Treatment of vulvar cancer through radiation: Applications and outcomes
In the treatment of vulvar cancer, two primary types of radiation therapy are commonly used: external and internal radiation.
External Radiation Therapy
External radiation therapy involves the use of machines placed outside the body. This treatment typically lasts for 4 to 6 weeks with daily sessions during weekdays, targeting the tumor and surrounding tissues with external beam radiation. The common side effects of this treatment include skin irritation or redness in the treated area, fatigue, swelling and discomfort in the vulvar or pelvic region, and possible urinary or bowel symptoms due to irritation or inflammation of surrounding tissues like the bladder or rectum.
Internal Radiation Therapy (Brachytherapy)
Internal radiation therapy, also known as brachytherapy, involves placing a radioactive source inside or near the cancer site for a shorter duration. This treatment is often delivered over several sessions spanning a few days to a week, depending on the tumor size and location. Common side effects of brachytherapy include localized vaginal irritation or soreness, discharge or bleeding, urinary or bowel irritations if nearby tissues are affected, fatigue, and short-term discomfort related to the insertion procedure.
Combining Radiation Therapy with Other Treatments
Since vulvar cancer treatment often combines surgery and radiation, side effects can vary based on the entire treatment plan and individual patient factors. Radiation therapy, both internal and external, is usually carefully planned by a multidisciplinary team to balance effectiveness with minimizing side effects.
Long-term and Short-term Effects
Long-term side effects of radiation therapy may include increased skin sensitivity, changes in skin texture, changes in hair texture or color, spider-like marks on the skin, and potential effects on sexual function. Radiation therapy can also cause ovarian failure, leading to the cessation of the menstrual cycle and infertility in some people. It is essential to discuss any potential long-term effects of radiation therapy, such as reduced fertility, with a doctor before treatment.
Short-term side effects of radiation to the vulva include tiredness, skin changes, vulvar sensitivity, nausea, vomiting, diarrhea, swelling in the legs, decreased red blood cell count, decreased white blood cell count, difficulty healing surgical wounds, and potential discomfort during sexual intercourse.
Subtypes of External Radiation Therapy
3D-CRT and IMRT are subtypes of external radiation therapy. 3D-CRT uses special computers to map the tumor's location and shapes and aims radiation beams at the tumor from several directions. IMRT can also adjust the strength of the beams to protect nearby tissues from receiving too high of a dose. IMRT uses a computer-driven machine that moves the person around as it emits radiation, shapes the beams, and aims them at the tumor from various angles.
The Role of Radiation Therapy in Vulvar Cancer Treatment
Radiation therapy for vulvar cancer is used to kill cancer cells, shrink a tumor to facilitate surgical removal, and kill any remaining cancer cells after surgery. Radiation therapy is often used in combination with chemotherapy during vulvar cancer treatment.
For those who may want to become pregnant in the future, it is important to discuss alternative methods of conception with a doctor before treatment, as radiation therapy may cause ovarian failure and infertility.
In summary:
| Radiation Type | Typical Duration | Common Side Effects | |-------------------------|-------------------------|----------------------------------------------------------| | External beam radiation | 4 to 6 weeks (daily) | Skin irritation, fatigue, swelling, urinary/bowel issues | | Internal radiation | Several sessions over days (usually less than 1 week) | Local irritation, discharge, bleeding, fatigue |
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