Chemotherapy for vulvar cancer
Chemotherapy (chemo) uses anti-cancer drugs that are usually given intravenously (into a vein), by mouth, or applied to the skin in other ways, such as in an ointment. Drugs taken by mouth or injected into a vein, called systemic chemo, enter the bloodstream and reach throughout the body, making this treatment potentially useful for cancer that has spread to distant sites.
Drugs most often used in treating vulvar cancer include cisplatin with or without fluorouracil (5-FU). Another chemo drug, mitomycin, may rarely be used. These may be combined with radiation. Different drugs are used to treat vulvar melanoma. Melanoma Skin Cancer has more information about drug treatment for advanced melanomas.
The role of chemo in treating vulvar cancer remains to be determined. In more advanced disease, chemo might be given with radiation therapy before surgery. This combined treatment may shrink the tumor, making it easier to remove it with surgery. So far, the results of treating vulvar cancers that have spread to other organs with chemo have been disappointing.
Many of the drugs used in cancer chemo work by attacking cells that are rapidly dividing. This is helpful in killing cancer cells, but these drugs can also affect normal cells, leading to side effects. Side effects of chemo depend on the type of drugs, the amount taken, and the length of time you are treated. Common side effects of some of the drugs used to treat vulvar cancer include:
- Nausea and vomiting
- Temporary loss of hair
- Mouth or vaginal sores
- Changes in the menstrual cycle, premature menopause, and infertility (inability to become pregnant). Most women with vulvar cancer, however, have already gone through menopause.
Chemo often affects the blood-forming cells of the bone marrow, leading to low blood counts. This can cause:
- Increased chance of infections (due to low white blood cell count)
- Increased chance of bleeding and bruising (due to low blood platelet count)
- Tiredness (due to anemia, that is, low red blood cell count)
Other side effects can occur depending on what drug is used. Most side effects are temporary and stop when the treatment is over, but some chemo drugs can have long-lasting or even permanent effects. For example, cisplatin can cause nerve damage (called neuropathy). This can lead to numbness, tingling, or even pain in the hands and feet. It can also damage the kidneys. To lower the risk of kidney damage, the patient is given plenty of fluids intravenously (IV) before and after each dose.
Ask your cancer care team about the chemo drugs you will receive and what side effects you can expect. Also be sure to talk with them about any side effects you do have so that they can be treated. For example, you can be given medicine to reduce or prevent nausea and vomiting.
For more information about chemo and its side effects, see A Guide to Chemotherapy.
Last Medical Review: 07/02/2014
Last Revised: 02/16/2016