Treatments and Side Effects

Talk to your gynecologic oncologist about the treatment options available for your type and stage of vaginal / vulvar cancer. Your doctor can explain the risks and benefits of each treatment and their side effects. Side effects are how your body reacts to drugs or other treatments.

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Vaginal and vulvar cancers are treated in several ways. It depends on the kind of cancer and how far it has spread. Treatments include surgery, chemotherapy, and/or radiation.

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Understanding the goals of treatment

As you begin your treatment, make sure that you understand what to expect. Is this for a cure? What are the chances of a cure? If there is no cure, will the treatment make me live better or longer? It is very important to understand the truth about what to expect from the treatment—and what are the potential costs of side effects, expenses, etc.—so that you can make the best decisions for yourself and the life you want to lead.

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Side Effects of treatment

All treatments for uterine cancer have side effects, but most side effects can be managed or avoided. Treatment may affect various aspects of your life, including your function at work, home, intimate relationships, and deeply personal thoughts and feelings.

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Before beginning treatment, it is important to learn about the possible side effects and talk with your treatment team members about your feelings or concerns. They can prepare you for what to expect and tell you which side effects should be reported to them immediately. They can also help you find ways to manage the side effects that you experience.

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Surgery: 

• Removal of small tumors or lesions: Cancer only on the surface of the vagina is removed along with a small part of surrounding healthy tissue to ensure that all of the cancer cells have been removed.

• Removal of the vagina (vaginectomy): Removing part of your vagina (partial vaginectomy) or your entire vagina (radical vaginectomy) may be necessary to remove all of the cancer. Depending on the extent of the cancer (see section above on staging), it may be necessary to perform a hysterectomy (removal of the uterus and ovaries) and nearby lymph nodes at the same time.

• Removal of the majority of the pelvic organs (pelvic exenteration): this may involve removal of the urethra/ bladder/distal ureters and/or anus/rectum. Exenteration is used if the cancer has spread​ locally or if vaginal cancer recurs after radiation.

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Source: Foundation for Women's Cancer

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Chemotherapy: Chemotherapy are drugs used to kill cancer cells. Chemotherapy is usually injected into a vein, but sometimes can be given as a pill. At the present time, it is not known if chemotherapy is effective for people with vaginal cancer. Chemotherapy can be used as a radiation sensitizer to make the radiation therapy more effective.

 

Radiation:

Radiation therapy (also called radiotherapy) use high-energy x-rays, or other types of radiation, to kill cancer cells or stop them from growing. Radiation is frequently used for more advanced stages of the disease (Stage II-IVA).

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For people being treated for vaginal cancer, the radiation can be delivered in several ways.​

• External radiation: uses a machine that directs the radiation toward the entire abdomen or just the pelvis, depending on the location of the cancer.

• Internal radiation (also called brachytherapy): involves placing radioactive devices in the vagina or surrounding tissue for a specified period of time.

• Proton beam: Proton therapy, also called proton beam therapy, uses protons rather than x-rays to treat cancer.

 

The extent of the cancer dictates which or both of these delivery systems are used and in what order.

 

Side effects of radiation

The side effects of radiation therapy depend on the dose used and the part of the body being treated. Common side effects include:

• Dry, reddened skin in the treated area

• Fatigue

• Diarrhea

• Discomfort when urinating

• Narrowing of the vagina

• Anemia

 

Most of these side effects are temporary. Be sure to talk with your treatment team members about any side effects that you experience. They can help you find ways to manage them.

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You may find it helpful to track any side effects you experience and then talk to your doctor about the ones that cause you concern. Often, your doctor will have a solution or suggestions for helping combat side effects. They won’t know unless you tell them!

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Resources:

Foundation for Women's Cancer

American Cancer Society

Centers for Disease Control