Chemotherapy is not usually given as the primary treatment for cervical cancer but is often used with radiotherapy in order to make the radiotherapy more effective. You may hear this type of treatment being called chemoradiotherapy or chemoradiation. Chemotherapy makes cervical cancer more sensitive to the effects of the radiotherapy. Radiotherapy treats cancer by using high-energy rays which destroy the cancer cells, while doing as little harm as possible to normal cells. Radiotherapy for cervical cancer can be given externally or internally (Brachytherapy), and often as a combination of the two.
Radiotherapy is usually given if the cancer has spread beyond the cervix and is not curable with surgery alone. Radiotherapy may also be used after surgery if there is a high risk that the cancer may come back. It is often given in combination with chemotherapy. Your cancer specialist (clinical oncologist), who plans your treatment, will be able to discuss any concerns you may have.
Planning is a very important part of radiotherapy, and makes sure that it is as effective as possible. It may take a few visits. On your first visit to the radiotherapy department, you will be asked to have a CT scan or lie under a machine called a simulator, which takes x-rays of the area to be treated. The treatment is planned by a cancer specialist (clinical oncologist). Marks (like tiny tattoos) will be made on your skin to show the radiographer (the person who gives you your treatment) where the rays are to be directed.
External radiotherapy is usually given as an outpatient and you will need to attend every weekday (Monday – Friday) for treatment, with a rest at the weekend. This treatment will be given in the hospital radiotherapy department. High-energy x-rays are directed from a machine at the area of the cancer. The number of treatments will depend on the type and size of the cancer, but the whole course of treatment will last a few weeks. Chemotherapy is usually given once a week each week throughout the duration of your planned treatment. Your consultant or radiographer will discuss the treatment and possible side effects with you. When you attend each session of radiotherapy, the radiographer will carefully position you on the couch and make sure that you are comfortable. The couch is very firm but the radiographer may put rests beneath your knees or put your feet into rests to make it more comfortable and to help you remain still. The treatment usually lasts only a few minutes and you will be alone in the room during this time. You will be able to talk to the radiographers should you need to as they will be monitoring you closely from the next room.
External radiotherapy is not painful but you do need to lie still when the treatment is being given. The radiation machine may move round you but doesn’t touch you. The radiotherapy treatment will not make you radioactive and it is perfectly safe for you to be around other people, including children, after your treatment. Always make sure that you drink plenty of water throughout the entire planned timescale for your radiotherapy treatment and especially make sure that you have a full bladder during each treatment as this helps to protect the bladder.
Internal Radiotherapy (Brachytherapy)
Brachytherapy gives a controlled dose of radiotherapy directly to the cervix and the areas close by. Under a general anaesthetic, tubes are places into the vagina and uterus so that the tubes lie directly touching the tumour. Radioactive balls (sources) can then be fed into the tubes and the radiation spreads directly out of the tube to the tumour. Sometimes you will have to have a scan with the tubes in place before the radiation dose is given. In some centres you will return to the ward after theatre with the tubes in place and the radiation is delivered by a machine, usually a selectron, for up to 24 hours. You will have to remain in bed during this time and will have a catheter in place to drain the bladder. This is generally put in place at the same time as the tubes so is in place when you wake up from the anaesthetic. The radioactive balls can be withdrawn regularly so that nurses can enter the room at regular intervals. It is not usually painful but may be uncomfortable and so painkillers can be given if necessary. Once the treatment is completed, the tubes will be removed by one of the doctors or nurses and this can be a bit uncomfortable. Painkillers will be given before they are removed and sometimes sedation or gas and air may be given to make it easier for you.
It is not possible to have visitors during this treatment and so it can make you feel very isolated, frightened and depressed at a time when you might want people around you. If you experience these feelings, it is important that you let the staff looking after you know. You might also find it helpful to take plenty of reading material and things to keep you occupied whilst you are in isolation. You only need to be in isolation whilst the tubes are in place. Once they have been removed, the radioactivity disappears and it is perfectly safe to be with other people.
In some radiotherapy departments, an implant containing a higher dose of radioactivity (microselectron) is used and this is only in place for a few minutes. These shorter treatments may need to be repeated several times, a few days apart, and may be given as an inpatient or an outpatient. It is often given under general anaesthetic for a short period of time. This treatment does not need a catheter to drain the bladder, however one may be needed when x-ray pictures are taken during the planning of the treatment.
"Radiotherapy." Jo's Cervical Cancer Trust. N.p., 19 Aug. 2013. Web. 02 Mar. 2015.