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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...
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 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 and radioactive material is placed inside the applicator.
Treatment time varies for each individual patient. Patients will need to stay in hospital during their treatment and will not be able to sit up in bed. You’ll be cared for in a single room while you’re having brachytherapy. Special precautions will need to be taken to prevent other people being exposed to radioactivity while the machine is giving you your treatment. (Macmillan Cancer Support December 2015)
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.
Recovery time from treatment varied. One woman returned to work after 2 weeks, others returned to work after 3 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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