About radiotherapy for vulval cancer | Cancer Research UK
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About radiotherapy for vulval cancer

Radiotherapy uses high energy waves to treat cancer. For vulval cancer, your specialist may suggest radiotherapy

  • Before surgery to shrink your cancer
  • To try to stop the cancer from coming back after surgery
  • To treat a cancer that wasn't completely removed with surgery
  • To treat your cancer if you can't have surgery
  • To control symptoms of advanced cancer

Having your treatment

You have radiotherapy treatment in the hospital radiotherapy department. You are most likely to have treatment once a day, Monday to Friday, with a rest at the weekends. Each treatment takes 25 minutes and does not hurt. It does not make you radioactive. At your first visit your doctor plans your treatment, using a large specialised CT scanning machine.

Most people have this treatment as an outpatient. You have to travel to the hospital every day. It is a good idea to take someone with you. You may not feel like driving yourself, or getting yourself home on public transport alone. If travel costs are a worry ask your nurse specialist to put you in touch with a social worker. They might be able to arrange financial help.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating vulval cancer section.

 

 

When radiotherapy is used

Radiotherapy uses high energy waves to treat cancer. For vulval cancer, your specialist may suggest radiotherapy

  • before surgery
  • after surgery
  • if your cancer wasn't completely removed
  • if you can't have surgery
  • to control symptoms of advanced cancer

Before surgery

Doctors call this neoadjuvant treatment. The idea is that the treatment shrinks your cancer before surgery. It may mean that you can have a smaller operation. Or it may make surgery possible when it wasn't before.

You may have chemotherapy during your course of radiotherapy. Doctors know that some chemotherapy drugs can help radiotherapy to work. Your doctor may call this chemoradiotherapy or concurrent therapy.

After surgery

Doctors sometimes use radiotherapy to try to stop cancer from coming back in the lymph nodes after you have had surgery. This is called adjuvant treatment. You are most likely to have this if 

  • two or more of the lymph nodes that were removed contain cancer cells
  • one of your lymph nodes was larger than 5mm in size
  • the cancer has broken through the capsule that surrounds the lymph node

In these cases there is quite a high chance of the cancer coming back, if you do not have any further treatment. The radiotherapy is used to try to kill off any cancer cells in the lymph nodes left behind after your operation. The treatment is given to the groin on one or both sides, depending on where the cancer was.

Generally, doctors prefer to use surgery to remove lymph nodes that could contain cancer cells. Although radiotherapy may cause fewer long term side effects, a treatment review,  reported that there is not enough evidence to say it is as good at stopping the cancer coming back as surgery, to remove the lymph nodes.

Remember that radiotherapy is a perfectly acceptable treatment, if there is any reason why you can't have surgery to remove your lymph nodes.

If your cancer wasn't completely removed

Your specialist may suggest you have radiotherapy after surgery if it was not possible to remove all of your vulval cancer. This can happen when the area containing cancer cells is too close to other important structures, such as your anus or the tube that drains your bladder (the urethra).

When the surgeon removes your cancer, they also remove a border of healthy tissue around it. This is called the margin. Sometimes, when the doctor examines the margin after surgery, it contains cancer cells. Your surgeon may tell you that they did not remove a clear margin of tissue. So, some cancer cells could have been left behind. 

In this situation, your surgeon may suggest more surgery. Or you could have a course of radiotherapy to kill off any cancer cells that have been left behind.

If you can't have surgery

You may have radiotherapy instead of surgery if you are not well enough for an anaesthetic, or to make a good recovery from the operation. A course of radiotherapy designed to cure a cancer is sometimes called radical radiotherapy. This is a difficult decision to make. 

A course of radiotherapy designed to cure the cancer is not an easy option. The skin in the vulva and groin is very delicate. It can break down because of the treatment. Your vulva and groin can become very sore and painful. This gets better over time after your treatment has finished, but it can be hard for a while.

To control symptoms of advanced cancer

In advanced vulval cancer, the area sometimes breaks down and forms an unpleasant wound. The wound may ooze. The discharge can smell and the wound can be painful. You may hear this called a fungating wound. They can happen in many different types of cancer.

Your nurse helps you to manage the wound. There are dressings available that have been designed to cope with this sort of problem. They can absorb the discharge and contain charcoal, which helps to control any smell. But it is better if the wound can be treated. 

Radiotherapy is very good at shrinking the cancer. It can help to stop the discharge and make the area more comfortable. The area may even heal over completely.

 

How you have radiotherapy treatment

You have radiotherapy treatment in the hospital radiotherapy department. You are most likely to have treatment once a day, Monday to Friday, with a rest at the weekends. Each treatment is called a fraction. The dose you have for each fraction adds up to the total dose of radiotherapy your specialist has prescribed for you. You have the treatment in fractions because the total dose all in one go would cause too many side effects.

Most people are able to have this type of treatment as an outpatient. You have to travel to the hospital every day. It is a good idea to bring someone with you. You may not feel like driving yourself, or getting yourself home on public transport alone. 

If travelling costs seem a bit much, ask your nurse specialist to put you in touch with a social worker. They might be able to arrange some funding for you to help cover the cost. If you are having difficulties getting around, you could ask your nurse if it is possible for you to get hospital transport.

If you live a long way from your nearest cancer centre, you may have to stay at the hospital. You can go home at the weekends when you are not having any treatment.

 

Planning radiotherapy treatment

Radiotherapy has to be carefully planned. At your first visit you lie under a large specialised CT scanning machine. Your treatment team uses the machine to work out exactly where to give your treatment to kill the most cancer cells, while missing as much healthy body tissue as possible.

CT scanner

 

Having radiotherapy treatment

The actual treatment only takes a few minutes. The radiographers help to position you on the couch and make sure you are comfortable. You are left alone for the treatment which can last around 20 minutes after you have been set up. The staff are able to hear you through an intercom, so call if you need them. The treatment does not hurt. You won't feel it at all. You must lie very still during the treatment.

A photo of a linear accelerator, which gives radiotherapy

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

 

More information about radiotherapy

Find out about

External radiotherapy

Radiotherapy planning

Side effects

Radiotherapy for cancer wounds

Managing fungating tumours

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: 10 February 2016