Radiotherapy uses high-energy rays to destroy cancer cells. You may have radiotherapy before surgery to try to shrink the cancer, making a smaller operation possible. You may also have radiotherapy after surgery if the cancer isn’t completely removed or if there is cancer in the lymph nodes.

Radiotherapy is also used to treat vulval cancer that 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. Sometimes, chemotherapy is given with radiotherapy. This is called chemoradiation.

Radiotherapy can be internal or external. Radiotherapy for vulval cancer is usually external. However, occasionally internal radiotherapy is given on its own or in combination with external radiotherapy.

External radiotherapy

High-energy x-rays are directed from a machine to the area of the cancer. You normally have external radiotherapy as a series of short, daily treatments in the hospital radiotherapy department. You’ll go to hospital for your treatment Monday–Friday and then have a rest at the weekend. 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.

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 doesn’t travel far, your surrounding organs won’t be affected. The source is left there 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.