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Chemotherapy

Chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

Why you have it

Your specialist may suggest chemotherapy to shrink your cancer before you have surgery. This is called neo adjuvant chemotherapy.

Your doctor may also suggest chemotherapy with radiotherapy (chemoradiotherapy). The chemotherapy helps the radiotherapy to work. The drugs you are most likely to have are either cisplatin, 5FU or both.

You might have chemoradiotherapy:

  • after surgery for early stage disease with positive lymph nodes
  • for vulval cancer that is not suitable for surgery

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. Your specialist will tell you about your exact plan.

Chemotherapy for advanced cancer

Your specialist may suggest chemotherapy to try to control vulval cancer that has spread. Carboplatin and paclitaxel are the drugs doctors use most often. 

Carboplatin can cause kidney problems, so you may have extra fluids through a drip before and after treatment. This helps to flush the carboplatin through your kidneys.

Your chemotherapy nurse will give you information about your treatment before you start.

How you have it

You have the treatment through a drip into your arm or hand. 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 might 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 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.

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 37.5C 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.

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: 
30 Apr 2019
  • 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

  • Cancer of the Vulva
    FIGO cancer report 2018
    L Rogers and M Cuello
    International Journal of Gynaecology and Obstetrics, 2018. Vol 143, Issue S2, Pages 4-13

  • Up To Date

    Treatment of vulval cancer

    Accessed April 2019

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