About radiotherapy for vaginal cancer
Radiotherapy is a common treatment for vaginal cancer. It uses high energy waves similar to x-rays to kill cancer cells.
You might have external radiotherapy, internal radiotherapy, or both. You might have chemotherapy alongside your radiotherapy.
How radiotherapy works
Radiotherapy works by damaging the DNA within cancer cells so they can no longer divide and grow. DNA is the genetic code that controls how the body's cells behave
External radiotherapy
External radiotherapy directs radiation at the cancer from a machine outside of your body. You have it in the hospital radiotherapy department each day, from Monday to Friday. The length of your course of treatment varies. This depends on the type and size of your cancer and on the aim of the treatment.
Your appointment usually lasts up to 25 minutes each time. The treatment itself takes only a few minutes. But it takes time to get you into the correct position and make sure you are comfortable.
You usually have a type of external radiotherapy called intensity modulated radiotherapy (IMRT).
Internal radiotherapy (brachytherapy)
Internal radiotherapy means giving radiotherapy to the cancer from inside the body. It's also called brachytherapy. This treatment gives a high dose of radiation to the cancer but very little to surrounding tissues.
You have internal radiotherapy in different ways. You might stay in hospital for a few days. Or you might have 2 or more treatments as an outpatient.
Combined chemotherapy and radiotherapy (chemoradiotherapy)
Your doctor might suggest chemotherapy alongside your radiotherapy treatment (chemoradiotherapy).
Chemoradiotherapy seems to work better than these treatments alone. Researchers think this is because chemotherapy makes cancer cells more sensitive to radiotherapy.
For this treatment, you have radiotherapy as normal and chemotherapy one day every week. You usually have a chemotherapy drug called cisplatin.
When you might have radiotherapy
Radiotherapy can be used in a number of different situations to treat vaginal cancer.
As your main treatment
Radiotherapy is the main treatment for many people with vaginal cancer.
You usually have radical radiotherapy if you have stage 1, 2, 3, or 4a vaginal cancer. Radical radiotherapy is intensive treatment to try to cure your cancer.
The area treated includes the vagina and the nearby lymph nodes in the 
. The lymph nodes in the are included if the cancer is in the lower part of the vagina.
To treat a cancer if you can't have surgery
Health problems might mean you can’t have surgery, or you could decide you don’t want it. You have tests to check how fit you are before you have any treatment including heart and lung tests.
You can have radiotherapy instead of surgery if surgery isn’t a suitable treatment for you.
To help stop the cancer coming back after surgery
You might have radiotherapy after surgery if there is a risk that the cancer might come back. This may be either in the vaginal area or in the nearby lymph nodes.
Treating cancer that couldn't be completely removed
You might have radiotherapy after surgery if it wasn’t possible to remove all your cancer.
When you have surgery, the surgeon sends the tissue they remove to the laboratory. Here the checks the tissue for cancer cells. There should be a border of cancer free tissue all around the edge. Doctors call this a clear margin. This helps your surgeon to be sure all the cancer is removed.
If there isn't a clear margin of tissue your specialist might suggest a course of radiotherapy. This is to kill off any possible cancer cells that may be left. Or they might recommend more surgery.
Controlling symptoms of advanced cancer
Radiotherapy treatment can help to relieve symptoms of advanced cancer. This is palliative radiotherapy.
The treatment can shrink the cancer for a time and helps relieve symptoms such as pain and bleeding. You usually have treatment as a short course over a few days.
Radiotherapy can also be used to treat an ulcerating cancer or fungating wound. This does not happen very often. But sometimes with an advanced vaginal cancer, the area breaks down and forms a wound. This might be painful and the wound could produce a smelly liquid (discharge). Radiotherapy can help stop the discharge and make the area more comfortable. The wound might even heal completely.
Side effects of radiotherapy
Radiotherapy can have side effects. The skin in the vaginal area and groin is delicate so can become very sore and painful. This can continue for a few weeks after treatment has finished.
It can be hard to cope with the side effects but they do gradually improve. Your radiographer and nurse will help you manage any side effects you have.
