Radiation therapy for vulvar cancer

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It can be used to treat vulvar cancer. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.

Radiation therapy is often combined with chemotherapy to treat vulvar cancer. This is called chemoradiation. The 2 treatments are given during the same time period.

Radiation therapy is given for different reasons. You may have radiation therapy or chemoradiation:

• to destroy cancer cells left behind after surgery to reduce the risk that the cancer will come back (recur) (called adjuvant radiation therapy)
• before surgery, with or without chemotherapy, to shrink a tumour (called neoadjuvant radiation therapy)
• as the main treatment for women who cannot have surgery or chemotherapy because of health problems
• to relieve pain or control the symptoms of advanced vulvar cancer (called palliative radiation therapy)

During external beam radiation therapy, a machine directs radiation to the tumour and some of the tissue around it.

For early stage vulvar cancer that has not spread to the lymph nodes in the groin, radiation therapy may be offered after surgery if the tissue removed along with the tumour (surgical margin) was less than 8 mm wide or the tumour grew deep into the underlying tissue.

For advanced vulvar cancer that has spread into the pelvis and other organs, radiation therapy may be offered before surgery. It may be combined with chemotherapy. The goal is to shrink the tumour so that less extensive surgery can be done to avoid disfigurement and loss of function.

Side effects can happen with any type of treatment for vulvar cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

During radiation therapy, the healthcare team protects healthy cells in the treatment area as much as possible. But damage to healthy cells can happen and may cause side effects. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after radiation therapy. Sometimes late side effects develop months or years after radiation therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the total dose of radiation, whether chemotherapy was given and the treatment schedule. Side effects can be more severe when chemotherapy is given with radiation therapy. Some common side effects of radiation therapy used for vulvar cancer are:

• fatigue
• skin problems
• diarrhea
• radiation cystitis
• nausea and vomiting
• low blood cell counts
• sexual problems including vaginal narrowing, vaginal dryness and painful intercourse
• treatment-induced menopause

Tell your healthcare team if you have these side effects or others you think might be from radiation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Find out more about radiation therapy and side effects of radiation therapy. To make the decisions that are right for you, ask your healthcare team questions about radiation therapy.