Vaginal and Vulval Cancer

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Vaginal and vulva cancer are cancers that start in the vagina (internally) and vulva (outside of vagina).

People with these cancers may have abnormal vaginal bleeding or discharge. They may also have pain in the pelvis, back passage or perineal area, which is the skin between the vagina and anus.

The Treatment Team

Doctors make a treatment plan for each person based on:

  • the type of cancer
  • where the cancer is
  • what other treatments have been tried
  • the person’s health.

The type of treatment a person gets is worked out by a team of doctors and health professionals often called a Multidisciplinary Team.

A highly trained radiation oncology team takes care of people having radiation therapy. This includes radiation oncologists, radiation therapists, medical physicists and radiation oncology nurses.

Treatments for Vaginal and Vulval Cancer

Doctors usually use surgery to treat these cancers. This is sometimes the only treatment people need.

If the surgeon can’t take out all the cancer, or if it has spread, the treatment team may also recommend radiation therapy after surgery. This is called adjuvant radiation therapy. Doctors sometimes also use chemotherapy.

Radiation oncologists can also do radiation therapy before surgery to shrink the tumour and make it easier to take out. This is called neoadjuvant therapy. Doctors sometimes also use chemotherapy at this stage as well.

If the cancer has spread, radiation oncologists use palliative radiation therapy to help with vaginal bleeding, bone pain and other symptoms.

Types of Radiation Therapy Used for Vaginal and Vulval Cancer

External Beam Radiation Therapy (EBRT)

This is the most common type of radiation therapy used for vaginal and vulval cancer.  

Radiation oncologists often use Volumetric Arc Therapy (VMAT), which is an advanced type of external beam radiation therapy, to carefully deliver radiation to treatment areas. 

This technique allows the radiation oncologist to target the radiation on the cancer while limiting radiation to healthy parts of the body.   

Radiation therapy also helps with symptoms such as pain or bleeding. Radiation therapy works by killing cancer cells in the vaginal and vulval area which stops them from growing.

People usually get radiation therapy for vaginal and vulval cancer daily from Monday-Friday for 5-7 weeks.

The treatment team works out the right number of treatments for each person.

General Information About Side Effects of Radiation Therapy

Radiation therapy is more effective with fewer side effects than ever before.

Recent advances mean radiation oncologists can effectively treat the cancer while getting less radiation on healthy body parts. This means much fewer side effects.

Side effects from radiation therapy vary between people, even for those having the same treatment.

While some people feel no side effects, some feel mild side effects, such as tiredness or skin redness during and/or just after treatment. These usually get better within a few weeks.

The treatment team will offer advice and medicine to help with side effects.

Serious side effects that start later (months to years after the radiation therapy) are rare.

Before starting treatment, your radiation oncologist will talk to you about side effects and answer your questions.

The side effects of radiation treatment can be split into 2 groups:

  1. Early side effects which occur during and shortly after radiation treatment.
  2. Late side effects which can occur months to years after radiation treatment.

For more information, go to the Potential Side Effects page.

Early side effects from radiation therapy for vaginal and vulval cancer can include: 

Fatigue: Feeling tired is common during radiation treatment, as the body works to heal. 

Skin irritation: The skin around the perineal area and between the buttocks may become red, dry, or itchy, this can feel like sunburn. 

Diarrhoea: Radiation can upset the digestive tract. This can lead to loose or watery poo. 

Nausea and vomiting: Some people feel unwell in the stomach and may vomit or have indigestion. 

Urinary discomfort: Radiation near the pelvic area can cause discomfort or a need to pee more often. 

Hair loss: Radiation will only cause hair loss in the treated area. 

These side effects are usually short term and can be helped with medications or lifestyle changes. The treatment team can provide advice to help you manage side effects.   

Late side effects vary between people and can happen a few months to a few years after treatment. 

These side effects may never occur, occur once, continue over time, or come and go.    

Bowel problems: Radiation therapy can cause long-term bowel issues such as diarrhoea, constipation, or changes in bowel habits. 

Sexual dysfunction: Both radiation therapy and surgery can affect sexual function. This can cause vaginal dryness and discomfort in women. Doctors may offer women a vaginal dilator to help with this.

Urinary problems: Radiation therapy may cause long-term urinary problems, such as needing to pee more often or more urgently. Rarely it causes incontinence. 

Lymphoedema: Surgery or radiation therapy can damage lymph nodes, leading to lymphoedema, which is swelling in the legs due to a build-up of lymph fluid.

Femoral neck or pelvic fracture: This is very rare and is when a bone in the pelvis fractures due to reduced strength. 

Radiation induced small bowel obstruction. 

Impaired fertility or infertility: It’s important to talk about fertility preservation before treatment starts. 

Premature ovarian failure: If a woman’s ovaries are present, radiation may cause early menopause. 

Second cancers: There is an extremely small risk of developing secondary cancers later in life. 

Find additional information about cancer types, research groups, and support groups.

Further Information
You can ask your Surgeon or General Practitioner for a referral to a Radiation Oncologist for a discussion about whether radiation therapy is a suitable treatment option for you.

Radiation Oncologist

The best person to talk to is a radiation oncologist. You can ask your doctor for a referral to find out if radiation treatment is right for you.

GPs and Health Professionals

Information for any health professional involved in a patient's cancer care with a particular focus on primary care providers.

Talking to Your Doctor

Your GP or other doctors in the cancer team can organise a referral to a radiation oncologist.

Treatment Centres

Search and find your closest Radiation Oncology Treatment Centre.

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