risk of the cancer coming back
• to help relieve symptoms such as bleeding.

Early menopause

Radiotherapy for cervical cancer affects the ovaries. If you are still having periods, radiotherapy will bring on an early menopause. You may have a period during the course of radiotherapy but no more after this. Your healthcare team will discuss this with you before your treatment starts. They can also give you information about treatments to manage menopausal symptoms.

Some women have an operation to move their ovaries higher up out of the radiotherapy site. Doctors call this ovarian transposition. You have it before radiotherapy starts. The aim is to prevent an early menopause. Whether it can be done will depend on the stage of the cancer and the risk of cancer having spread to the ovaries. Your cancer doctor can talk this over with you.

The ovaries can be moved using laparoscopic (keyhole) surgery. Sometimes they are moved during a hysterectomy for cervical cancer. The surgeon may do this if radiotherapy might be needed after surgery. Ovarian transposition is not always successful at protecting the ovaries. Some women will still have an early menopause.

Fertility

As well as affecting the ovaries, radiotherapy for cervical cancer also affects the womb. Afterwards, the womb cannot carry a child. If you would like to have children in future, your cancer doctor can refer you to a fertility specialist. They can see you before you begin treatment to talk through your fertility options.

How radiotherapy is given

Radiotherapy for cancer of the cervix may be given:

• externally, from a machine outside the body
• internally, from radioactive material that is put into the treatment area – doctors call this brachytherapy.

You may have both external and internal radiotherapy. The doctor who plans your treatment will discuss this with you.