Cervical Cancer

Internal radiotherapy


Internal radiotherapy (sometimes called brachytherapy) for cervical cancer is usually given after external radiotherapy. Treatment may be low or high dose rate radiotherapy. It is given using applicators, which look like rods (sometimes called ovoids or tubes), that are placed in the cervix and vagina under either local or general anaesthetic.

Treatment time varies for each individual patient. Low dose rate therapy is given for a specific number of hours via a selectron machine which is programmed to the exact numbers of hours of treatment. Patients will need to stay in hospital during their treatmen tand will not be able to sit up in bed.  
“You’ll be cared for in a single room. This is to prevent other people being exposed to radioactivity while the machine is delivering the treatment. However, the radioactive source can be withdrawn from the applicators back into the brachytherapy machine if a nurse or doctor needs to come into the room. This keeps the dose of radioactivity to the nurses and doctors as low as possible. Visitors are usually restricted and children aren’t encouraged to visit while you’re having your treatment.” (Macmillan Cancer Support April 2012) 

High dose rate therapy is usually given over a course of two or more sessions as an outpatient.

All the women we interviewed were treated as inpatients. On two occasions, patients said that the clinicians had difficulty inserting the rods in to their vagina, but most did not. Some women described feeling pain or discomfort when they woke from their anaesthetic but pain relief was available.

When treatment began, a few said that they initially felt panic, but were comforted by knowing that they could attract the nurses' attention on the CCTV screen if they needed to.

Many found their treatment difficult and uncomfortable because they had to lie still for a long time, or they had sickness, and had found it painful or uncomfortable (see Interview 09 below). Others found it less painful; one treated for 19 hours explains that she did not feel distressed during that time. Some said they could not sleep during their treatment, despite being given sleeping pills, because they were afraid of dislodging the rods in the vagina. One describes how she coped.

After treatment finished the rods are removed using entenex (gas and air). Most said they found this uncomfortable but not painful. Many described feeling very weak, several had a sore back and felt exhausted and a few had lost weight. A few recalled having cystitis for a couple of days, others had constipation, diarrhoea and sickness for a short while. One woman said she felt very emotional the day after her treatment.

After radiotherapy, women are usually encouraged to use a 'douche' to keep their vagina free from infection and, if they are not sexually active, a dilator to prevent the vagina from narrowing. Most women who used a 'douche' or a dilator found them easy to use.

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Recovery time from treatment varied. One woman returned to work after two weeks, others returned to work after three months. Most women we interviewed also had external radiotherapy and a combination of these two radiotherapy treatments had led to some long-term side effects (see 'External radiotherapy').

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Pulsed Dose Rate Brachytherapy (PDR) is a new method of internal radiotherapy which is only available in some specialist centres. In this treatment the applicators stay in place for the same length of time as low dose rate treatment, but short doses of higher dose radiation are given in pulses rather than as a continuous low dose.

Last reviewed April 2014.
Last updated April 2014.

 

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