Radiotherapy treats cancer using high-energy X-rays that destroy the cancer cells while doing the least possible damage to normal cells.
Radiotherapy for cervical cancer can be external or internal, and sometimes a combination of the two is given. Radiotherapy treatment can last for 5-8 weeks.
Radiotherapy can be given to treat cervical that is in an early stage. It is also commonly given to treat larger tumors in the cervix or if the cancer has spread beyond the cervix and is not curable just with surgery. Radiotherapy can also be used after surgery if there is a high risk of the cancer returning. It is often given in combination with chemotherapy.
Radiotherapy treatment for cervical cancer affects the ovaries. In young women who still are getting their period, radiotherapy can make the ovaries stop producing eggs and also the hormones estrogen and progesterone. This affects fertility, preventing these women from getting pregnant and bringing about early menopause.
In some cases, an operation can be carried out before radiotherapy is given; with this operation, the ovaries are moved to a part of the abdomen where it will not be affected by radiotherapy in an attempt to prevent early menopause as a side effect. This operation is known as ovarian transposition. In some cases, it may not be successful, and early menopause may occur.
External radiotherapy is normally given on an outpatient basis. High-energy X-rays are emitted by a machine, called a linear accelerator, to the area where the cancer is located.
Radiation Therapy Planning
Radiotherapy must be carefully planned in order to ensure that it is as effective as possible.
On your first visit to the radiotherapy department, you will have a CT scan done or you will lie down below a machine that will take x-rays of the area to be treated.
You may have small marks made on your skin (tattoos) to help the technician find the position more precisely so that the rays can be directed to this area. These marks must remain visible throughout the treatment. These are extremely small permanent marks, and you won't have these done without your consent.
At the beginning of each session, the technician will carefully place you so that you are comfortable, as you must remain still during the treatment. Radiotherapy isn't painful. During the treatment you will stay in the room alone, though you can talk to the technician monitoring you from an adjacent room.
Internal radiotherapy (also called brachytherapy) administers radiation directly to the cervix and nearby area.
A radioactive pellet is placed near the cancer or in the area where the cancer was located if the patient has had surgery to eliminate the cancer.
If a hysterectomy hasn't been performed, intrauterine brachytherapy will be performed. An applicator with a radioactive pellet is inserted in the vagina, passing through the cervix and into the uterus. To prevent the applicators from moving, cotton or gauze is placed in the vagina or even in the interior of the rectum, and a catheter is placed in the bladder to drain out urine.
Having the applicators in place during the treatment can be bothersome, which is why a painkiller will be needed.
If you have had a hysterectomy, just one applicator is placed inside your vagina. With intravaginal brachytherapy, you will not need anesthesia or sedation to insert the applicator, and no filler is needed.
You will have CT scans, X-rays, or MRIs done to check on the position of the applicators. Once the correct positioning is confirmed, the brachytherapy machine is connected, the radioactive source is put in place, and treatment is administered.