Radiation Therapy for Vulvar Cancer

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 temporary side effects of radiation therapy to the pelvis include

• Tiredness
• Upset stomach, nausea, and vomiting
• Loose bowels or diarrhea
• Skin changes
• Low blood counts

These side effects tend to be worse when chemotherapy is given with radiation.

Tiredness can become severe a few weeks after treatment begins. Diarrhea, nausea, and vomiting from radiation can usually be controlled with medicines.

Skin changes are common in the area the radiation passes through to reach the cancer. This can range from mild, temporary redness to permanent discoloration. Radiation can cause the vulvar area to become sensitive and sore. 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). Low red blood cell counts can lead to feeling tired and short of breath. Low white blood cells can increase the risk of serious infection. 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 can lead to poor fluid drainage from the legs. The fluid can build up and lead to severe leg swelling that doesn’t go down at night. This is called lymphedema. Information about lymphedema and how to manage it can be found in Lymphedema.

If you have side effects from radiation, tell your cancer care team. There are often ways to relieve them.

For more information about radiation as a treatment for cancer, see A Guide to Radiation Therapy.