Having your radiotherapy for vaginal cancer | Cancer Research UK
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Having radiotherapy for vaginal cancer

Many women have a course of external radiotherapy first and then internal radiotherapy treatment after that.

External radiotherapy

You go to the hospital for treatment once a day, from Monday to Friday, with a break at weekends. The length of your course of treatment depends on the type and size of your cancer and on the aim of the treatment. The treatment only takes a few minutes each time. It doesn't hurt. You won't feel it at all. Having external radiotherapy does not make you radioactive.

Internal radiotherapy

There are two ways that internal radiotherapy (brachytherapy) may be given for vaginal cancer. It can be from radioactive sources placed inside the vagina (intracavitary radiotherapy). Or from radioactive implants put into the cancer and surrounding tissues (interstitial radiotherapy).

Intracavitary radiotherapy is more commonly used in the UK. You can have this treatment as one long inpatient treatment, over 2 to 5 days. Or in 2 or more short treatments, either as an outpatient or with overnight stays in hospital.

 

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External radiotherapy to treat vaginal cancer

You have external radiotherapy treatment in the hospital radiotherapy department as an outpatient. You go to the hospital for treatment once a day, from Monday to Friday, with a break at the weekends. The length of your course of treatment varies, depending on the type and size of your cancer and on the aim of the treatment. 

Many women have a course of external radiotherapy first and then internal radiotherapy treatment after that. The daily external treatment takes between 15 to 25 minutes.

The radiographers help you onto the treatment couch, and make sure you are comfortable. You are alone in the room for the treatment. The staff can hear and see you through an intercom and closed circuit television screen, so you can call if you need them. 

The treatment doesn't hurt. You won't feel it at all. The staff ask you to lie very still for the treatment. Here is an example of a treatment room.

A photo of a linear accelerator, which gives radiotherapy

Having external radiotherapy doesn't make you radioactive. It is perfectly safe to be with other people, including children, throughout your treatment course.

The treatment can be very tiring, particularly towards the end of your course. This can be partly because you are having to travel back and forth to the hospital each day. But it is also because tiredness is a side effect of radiotherapy treatment.

 

Internal radiotherapy to treat vaginal cancer

Internal radiotherapy is known as brachytherapy. Brachytherapy is where a small pellet of radioactive material (radiation source) is placed in special applicators, positioned either directly into your tumour or very close to it. This allows a high dose of radiation to be given directly to the area to be treated.

When you have brachytherapy, you may need to stay overnight in the hospital or come in several times for different outpatient appointments. These can either be low doserate (LDR), pulsed doesrate (PDR) or high doserate (HDR) treatments.

 

Low dose rate treatment

LDR brachytherapy is a treatment given constantly over a long period of time. Throughout the treatment the radiation dose is low. Patients have applicators inserted into the vagina and cervix. You stay in an purpose built, single room overnight in the hospital. You are radioactive during this time and are unable to have any visitors.

Once the applicators are removed, you can move around and have visitors. You may be able to go home either that same day or the following day.

Before treatment

You are admitted overnight at the hospital for this treatment. You may stay on the ward the night before the procedure. When you have the treatment, you are taken to theatre and have an anaesthetic. The anaesthetic may be an injection into your spine (epidural) so you feel nothing below the waist. Or you may have a general anaesthetic, which puts you to sleep.

The doctor places the applicators inside the vagina and cervix. This is held in place by gauze pack in the vagina. The doctor also puts a catheter (tube) into the bladder.

During treatment

When you wake up, you are returned to a purpose built, single room on the ward. Your treatment can last between 1 to 3 days. You need to remain lying flat in bed. If you move around there is a small possibility that the applicators may move. The nurses make sure you are as comfortable as possible.

You have a call bell to hand so you can ring the nurses if you need anything. Your room has a camera so that the nurses can observe you on a CCTV screen outside.

After treatment

The applicators and gauze pack are removed once the treatment is complete. You may be able to go home either that same day or the following day.

 

High dose rate treatment

HDR brachytherapy is a temporary treatment. It involves placing applicators in the vagina as close to the cervix as possible. Applicators are taken out once the treatment is over. You are only radioactive when the treatment machine is switched on. So you are safe to be around everyone including children.

The treatment is given by a special brachytherapy machine which is kept in a purpose built  room. The machine contains a small radioactive pellet which leaves the machine and enters the applicator. Once inside it releases radiation. You won’t feel anything. This can last 15 minutes depending on the treatment.

Before treatment

The doctor gives you a physical examination to check what size applicator can be used for the treatment. The applicator is a tube which comes in different sizes. This tube is then inserted in your vagina and held in place with a clamp. The doctor uses a jelly to help insert the applicator in so it’s as comfortable as possible. 

You have a CT scan which takes a short time. The radiographers wait outside while this happens. The radiographers remove the applicator after the scan and you are free to go home.

During treatment

You come back for treatment within a week. You are in the same position as you were for the CT scan. The same tube is inserted and connected to the brachytherapy machine. The radiographers leave the room and observe you from outside from a CCTV screen during treatment.

After treatment

The radiographers remove the tube once treatment is completed. You are then free to go home. You usually have between 2 to 4 treatments. The treatment is the same every time.

 

Pulse dose rate treatment

The pulsed dose rate (PDR) brachytherapy system is a machine which gives a dose of radiation for 10 minutes every hour for 12 to 24 hours. You may not be allowed any visitors during your time in hospital.

Before treatment

The doctor gives you a short anaesthetic and puts the applicators into your vagina and uterus. At the same time you have a fine tube (catheter) put into your bladder. The applicators are held in place with a vaginal gauze pack, to stop them moving.

When you wake up you have a CT and/or MRI scan to check the position of the applicators. Your doctor uses these scans to plan your brachytherapy treatment.

During treatment

When you wake up, you’ll be in a purpose built, single room on the ward. A member of your treatment team connects the applicators to the machine. It gives the brachytherapy treatment automatically each hour. If you experience any discomfort during your treatment, pain relief will have been prescribed and is readily available.

You need to remain in bed in while the applicators are in place. You have a call bell to hand so you can ring the nurses if you need anything. Your room has a camera so that the nurses can observe you on a CCTV screen outside. If you think the applicators have moved, tell the nurse or doctor straight away.

After treatment

A nurse removes the applicators out for you on the ward. Pain relief is available if required. You may also have gas and air to breathe when the applicators are removed as this can help you to relax. Once the radioactive sources are removed, all the radiation has gone. You may be able to go home that day or stay overnight, depending on how you feel.

 

For more information

Find out about

External radiotherapy

Planning external radiotherapy

Internal radiotherapy

Internal radiotherapy safety procedures

For general information and support

Contact the Cancer Research UK nurses on freephone 0808 800 4040 (Open 9am - 5pm, Monday to Friday)

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Updated: 23 September 2015