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Overview
Radiation therapy uses a controlled dose of radiation to kill cancer cells or damage them so they cannot grow or spread.
Radiation therapy may be given after surgery to help destroy any remaining cancer cells. It may also be given alongside chemotherapy (chemoradiation) as the main treatment for cervical cancer.
Side effects from radiation therapy include fatigue as well as bladder and bowel changes.
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About radiation therapy
Also known as radiotherapy, this treatment uses targeted radiation, such as x-ray beams, to damage or kill cancer cells. Radiation therapy is often used with chemotherapy as the main treatment for cervical cancer. This is called chemoradiation.
Radiation therapy may also be given after surgery to help destroy any remaining cancer cells and lower the risk of the cancer coming back. This is called adjuvant therapy.
If scans show that the cancer has spread to nearby lymph nodes or tissues around the cervix, chemoradiation is usually recommended as the main treatment. In these cases, surgery to remove the uterus or cervix is often not needed.
There are 2 main ways of delivering radiation therapy: externally or internally. It is common to have both types to treat cervical cancer.
External beam radiation therapy (EBRT)
In EBRT, a machine precisely directs radiation beams from outside the body to the affected areas of the pelvis. You will lie on a treatment table under the radiation machine. Each treatment session takes around 10–15 minutes and is painless.
EBRT for cervical cancer is usually given daily, Monday to Friday, over 4–6 weeks. The exact number of treatment sessions you have will depend on the type and size of the cancer, and whether it has spread to the lymph nodes.
Internal radiation therapy (brachytherapy)
Brachytherapy delivers radiation directly to the cancer from inside your body, usually through the vagina. It allows a higher radiation dose to be delivered to the cancer, while reducing the amount of radiation to nearby organs (e.g. bowel, bladder).
It’s usually given after external radiation (EBRT). The most common type is high-dose-rate (HDR) brachytherapy, with only a few sessions. You may have treatment as a day patient or stay overnight in hospital. A general or spinal anaesthetic is usually given. A device called an applicator is placed into the cervix through the vagina to deliver the radiation. Treatment usually takes about 10–20 minutes.
After brachytherapy, you may feel some discomfort in the vaginal region or have a small amount of bleeding. Pain medicines can help. Brachytherapy for cervical cancer is not provided at all hospitals, so you may have to travel for treatment.
Side effects
The side effects you have will vary depending on the dose of radiation and the length of the treatment. One of the main side effects can be changes to the vagina. Other side effects include:
Fatigue
Fatigue
Tiredness usually builds up slowly during the treatment, particularly near the end. It may last for some time after treatment ends.
Bladder and bowel changes
Bladder and bowel changes
You may pass urine more often or with more urgency, or feel a burning sensation. Try to drink plenty of water to dilute your urine. Bowel movements may be more frequent, urgent or loose (diarrhoea), or you may pass more wind than normal.
Skin redness, soreness and swelling
Skin redness, soreness and swelling
Radiation therapy may make the skin in the treatment area dry and itchy. Occasionally, your skin may look red and peel, like sunburn. The treatment team will recommend creams to use to ease any itching and make you more comfortable.
Hair loss
Hair loss
When radiation therapy is aimed at your pelvic area, you may lose your pubic hair. This hair may grow back after the treatment ends, but it will usually be thinner.
Vaginal discharge
Vaginal discharge
Radiation therapy may cause or increase vaginal discharge. Let your treatment team know if it smells different or has blood in it.
Menopause
Menopause
If your ovaries have not been removed, radiation therapy can stop the ovaries producing hormones, which leads to early menopause. Your periods will stop, you will no longer be able to become pregnant, and you may have menopause symptoms. You can talk to your doctor about whether you can take menopausal hormone therapy (MHT).
Most side effects of radiation therapy will be short term and appear during or soon after treatment. Side effects can take several weeks to get better and some may continue for longer. Sometimes, side effects may not show up until months or years after treatment. These are called late effects.
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