Cervical Cancer
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 is often given as a combination of the two. It may also be combined with chemotherapy (chemoradiotherapy).
External radiotherapy for cervical cancer may be given in cases where:
- the cancer is not curable with surgery alone
- the cancer is in early to locally advanced stages
- it is used to help relieve symptoms
- there is a high risk that the cancer may come back
- the cancer has come back after surgical treatment
External radiotherapy is given on a treatment schedule: it is typically given once a day, Monday to Friday, at a hospital outpatient clinic with a break at weekends. A course of treatment typically lasts between 5 to 5 and a half weeks.
People attend a radiotherapy planning session before treatment begins. In this session, the area to be treated is 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.
Experiences with external radiotherapy for cervical cancer
She describes her radiotherapy planning.
She describes her radiotherapy planning.
She explains why she found her radiotherapy planning upsetting.
She explains why she found her radiotherapy planning upsetting.
Many said that their radiotherapy was painless and straightforward. Several described suffering side effects after about 2 or 3 weeks of treatment. Some had more, or more severe, side effects than others.
Many experienced at least some of the following side effects: exhaustion, weakness, diarrhoea, sickness, a weak bladder and cystitis.
She describes her external radiotherapy.
She describes her external radiotherapy.
She describes the side effects she experienced during her external radiotherapy.
She describes the side effects she experienced during her external radiotherapy.
She explains that the diarrhoea she suffered during external radiotherapy was worth it if it meant getting rid of the cancer.
She explains that the diarrhoea she suffered during external radiotherapy was worth it if it meant getting rid of the cancer.
Yes I mean I'd been warned of this one as well, they said 'You will probably get diarrhoea with it because again the area that's being treated, you know although its getting in there and if there's any cancerous cells it will do them good and get rid of those. Its also gonna go to the bowel because that's also in the same area. So,' he said 'I'll be very surprised if you didn't you know suffer from diarrhoea.' But again the medication sorted it out, it wasn't bad. It doesn't matter really in the end, if its gonna do you good You know if its getting rid of cancer, six weeks of diarrhoea is nothing.
She suffered severe bowel problems and sickness during her radiotherapy for advanced cancer.
She suffered severe bowel problems and sickness during her radiotherapy for advanced cancer.
One woman's skin was red and sore from her radiotherapy and she described it as having 'burned skin' (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 radiotherapy.
She describes the exhaustion, diarrhoea and sore skin she experienced during her external radiotherapy.
It was after I think three weeks of radio that when it start. First my tummy and my back start getting like burned, very dark. It was like a square on my tummy and a square on my back. That's where the radiations were so it was like a burn. And the radiologist told me not to wash with any shower cream or anything, just water. And I was feeling tired all the time really, really tired and I remember that I was waiting in this room and we were all looking very tired.
And this girl she came all lively, it was her first day and I look at her and say oh yeah just wait another few weeks and you're gonna be the same as us. It was like we were zombies you know. We didin't talk, we just sat there looking at each other. And we saw each other every day but we didn't strike conversation because everyone was so tired.
So we were just sitting there looking. And at this point I had started having diarrhoea quite badly. I used to go to toilet maybe six, seven, eight, nine times a day. And it was really bothering me because it was like I had to travel to the hospital and at this point I was going by minicab provided by the hospital because I couldn't travel on public transport. So the doctor arranged for me to have someone to pick me up in the morning for my treatment and bring me back after the treatment. And I was going oh my gosh what if I need to go to the toilet and I'm in a car, what am I going to do? But luckily that never happened. And I was very, very tired, very sore because my tummy and my back were burned. I used to put E45 cream, it didn't help at all.
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 it had left marks on her body. Another had a weakened immune system and a painful hip 5 years after treatment.
A third needed an operation to remove fluid from her uterus which is very unusual.
Many women experienced long-term problems with their bowel.
Some found their constipation or diarrhoea ended a few months after treatment while 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 30s described how she still experienced problems with her bowel 9 years after her treatment and explained how she learned to live with it.
She explains how she has learnt to cope with long term bowel problems following radiotherapy.
She explains how she has learnt to cope with long term bowel problems following radiotherapy.
Mentally it was easy when I was with my husband because I thought he understands, he knows. But when I was going into a new relationship it was something that I thought someone's not going to like me because of this. But its actually amazing how people understand. My new boyfriend hasn't got a problem with it at all. And he will be in the car with me and spot the toilets for me if I need to go so he's very supportive. I think its something again you've got to talk about. If you don't tell your friends and you don't admit that you've got a problem then you probably have a problem yourself mentally because dealing with that is quite hard if you don't admit it. And I think probably I could wear one of those medi alert bracelets if I needed to for shops and things but I don't want to do that, I don't want to be treated as an invalid, I want to be a normal person and if you need to there's always ways basically.
Radiotherapy causes the ovaries to stop working, leading to an early menopause.
Most of the women interviewed had taken hormone replacement therapy (HRT). Many said it had helped to control their menopausal symptoms, apart from one who had difficulty finding a suitable type of HRT, which considerably affected her daily life for a couple of years.
She experienced problems getting the right dosage of hormone replacement therapy for her premature menopause.
She experienced problems getting the right dosage of hormone replacement therapy for her premature menopause.
They tried the different type of hormone replacement therapy and they never managed to get the right amount. Because I had so much trouble finding the right hormone level and eventually because of all this bleeding I start being anaemic and I was always tired. And possibly sort of also my brain balance went. I felt sort of weaker, not well, completely, I had a real problems, mental problems. I was crying in the street with no reason whatsoever. And this has been the worst part of my therapy which wasn't the cancer therapy it was afterwards, trying to sort of get me back to my periods and because I was only 43 so they thought well we can carry on for another 10 years if possible. But that was the worst time of my life, literally I cracked up. Eventually one day I had an appointment with the doctor that was specifically for the hormone replacement and I went there, I threw the tablets on the table and I said "I don't want to take them any more," and again I did probably a horrible scene in front of this person but it was my way of reacting and my way of saying that's enough, I don't want. And in fact it took about six months for my body to get rid of all the, probably chemicals. But after that that was it, I've never been happier because my periods stopped and that was, I had no side effects. Actually while I was taking the hormone replacement therapy I had hot flushes and all this sort of thing. Afterwards that was it, nothing. I was ever so pleasant.
For more information about menopause, see the ‘Menopause’ section of our website.
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