Radiation therapy uses high-energy rays (such as gamma rays or x-rays) and particles (such as electrons, protons, or neutrons) to kill cancer cells. In treating vulvar cancers, radiation is delivered from outside the body in a procedure that is much like having a diagnostic x-ray. This is called external beam radiation therapy. It is sometimes used along with chemotherapy to treat more advanced cancers to shrink them so they can be removed with surgery. This can sometimes allow the cancer to be removed with a less extensive surgery. Radiation alone may be used to treat lymph nodes in the groin and pelvis.
Common side effects of radiation therapy include tiredness, upset stomach, or loose bowels. Serious fatigue, which may not occur until about 2 weeks after treatment begins, may also occur. When radiation is given to the pelvis, diarrhea is common, but can usually be controlled with over-the-counter medicines. Nausea and vomiting may also occur, but can be treated with medicines. These side effects tend to be worse when chemotherapy is given with radiation. Radiation to the pelvis can also irritate the bladder, and cause problems with urination. Irritation to the bladder is called radiation cystitis, and can result in discomfort and an urge to urinate often. Pelvic radiation can also lead to premature menopause.
Skin changes are also common. As the radiation passes through the skin to the cancer, it may damage the skin cells. This can cause irritation ranging from mild, temporary redness to permanent discoloration. The skin may release fluid, which can lead to infection, so the area exposed to radiation must be carefully cleaned and protected.
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.
Women who receive radiation to the inguinal (groin) area after a lymph node dissection may have problems with the surgical wound site. It may open up or have trouble healing.
Radiation to the lymph nodes also increases the risk of lymphedema (this was discussed in detail in the "Surgery" section).
If you have side effects from radiation, discuss them with your cancer care team. There are often methods to relieve these symptoms.
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