Radiotherapy uses high-energy rays to destroy cancer cells. Sometimes, chemotherapy is given with radiotherapy. This is called chemoradiation.

You may have radiotherapy:

• before surgery, to try to shrink the cancer and make a smaller operation possible
• after surgery, to reduce the risk of the cancer coming back – it may be used if the cancer was not completely removed, or if there was cancer in the lymph nodes
• if you cannot have surgery
• if vulval cancer has come back or spread.

If the cancer is advanced, the main aim of radiotherapy may be to improve quality of life by shrinking the tumour and reducing symptoms. This is known as palliative radiotherapy.

How radiotherapy is given

Radiotherapy can be internal or external. Radiotherapy for vulval cancer is usually external. Occasionally internal radiotherapy is given, in combination with external radiotherapy.

External radiotherapy

External radiotherapy uses a machine called a linear accelerator. It is like a large x-ray machine. A radiographer gives you the treatment in the radiotherapy department at the hospital. 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. The number of treatments you have will depend on the type and size of the cancer. The whole course of treatment for vulval cancer will usually last a few weeks.

External radiotherapy is painless. It will not make you radioactive, and it is safe for you to be around other people. This includes children and pregnant women.

Internal radiotherapy (brachytherapy)

For internal radiotherapy, your doctor will insert a radioactive source directly into the cancer. This gives a high dose of radiotherapy to the tumour. As the radiation does not travel far, your sur-rounding organs will not be affected.

The radioactive source is left in the cancer for some time, which can range from 30 minutes to a couple of days. It depends on the amount of radiation needed. You can talk to your doctor about whether brachytherapy is suitable for you.

Chemoradiation

Radiotherapy may be given with chemotherapy. Doctors call this chemoradiation. The chemotherapy drugs can make the cancer cells more sensitive to radiotherapy.

The chemotherapy drug most commonly used is cisplatin. It is usually given once a week throughout your radiotherapy.

The side effects of chemoradiation are similar to radiotherapy side effects. But they can be more severe. Your doctor, radiographer or specialist nurse can give you more information about chemoradiation and the possible side effects of treatment.

Fertility

Radiotherapy to the pelvis can affect your fertility. If you would like to have children in the future, your cancer doctor can refer you to a fertility specialist before treatment begins. They can talk through possible fertility options with you.