Radiation therapy uses high energy x-rays to kill cancer cells. These x-rays may be given externally in a procedure that is much like having a diagnostic x-ray. This is called external beam radiation therapy. This treatment usually takes 6 to 7 weeks to complete. For cervical cancer, this type of radiation therapy is often given along with low doses of chemotherapy with a drug called cisplatin.
Another type of radiation therapy is called brachytherapy, or internal radiation therapy. For cervical cancer, the radioactive material is placed in a cylinder in the vagina. For some cancers, radioactive material may be placed in thin needles that are inserted directly in the tumor. Low-dose brachytherapy is completed in just a few days. During that time, the patient remains in the hospital with instruments holding the radioactive material in place. High dose rate brachytherapy is done as an outpatient over several treatments. For each treatment, the radioactive material is inserted for a few minutes and then removed. The advantage of high-dose rate is that it does not require prolonged immobilization.
Common side effects of radiation therapy include tiredness, upset stomach, or loose bowels. Some people have problems with nausea and vomiting. These side effects tend to be worse when chemotherapy is given with radiation. Skin changes are also common, with the skin in the treated area looking and feeling sunburned. 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 makes sex (vaginal intercourse) painful. A woman can help prevent this problem by stretching the walls of her vagina several times a week. This can be done by engaging in sexual intercourse 3 to 4 times per week or by using a vaginal dilator (a plastic or rubber tube used to stretch out the vagina). Vaginal dryness and painful intercourse can be long-term side effects from radiation. Pelvic radiation can damage the ovaries, causing premature menopause. Radiation can irritate the bladder and problems with urination may occur. Vaginal (local) estrogens may also be used to help with vaginal dryness and atrophy. Radiation to the pelvis can also weaken the bones, leading to fractures. Hip fractures are the most common, and may occur 2 to 4 years after radiation. Bone density studies are recommended. Radiation can also lead to low blood counts, causing anemia (low red blood cells) and leukopenia (low white blood cells). The blood counts usually return to normal after radiation is stopped.
If you are having side effects from radiation, discuss them with your cancer care team.
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