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Chemotherapy

When, where and how you have chemotherapy for vulval cancer, and the possible side effects.

How it works

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

Why you have it

Your doctor may suggest chemotherapy to shrink your cancer before you have surgery. This is called neoadjuvant chemotherapy.

You might have the chemotherapy on its own, or combined with radiotherapy. This isn’t standard treatment at the moment. 

Your doctor may also suggest chemotherapy with radiotherapy if you are having radiotherapy as your main treatment. The chemotherapy helps the radiotherapy to work. It is called chemoradiation.

Some drugs are called radio sensitisers. These are drugs that can make cancer cells more at risk from radiation. The drugs you are most likely to have are either 5FU, cisplatin or both. 

You won't have chemotherapy every day when you are having radiotherapy. You will probably have treatments at the beginning of your radiotherapy course and weekly throughout. But there are different treatment plans, and you will have to ask your own specialist about your exact treatment schedule.

Chemotherapy for advanced cancer

Your specialist may suggest chemotherapy to try to control vulval cancer that has spread. Cisplatin is the drug doctors use most often. You may have this on its own or in combination with other chemotherapy drugs.

Cisplatin can cause kidney problems, so before the treatment you will usually have extra fluid through a drip. This helps to flush the cisplatin through your kidneys. For this reason, you may have to have this treatment in hospital.

How you have it

Chemotherapy for vulval cancer is usually given into your bloodstream (intravenously). 

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

When you have it

You have chemotherapy as cycles of treatment, with breaks in between.

It is difficult to generalise because there are different timetables for different chemotherapy drugs. But you are most likely to have treatment for one to 5 days, with a break of 2 or 3 weeks between each treatment.

This allows your body to recover from the treatment. It also means the drugs catch the cancer cells at different stages of development. Chemotherapy can only kill cancer cells when they are growing and dividing into new cells. Each treatment will kill off cells that were resting last time round.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You’ll sit in a chair for a few hours so it’s a good idea to take newspapers, books or electronic devices to help to pass the time.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • a lower resistance to infections
  • bleeding and bruising easily
  • diarrhoea or constipation
  • hair loss
Contact your doctor or nurse immediately if you have any signs of infection such as a temperature higher than 38C or generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

  • which drugs you have
  • how much of each drug you have
  • how you react

Tell your treatment team about any side effects that you have.

Most side effects only last for the few days that you’re having the chemotherapy drugs. Your treatment team can help to reduce your side effects.

If you have not yet had your menopause, it is important to know that chemotherapy can affect your ovaries. You may not be able to become pregnant after this type of treatment and may have an early menopause. You can have HRT for menopausal symptoms if you've had vulval cancer.

When you go home

Chemotherapy for vulval cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.

Last reviewed: 
24 Feb 2016
  • Referral for suspected cancer. A clinical practice guideline
    The National Institute for Health and Care Excellence (NICE), June 2015
    Link to the referral guidelines on the NICE website

  • Guidelines for the Diagnosis and management of Vulval Carcinoma
    British Gynaecological Cancer Society and the Royal College of Obstetricians and Gynaecologists, May 2014

  • 2014 UK National Guideline on the Management of Vulval Conditions
    British Association for Sexual Health and HIV, February 2014

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