Treatment of vulvar cancer with radiation: Methods and outcomes

Treatment of vulvar cancer through radiation: Purposes and outcomes

External radiation therapy, a common treatment for vulvar cancer, involves the use of machines placed outside the body. This therapy has several subtypes, including 3D conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT).

Before starting treatment, it's essential to discuss potential long-term effects with a doctor. For instance, radiation therapy may affect fertility, and people who receive pelvic radiation may stop having a monthly menstrual cycle, which could be permanent in some cases.

The high energy waves used in radiation therapy, such as X-rays, damage or destroy cancerous cells by causing small breaks in their DNA. Common short-term side effects include tiredness, skin changes, vulvar sensitivity, nausea, diarrhea, swelling in the legs, decreased red and white blood cell counts, difficulty healing surgical wounds, and increased risk of infection.

During external radiation treatment, sexual intercourse may be uncomfortable due to side effects, but it will not affect a partner. However, people undergoing internal radiation may need to avoid sex temporarily.

Radiation therapy can be used in combination with chemotherapy to treat vulvar cancer. It can help shrink a tumor before surgical removal, kill any cancer cells left behind after surgery, or serve as an alternative to surgery for those who cannot have it.

Self-care measures during radiation therapy include wearing loose clothes, washing with lukewarm water, protecting the area from sunlight, avoiding hot water, and asking a doctor before shaving or applying products to the area.

For patients who cannot tolerate chemotherapy, treatment options include radiation therapy alone combined with surgical approaches such as limited vulvar excision and sentinel lymph node removal. Emerging immunotherapy approaches targeting PD-L1 are also being investigated as potential alternatives. Treatment in specialized centres is recommended to optimize outcomes and reduce complications.

Internal radiation therapy involves placing an implant in the cancer site or surrounding tissue. The duration of radiation therapy can range from days to weeks. Long-term side effects may include increased skin sensitivity, changes in skin texture or hair color, spider-like marks on the skin, and potential effects on fertility.

In addition, doctors may use radiation therapy after surgery to kill any cancer cells that may remain, or alone or with chemotherapy to treat cancer in people who cannot have surgery. The radiation can shrink a more advanced tumor so that surgeons can remove it, potentially causing less harm to surrounding tissue.