Chemotherapy for vaginal cancer

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream. Treatment that reaches the whole body in this way is called a systemic treatment.

You might have chemotherapy as part of your treatment for vaginal cancer.

When you have it

When you have chemotherapy depends on how far it has grown or spread (the stage) and the type of cancer.

Chemotherapy with radiotherapy (chemoradiotherapy)

Chemoradiotherapy means having chemotherapy and radiotherapy treatment together.

Radiotherapy uses radiation, usually x-rays, to destroy cancer cells.

These treatments can often work better when they are given together and can lower the risk of the cancer coming back.

You might have chemoradiotherapy:

  • as your main treatment
  • after surgery, if there are any remaining cancer cells

Chemotherapy on its own

You might have chemotherapy on its own if chemoradiotherapy or surgery aren’t suitable treatments for you.

You might also have it as your main treatment if you have advanced vaginal cancer. It can’t cure your cancer, but it might:

  • relieve symptoms
  • control the growth of the cancer
  • improve your quality of life

How often do you have it?

You usually have chemotherapy in cycles of treatment Open a glossary item. How long each cycle lasts and when you have treatment depends of which drug you have, and any other treatments you are having.

Types of chemotherapy

There are many different chemotherapy drugs. Your doctor will decide which drugs and the exact number of treatments you have. You may have one or more of the following drugs:

  • cisplatin

  • carboplatin

  • paclitaxel (taxol)

  • fluorouracil

  • mitomycin

  • topotecan

You can read more about your chemotherapy by looking at our A to Z list of cancer drugs.

How you have chemotherapy

You have most of these drugs as injections into a vein or through a drip (intravenous infusion). Some chemotherapy treatments are taken as tablets or a capsule.

Into your bloodstream

You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment. This means your doctor or nurse won't have to put in a cannula every time you have treatment.

Diagram showing a central line

Taking your tablets or capsules

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.

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 things in to do. For example, newspapers, books or electronic devices can all 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.

Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.

Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test. 

Your doctors and pharmacists work out your chemotherapy dose based on your blood cell levels, and your weight, height and general health.

Before your first chemotherapy, your doctor will explain what drugs you need, how you have them, and what the side effects are. You’ll sign a consent form. This is a good time to ask any questions you might have.

DPD deficiency

Between 2 and 8 out of 100 people (2 to 8%) have low levels of an enzyme called dihydropyrimidine dehydrogenase (DPD) in their bodies. A lack of DPD can mean you’re more likely to have severe side effects from capecitabine or fluorouracil. It might take you a bit longer to recover from the chemotherapy. These side effects can rarely be life threatening.

Before starting treatment with capecitabine or fluorouracil you have a blood test to check levels of DPD. So you may start treatment with a lower amount (dose) of the drug or have a different treatment. Your doctor or nurse will talk to you about this.

Side effects

Common chemotherapy side effects include:

  • feeling sick

  • loss of appetite

  • losing weight

  • feeling very tired

  • increased risk of getting an infection

  • bleeding and bruising easily

  • diarrhoea or constipation

  • hair loss

Contact your hospital advice line immediately if you have signs of infection. These include a temperature above 37.5C or below 36C, 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.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you:

  • take any supplements
  • have been prescribed anything by alternative or complementary therapy practitioners

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.

When you go home

Chemotherapy for vaginal 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.

  • Cancer of the vagina: 2021 update
    FIGO cancer report
    TS Adams, LJ Rogers and MA Cuello
    International Journal of Gynaecology and Obstetrics, 2021. Volume 155. Pages 19-27

  • ESTRO/ESGO/SIOPe guidelines for the management of patients with vaginal cancer
    RA Nout and others
    International Journal of Gynecological Cancer, 2023. Volume 33. Pages 1185-1202

  • Gynecological Tumours: Essentials for Clinicians
    A duBois, M Hall and CC Fotopoulou
    ESMO Press, 2017

  • Cancer: Principles and Practice of Oncology (12th edition)
    VT DeVita, TS Lawrence and SA Rosenberg
    Wolters Kluwer, 2023

Last reviewed: 
10 May 2024
Next review due: 
10 May 2027

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