Chemotherapy for vulval cancer

Chemotherapy uses anti cancer or cytotoxic drugs to destroy cancer cells. They work by disrupting the cells' growth. The drugs circulate in the bloodstream around the body. You most often have chemotherapy into the bloodstream, through a drip (IV) or by injection. But some drugs are available as tablets. Others come as a cream that you put on the skin.

You have chemotherapy as cycles of treatment, with breaks in between. It is difficult to generalise because there are different timetables for different chemo 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. Chemo 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.

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. There is more about the specific side effects of cisplatin in the main chemotherapy section.

This is not yet standard treatment for cancer of the vulva. But your doctor may suggest it if your cancer needs shrinking before surgery. Or if you are to have radiotherapy as your main treatment. With this treatment, you are really having the chemotherapy because it 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. There is information in the main chemotherapy section about the side effects of 5FU and the side effects of cisplatin.

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 side effects vary. Each drug has a different set of side effects and each person will react differently. Not all drugs cause hair loss, for example.

You are very unlikely to get all the side effects listed for any particular drug. Your reaction will be individual to you and will also depend on the drug dose and on any other chemotherapy drugs you are having at the same time. The commonest side effects with chemotherapy are

• Tiredness
• Feeling or being sick
• A drop in blood cells, causing increased risk of infection
• Diarrhoea
• Sore mouth
• Hair thinning or hair loss

These links will take you to information on coping with that particular side effect.

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. There is more about chemotherapy and early menopause in the main chemotherapy section. 

In our chemotherapy section, we have specific side effect information for many drugs. Ask your doctor or nurse to write down the names of the drugs you will be having. Then you can look down our alphabetical list of chemotherapy drugs to find more information about your own treatment.

We don't yet know much scientifically about how some nutritional or herbal supplements may interact with chemotherapy. Some could be harmful. It is very important to let your doctors know if you take any supplements. Or if you are prescribed them by alternative or complementary therapy practitioners.

Talk to your specialist about any other tablets or medicines you take while you are having active treatment. There is information about the safety of herbal, vitamin and diet supplements in the complementary therapies section.

Some studies seem to suggest that fish oil preparations may reduce the effectiveness of chemotherapy drugs. If you are taking or thinking of taking these supplements talk to your doctor to find out whether they could affect your treatment.

For more about chemotherapy look at the chemotherapy section. It explains the treatment in more detail including

• How it works
• Planning chemotherapy
• How you have chemo
• General side effects
• Living with chemotherapy