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Radiation Therapy
Radiation therapy is used for cancers that have spread beyond the cervix (II, III, or IV) or very large lesions (larger than 5 centimeters).
Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or shrink the tumor. Radiation therapy is used instead of surgery in most cases. However, it is sometimes necessary after surgery if it is discovered that the cancer has spread outside the cervix, or to reduce the risk that a cancer will come back after surgery.
There are two types of radiation therapy: external and internal. External radiation therapy uses a machine outside the body to send radiation toward the cervical cancer. Internal radiation therapy uses a small amount of radioactive material that is delivered directly to the tumor using implants. The type of radiation used depends on the stage of the cervical cancer. A radiation oncologist, a doctor who specializes in radiation therapy, will give you your radiation treatments. The length of your radiation treatment will be determined by your radiation oncologist.
For internal radiation therapy, implants are inserted through the vagina into the cervix, where they are placed next to the tumor while the patient is under anesthesia. The implants stay in place for a few days. During that time, you will stay in the hospital, with limited visits, to protect others from the radiation. Internal radiation therapy may also be done on an outpatient basis, using something called high-dose-rate radiation. Outpatient radiation treatment is done under sedation, in several three-hour visits. Whether your radiation is received inpatient or outpatient, once the implants are removed, no radioactivity is left in your body.
When external radiation is prescribed, patients will be given an appointment for pretreatment simulation. Simulation involves taking X-rays of your pelvis and marking the skin on your hips and lower back with a colored marking pen to show the radiation therapist where to aim the radiation. The simulation is painless; however, you will have to lie face down on a special table for at least an hour. You will need to keep the colored lines marked on your skin, so you should not take tub baths during the course of radiation treatment, and sponge baths are better than showers.
On the days of your actual treatment with external radiation, you will lie on a treatment table, and the radiation therapist will position you so the radiation will reach the right part of your body. Once you are positioned, you cannot move until the treatment is finished. External radiation typically requires 25 outpatient visits lasting about 30 minutes. Your position on the table will be the same for each treatment. Your doctor will tell you when you can wash off your colored markings, after the course of treatment is over.
During treatment, sexual intercourse is not recommended. Even after treatment is completed, the side effects of radiation therapy may make sexual intercourse uncomfortable or painful for a period of time. Other side effects of radiation therapy include:
- Fatigue
- Dryness, itching, tightening, and burning in the vagina
- Red, dry, tender, itchy skin
- Moist, weepy skin (later in treatment)
- Hair loss in the treated area
- Loss of appetite
- Diarrhea
- Frequent and uncomfortable urination
- Reduced white blood cell count
- Premature menopause
In most cases, chemotherapy will be given with the radiation to help the radiation work better, as a radiation sensitizer.
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