Radiotherapy uses high energy x-rays to kill cancer cells. You might have external or internal radiotherapy, or both, for vaginal cancer.
External beam radiotherapy directs radiation at the cancer from a machine outside of your body. You usually go to hospital each day from Monday to Friday. Your appointment usually lasts up to 25 minutes each time. The treatment itself takes only a few minutes but it takes time to get you into the correct position.
Internal radiotherapy (brachytherapy) uses a radioactive source or implant that is put into your vagina through an applicator. You have internal radiotherapy in different ways. Depending on the type of your cancer and your treatment plan, you might stay in hospital for a few days, or you might have 2 or more treatments as an outpatient.
When you might have radiotherapy
Radiotherapy can be used in a number of different situations to treat vaginal cancer.
As your main treatment
Radiotherapy is the main treatment for many women with vaginal cancer.
Some women with stage 1, 2 or 3 vaginal cancers will have radical radiotherapy to try to cure their cancer. This might also be possible for some women with stage 4a cancer.
Radiotherapy causes different side effects to surgery. The skin in the vaginal area and groin is very delicate so can become very sore and painful. This can continue for a few weeks after treatment has finished, before things gradually improve. It can be hard to cope with at the time.
To treat a cancer if you can't have surgery
You can have radiotherapy instead of surgery if you can’t have an anaesthetic for some reason. This is usually because you have another chronic health condition, such as heart or lung problems.
To help stop cancer coming back after surgery
Radiotherapy is sometimes used to prevent 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 2 or more of the removed lymph nodes contain cancer cells.
You have radiotherapy to the groin area. This might be to one or both sides of the groin. The idea is that radiotherapy kills off any cancer cells left behind after your operation.
Treating cancer that couldn't be completely removed
You might have radiotherapy after surgery if it wasn’t possible to remove all your vaginal cancer. The cancer may have been too close to other important structures, such as the tube that drains your bladder (the urethra).
When you have cancer surgery, the surgeon sends the tissue they remove to the laboratory. In the laboratory, the pathologist checks the tissue for cancer cells. There should be a border of cancer free tissue all around the edge. Doctors call this a clear margin. This helps your surgeon to be sure all the cancer has been removed.
If there isn't a clear margin of tissue your specialist might suggest a course of radiotherapy to kill off any possible cancer cells that may be left. Or they might recommend further surgery.
Combined radiotherapy and chemotherapy
Your doctor might suggest chemotherapy alongside your radiotherapy treatment (chemoradiation).
Having radiotherapy and chemotherapy at the same time seems to work better at killing cancer cells than these treatments alone. The reason for this is not very clear. Researchers think it may be because the chemotherapy makes cancer cells more sensitive to radiotherapy, or vice versa.
For this treatment, you have radiotherapy as normal and chemotherapy at the same time. Usually, this means an injection of a chemotherapy drug called cisplatin, once a week throughout your course of radiotherapy.
Controlling symptoms of advanced cancer
Radiotherapy treatment can help to relieve symptoms in advanced cancer. This is called palliative radiotherapy.
The treatment can shrink the cancer for a time and helps relieve symptoms such as pain and bleeding. You usually have treatment as a short course over a few days.
Radiotherapy can also be used to treat an ulcerating cancer or fungating wound. This does not happen very often. But sometimes with an advanced vaginal cancer, the area breaks down and forms a wound. This might be painful and the wound could produce a smelly liquid (discharge).
Dressings are available and your nurse will help you manage the wound. These can absorb the discharge and they contain charcoal to control any smell. But it’s better if the wound can be treated.
Radiotherapy is very good at shrinking cancer. It can help stop the discharge and make the area more comfortable. The wound might even heal completely. Your doctor might also prescribe antibiotics because these can help to stop any discharge and clear up any infection.
This page is due for review. We will update this as soon as possible.