Radiation therapy

Radiation therapy at a glance

• Radiation therapy uses radio beams, x-rays or charged particles to destroy cancerous cells in a specific region or organ before it spreads.
• Radiation can be performed to cure and eliminate a cancer or to relieve cancer symptoms.
• Cancer treatments are delivered either internally or externally, depending on the size and location of the cancer.
• Side effects of gynecological cancer radiation treatments may include urinary bladder irritation, diarrhea and sexual dysfunction.

What is radiation therapy?

Radiation therapy is a non–surgical procedure used to treat certain types of cancer and tumors. The therapy uses radio beams, x-rays, gamma rays or charged particles to target cancer cells. Radiation therapy may be a stand-alone treatment option or used in combination with chemotherapy and surgery for many gynecological cancers. Radiation is a common cancer treatment and can be more advantageous than traditional surgery because it doesn’t damage the tissue as badly.

Radiation for cancer treatment is typically delivered in a six-week treatment course. Radiation may be delivered externally or internally and in daily doses for several weeks, depending on the treatment plan. Because the reproductive organs are small, internal radiation is typically used when treating gynecological cancers. Common gynecological cancers treated with radiation include vaginal, cervical and uterine cancers. Radiation treatment may attempt to completely eliminate cancer (curative) or to subdue symptoms of cancer (palliative).

Specific types of gynecological radiation include:

• Brachytherapy—this is an internal radiation therapy commonly used to treat vaginal, cervical and uterine cancers. The radiation is placed directly inside the body and near the cancer cells. In the case of gynecological cancers, the radiation may be delivered vaginally or with devices such as wires or balloons inserted into the tissue. Brachytherapy may be delivered in low or high doses. Low dose is delivered slowly over a few days (keeping the patient in the hospital for the length of the treatment) while high dose is delivered quickly and all at once, allowing the patient to return home the day of treatment.
• External beam therapy—commonly known as whole pelvic radiotherapy when treating gynecological cancers, this form of radiation uses a machine pointed at the patient that emits radiation beams, similar to that of an x-ray. A painless procedure, external beam therapy is delivered in a series of sessions lasting six weeks. New advances in external beam radiation therapy allow for more targeted capabilities – meaning less noncancerous cell damage. Three-dimensional conformal radiotherapy (3D-CRT) tailors the beams better than traditional radiation. Intensity modulated radiation therapy (IMRT) modifies individual beam intensity which results in a more precise delivery dose.
• Proton beam radiotherapy—this is another type of external beam therapy treatment that is used when a patient’s cervical cancer has spread into the lymph nodes.

Depending on the radiation treatment, a patient may need to be isolated to prevent the spread of radioactive material.

Radiation therapy considerations & side effects

Although designed to attack and eliminate cancer cells, radiation therapy may damage normal cells, and this can cause long-term consequences. Those undergoing radiation will likely experience some side effects. Typically the general side effects are temporary and end with the treatment.

Pelvic radiation side effects include urinary bladder irritation, diarrhea, as well as sexual dysfunction, including loss of vaginal elasticity. Some women may stop menstruating after being exposed to high levels of radiation and experience menopausal symptoms, such as vaginal dryness and itching. If both ovaries are receiving radiation, a woman may lose her fertility.

For women who wish to preserve their fertility, surgeons may opt to perform ovariopexy surgery, in which the ovaries are sutured up out of the radiation field area to try to preserve ovarian function. A woman may also choose to freeze her embryos prior to radiation.

Every woman with gynecological cancer will have different reactions to treatments such as radiation. Radiation may not be an appropriate treatment in some cases. A detailed and thorough discussion with a gynecologic oncologist will enable the best possible treatment plan.

Learn More about the  CU Anschutz Fertility Preservation and Reproductive Late Effects Program program.

For more information, read the CU Anschutz Department of Radiation Oncology page.