Chemotherapy for vulval cancer

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream. For vulval cancer, you usually have chemotherapy in combination with radiotherapy. This is chemoradiotherapy. 

When you have it

Your doctor may suggest you have chemotherapy with radiotherapy (chemoradiotherapy). You won't have chemotherapy every day when you are having radiotherapy. You usually have it at the beginning of your radiotherapy course and then once a week during radiotherapy. But there are different ways of having chemoradiotherapy. Your doctor will tell you about your exact plan.

You may also have chemotherapy:

  • to shrink the cancer before you have surgery. This is called neo adjuvant chemotherapy
  • instead of surgery if you can't have surgery for any reason
  • to try to control vulval cancer that has spread. This is advanced vulval cancer 

Types of chemotherapy you might have

You may have one drug or a combination of drugs to treat vulval cancer. Your doctor or chemotherapy nurse will give you information about your treatment before you start.

The most common types of chemotherapy drugs are:

  • cisplatin
  • fluorouracil (5FU)
  • carboplatin
  • paclitaxel

Check the name of the chemotherapy treatment with your doctor or nurse, then find out about it on our A to Z list of cancer drugs.

How you have chemotherapy

You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment.

Treatment cycles 

You usually have chemotherapy as cycles of treatment. This means that you have treatment and then a break to allow your body to recover.

There are different ways of having treatment. Your doctor and chemotherapy nurse can tell you exactly what will happen.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

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

Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.

Before you start chemotherapy

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

DPD deficiency

Between 2 and 8 out of 100 people (2 to 8%) have low levels of an enzyme called dihydropyrimidine dehydrogenase (DPD) in their bodies. A lack of DPD can mean you’re more likely to have severe side effects from capecitabine or fluorouracil. It might take you a bit longer to recover from the chemotherapy. These side effects can rarely be life threatening.

Before starting treatment with capecitabine or fluorouracil you have a blood test to check levels of DPD. So you may start treatment with a lower amount (dose) of the drug or have a different treatment. Your doctor or nurse will talk to you about this.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • increased risk of getting an infection
  • bleeding and bruising easily
  • diarrhoea or constipation
  • hair loss
Contact your doctor or nurse immediately if you have signs of infection. These include a temperature above 37.5C or below 36C, 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 a few days or so. Your treatment team can help to manage any side effects that you have.

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.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you:

  • take any supplements
  • have been prescribed anything by alternative or complementary therapy practitioners

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. They could be harmful.

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.

  • British Gynaecological Cancer Society (BGCS) vulval cancer guidelines: recommendations for practice
    J Morrison and others
    British Gynaecological Cancer Society, 2020

  • Cancer of the vulva: 2021 update (FIGO cancer report 2021)

    A Olawaiye and M Cuello

    International Journal of Gynaecology and Obstetrics, 2021. Vol 155, Issue S1, Pages 7-18

  • Cancer: Principles and Practice of Oncology (11th edition)
    VT DeVita, TS Lawrence, SA Rosenberg
    Wolters Kluwer, 2019

  • Consent forms for SACT (Systemic Anti-Cancer Therapy)
    Cancer Research UK, Last accessed January 2023 

  • Squamous cell carcinoma of the vulva: Medical therapy and prognosis
    UpToDate, Last updated Dec 2022

Last reviewed: 
31 Jan 2023
Next review due: 
31 Jan 2026

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