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Radiation Therapy for Cervical Cancer

Radiation Therapy for Cervical Cancer

Radiation treatment is also called radiotherapy. It's one way to treat cervical cancer.

The goal of radiation is to kill cancer cells. It works by directing strong X-rays at the tumor. To get this treatment, you'll see a radiation oncologist. This doctor determines your treatment plan and should work closely with the gynecologic oncologist to coordinate your care. The plan establishes what kind of radiation you'll have and how long the treatment will last. Your radiation oncologist can tell you what to expect during treatment. You'll also learn how you may feel during and after the treatment.

Women with cervical cancer who are treated with radiation usually receive low-dose chemotherapy at the same time. This makes the radiation work more effectively. For smaller cancers or ones that have not spread, radiation works as well as surgery. Doctors also use radiation for larger cancers or those that have spread because it may help cure them.

You may also have radiation after surgery. Then the goal is to make sure that any cancer cells not removed during surgery are destroyed. If you have an advanced cancer that cannot be cured, your doctor may use radiation to ease symptoms, such as pain or bleeding.

Your radiation oncologist may do some imaging tests to decide on your treatment. These tests take pictures of the inside of your body. They help show where you need treatment. They may include X-rays and computed tomography (CT) scans. You may have the same tests after treatment to see how well it worked. 

What to know about radiation therapy

Radiotherapy is a local therapy. That means it only affects the cancer cells in the area of the body that is treated. Your doctor may suggest radiation therapy in these cases:

  • You have cervical cancer that has spread beyond the cervix.

  • You have a large cancer that is found only in the pelvis. When cancers are large, radiation therapy is the preferred treatment.

  • You need treatment after surgery to make sure that all the cancer cells are gone.

  • You have early-stage cervical cancer, so you can have radiation as an alternative to surgery. Radiation therapy is as effective as radical hysterectomy for treating small cervical cancers.

  • You cannot have surgery because you have other medical problems.

  • You need treatment to shrink a tumor before surgery. (There is no evidence that this is better than radiation alone.)

You can get radiation in two ways. You may get only one of these types of radiation or both of them:

  • External radiation. This radiation comes from a machine. This is sometimes called EBRT, which stands for external beam radiation therapy. Tumors are thicker in some places than others. Traditional radiation therapy sends the same strength of radiation across the whole tumor. That means some parts may get too little or too much radiation. A  form of external beam radiation therapy called intensity modulated radiation therapy (IMRT) helps make sure the tumor gets the appropriate amount of radiation. IMRT uses small beams of different strengths to better fit the tumor's shape and size.

  • Internal radiation. This radiation is when radioactive material is placed inside you. The doctor puts it directly into, or near, the tumor. This type of radiation is also called brachytherapy. "Brachy" means "near" and refers to how close the radiation is to your tumor.

When radiation is used as the primary form of therapy, it includes both external radiation and brachytherapy. 

Common side effects of radiation therapy

Radiation treatment affects normal cells as well as cancer cells. It may cause side effects. These depend on how much radiation you get and where you get it.

Diarrhea is the most common side effect of radiation for cervical cancer. These are some other side effects of radiation:

  • Fatigue

  • Skin changes

  • Loss of appetite

  • Nausea and vomiting

  • Upset stomach

  • Loose bowels

  • Vaginal dryness and painful intercourse can be long-term side effects 

  • Pelvic radiation can damage the ovaries and cause premature menopause

  • Bladder irritation and problems with urination

  • Weakened pelvic (hip) bones and increased risk of fractures

  • Low blood counts, causing anemia (low red blood cells) and leukopenia (low white blood cells)

Pelvic radiation therapy may cause scar tissue to form in the vagina. The scar tissue can make the vagina more narrow (called vaginal stenosis) or even shorter, which can make sex (vaginal intercourse) painful. Ask your radiation oncologist about the use of a dilator in order to prevent this problem. 

Most problems usually go away or get better within a few weeks after radiation ends. Many can be treated, so be sure to talk with your doctor or nurse about any problems you have.

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