External radiotherapy for cervical cancer

Radiotherapy uses high-energy X-rays to destroy cancer cells, while harming normal cells as little as possible. Radiotherapy for cancer of the cervix can be given externally or internally (see ‘Internal radiotherapy‘), and often as a combination of the two. It may be given if the cancer is not curable with surgery alone or if there is a high risk that the cancer may come back. It may be combined with chemotherapy.

External radiotherapy is usually given once a day, Monday to Friday, at a hospital outpatient clinic, a course of treatment lasts between 5 to 8 weeks.

Patients attend a radiotherapy planning session before treatment begins so that the area to be treated can be marked out using small tattoos or indelible ink marks on the skin. Most women we interviewed found this procedure straightforward, apart from one who had found it distressing.

She describes her radiotherapy planning.

Age at interview 41

Gender Female

Age at diagnosis 39

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She explains why she found her radiotherapy planning upsetting.

Age at interview 42

Gender Female

Age at diagnosis 36

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Many said that their radiotherapy was painless and straightforward. Several described suffering side effects after about two or three weeks of treatment. Some had more, or more severe, side effects than others. Many experienced at least some of the following’ exhaustion, weakness, diarrhoea, sickness, a weak bladder and cystitis.

She describes her external radiotherapy.

Age at interview 35

Gender Female

Age at diagnosis 34

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She describes the side effects she experienced during her external radiotherapy.

Age at interview 46

Gender Female

Age at diagnosis 36

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She explains that the diarrhoea she suffered during external radiotherapy was worth it if it…

Age at interview 41

Gender Female

Age at diagnosis 39

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She suffered severe bowel problems and sickness during her radiotherapy for advanced cancer.

Age at interview 36

Gender Female

Age at diagnosis 27

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One woman whose skin was red and sore from her radiotherapy described this as burned (this is unusual nowadays) and discussed how it contributed to her exhaustion. Another mentioned that she had soreness in the area she had radiotherapy which disappeared two weeks after her treatment finished. A third experienced blistering on her bottom.

She describes the exhaustion, diarrhoea and sore skin she experienced during her external…

Age at interview 31

Gender Female

Age at diagnosis 30

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Long-term side effects and recovery

Most found that their sickness, exhaustion and bladder problems ended a few weeks after treatment but many had felt tired, and a few had bladder problems, for several months afterwards.

A woman whose skin had been red and sore said it had healed after a few weeks but had left marks on her body. Another had a weaker immune system and a painful hip five years after treatment. A third needed an operation to remove fluid from her uterus which is very unusual.

Many women had experienced long-term problems with their bowel. Some found their constipation or diarrhoea ended a few months after treatment, others had these side effects for several years. Most said their constipation or diarrhoea had become less frequent over time or was controlled with medication. One woman in her thirties describes how she still experiences problems with her bowel 9 years after her treatment and she explains how she has learnt to live with it.

She explains how she has learnt to cope with long term bowel problems following radiotherapy.

Age at interview 36

Gender Female

Age at diagnosis 27

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Radiotherapy causes the ovaries to stop working, leading to an early menopause. Most of the women interviewed had taken HRT (hormone replacement therapy). Many said it had helped to control their menopausal symptoms, apart from one who had difficulty finding a suitable type of HRT, and this had considerably affected her daily life for a couple of years.

She experienced problems getting the right dosage of hormone replacement therapy for her…

Age at interview 53

Gender Female

Age at diagnosis 42

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Internal radiotherapy for cervical cancer

Internal radiotherapy (sometimes called brachytherapy) for cervical cancer is usually given after external radiotherapy or sometimes after surgery. Treatment may be low or high dose...